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Avatar PM 2023 Update 81

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Product Requirements / Recommendations

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Product Update Form Description

An issue is resolved where the File Import for 'Electronic Re-Billing Service Assignment' is giving an incorrect error message about a missing 'Original Claim Reference number' when it is not allowed for deletes in the form.

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Details
NEW0 CHANGED0 FIXED1
Fixed (1)
File Import - Electronic Re-Billing Service Assignment
Functionality for 'File Import - Electronic Re-Billing Service Assignment' is updated to ensure that no error is received regarding a missing 'Original Claim Reference Number' when it is not allowed in the file. It is not allowed when the file is a 'Delete' file. KB0074259 v0.01
Topics
• File Import • Re-Bill
 
Acceptance Tests
AV-88269 Summary | Details
File Import - Electronic Re-Billing Service Assignment
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Client Ledger
  • Crystal Report Viewer
  • Electronic Re-Billing Service Assignment
  • File Import
Scenario 1: File Import - Verification of 'Electronic Re-Billing Service Assignment' file type import, 'Add' record
Specific Setup:
  • Previously generated bills containing one or more valid claim(s).
  • 'Electronic Re-Billing Service Assignment' File Import file containing one or valid import rows for 'Add' record type (value 'ADD' in segment 4).

Note - Values '3' and '4' for 'Service Inclusion/Exclusion Default' (segment 5) are only allowed where Registry Setting 'Multiple Claim Original Reference Number/Claim Submission Reason Code' is enabled.

Note - Allowed values for ' Claim Submission Reason Code' (segment 8) in import file may be restricted based on Registry Setting 'Claim Submission Reason Codes'.

Note - Allowed values for 'Claim Original Reference Number' (segment 9) in import file may be required based on Registry Setting 'Require Claim Original Reference Number'.


Steps
  1. Open 'File Import' form.
  2. Select File Type 'Electronic Re-Billing Service Assignment'.
  3. Click 'Process Action' button.
  4. Select Avatar Cal-PM 'Electronic Re-Billing Service Assignment' import file and click 'Open' button.
  5. Select 'Compile/Validate File' in 'Action' field.
  6. Select loaded import file and click 'Process Action' button.
  7. Ensure that 'Compile/Validate File' action completes.
  8. Select 'Print File' in 'Action' field.
  9. Select compiled import file and click 'Process Action' button.
  10. In 'Electronic Re-Billing Service Assignment File Import Report', ensure that all valid import row(s) are included in report results, with values from import file.
  11. Select 'Post File' in 'Action' field.
  12. Select compiled import file and click 'Process Action' button.
  13. Ensure that 'Post File' action completes.
  14. Open 'Electronic Re-Billing Service Assignment' form.
  15. Enter 'Client ID' and/or 'Claim Number' value(s) from 'Electronic Re-Billing Service Assignment' import file.
  16. Click 'Display Re-Bill Information' button.
  17. In 'Electronic Re-Billing Service Assignment Report', ensure that all re-billing records/data filed via 'File Import' are included in report results, with values from import file.
  18. In 'Electronic Re-Billing Service Assignment Report', ensure that if 'Service Inclusion/Exclusion Default' field/segment in import file is set to '1' ('Include All'), '3' ('Include All Assigned Services for Re-bill') or '4' ('Include all Un-Assigned Services For Re-Bill'), all services from claim (or assigned/unassigned services from claim) are selected/filed for re-billing inclusion.
  19. In 'Electronic Re-Billing Service Assignment Report', ensure that if 'Service Inclusion/Exclusion Default' field/segment in import file is set to '2' ('Exclude All'), only service IDs identified in import file are selected/filed for re-billing inclusion with claim.
  20. In 'Electronic Re-Billing Service Assignment Report', ensure that fields are filed with data values from import file ('Billing Form', 'Claim Submission Reason Code', 'Claim Original Reference Number').
  21. In 'Electronic Re-Billing Service Assignment Report', ensure that if 'Claim Submission Reason Code' segment/value is not included in import file row(s), value '6' ('Corrected Adjustment of Prior Claim') is filed as default.
  22. In 'Electronic Re-Billing Service Assignment Report', ensure that if 'Add' type record is filed via 'File Import' where an unbilled 'Electronic Re-Billing Service Assignment' entry already exists, the data from most recent file import is present/replaces previously filed entries.



Scenario 2: File Import - Verification of 'Electronic Re-Billing Service Assignment' file type import, 'Delete' record
Specific Setup:
  • Previously generated bills containing one or more valid claim(s).
  • Previously filed and unbilled 'Electronic Re-Billing Service Assignment' information for one or more valid claim(s)/service(s).
  • 'Electronic Re-Billing Service Assignment' File Import file containing one or valid import rows for 'Delete' record type (value 'DEL' in segment 4).
Steps
  1. Open 'File Import' form.
  2. Select File Type 'Electronic Re-Billing Service Assignment'.
  3. Click 'Process Action' button.
  4. Select 'Electronic Re-Billing Service Assignment' import file and click 'Open' button.
  5. Select 'Compile/Validate File' in 'Action' field.
  6. Select loaded import file and click 'Process Action' button.
  7. Ensure that 'Compile/Validate File' action completes.
  8. Select 'Print File' in 'Action' field.
  9. Select compiled import file and click 'Process Action' button.
  10. In 'Electronic Re-Billing Service Assignment File Import Report', ensure that all valid import 'Delete' row(s) are included in report results, with values from import file.
  11. Select 'Post File' in 'Action' field.
  12. Select compiled import file and click 'Process Action' button.
  13. Ensure that 'Post File' action completes.
  14. Open 'Electronic Re-Billing Service Assignment' form.
  15. Enter 'Client ID' and/or 'Claim Number' value(s) from 'Electronic Re-Billing Service Assignment' import file.
  16. Click 'Display Re-Bill Information' button.
  17. In 'Electronic Re-Billing Service Assignment Report', ensure that all re-billing records/data deleted via 'File Import' are deleted/not present in report results.
Topics
• File Import • Re-Bill