Avatar PM 2023 Update 79

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Product Requirements / Recommendations

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Product Update Form Description

An issue is resolved where the following error: 'One Room and Board Service Has Already been Reported for the date in Question' is occurring due to a PPS guarantor being billed as a NoPay and a Pay guarantor.

Included Updates

10, 57, 62, 66

Required Updates

None

Details

NEW0 CHANGED0 FIXED1

Fixed (1)

AV-80087 Details \| User Acceptance Tests 837 Billing An issue has been resolved to ensure the claims balances that are transferred from a non-PPS guarantor to a PPS guarantor can be billed successfully. KB0073894 v0.01	Topics • 837 Institutional • NX

Acceptance Tests

AV-80087 Summary | Details

837 Billing

Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:

Client Ledger
Electronic Billing
Spreadsheet Remittance Posting

Scenario 1: 837 Institutional Bill - - Running a bill for the PPS guarantor when the services are transferred to the PPS guarantor

Specific Setup:

Client A: Has closed services that will bill to a primary guarantor that is not a PPS Guarantor. The client’s secondary guarantor is a PPS Guarantor.
Crete Interim Billing Batch File is used to create a batch to use in billing.

Steps

Open an 'Electronic Billing' form.
Compile a Claimed 837 Institutional using the interim billing batch for the primary guarantor.
Open the 'Spreadsheet Remittance Posting' for the client.
Post a transfer service from the primary guarantor to the PPS guarantor.
Open an 'Electronic Billing' form.
Run an 837-Institutional bill for the PPS guarantor and the program.
Fill out the date of service fields with the first date of service and the last date of service for the client's episode.
Process the EB837 billing.
Verify the bill compiles successfully.
Verify that the correct services are contained in the dump file.
Close the form.

Topics

• 837 Institutional • NX