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Avatar PM 2023 Update 82

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Product Requirements and Recommendations

Avatar PM required
RADplus required

Recommended Update Level

Avatar PM 2023 Monthly Release 2023.03.00
RADplus 2023 Monthly Release 2023.03.00

Product Update Description

The 837 Professional bill is updated to allow for suppression of 'Other Subscriber Address (2330A-N3)' segment via the 'Select Segments To Suppress' field on the 'Guarantor/Program Billing Defaults' form (837 Professional section).

Required Updates

None

Included Updates

10, 57, 62, 66, 79

Details
NEW0 CHANGED0 FIXED1
Fixed (1)
Electronic Billing - 837 Professional
'Electronic Billing' has been modified to suppress the '2330A-N3 Other Subscriber Address' segment when the 'Guarantor/Program Billing Defaults Template' is set to suppress it. KB0073977 v0.01
Topics
• 837 Professional • NX
 
Acceptance Tests
AV-88693 Summary | Details
Electronic Billing - 837 Professional
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission (Outpatient)
  • App Dashboard
  • Client Charge Input
  • Client Ledger
  • Create Interim Billing Batch File
  • Diagnosis
  • Dictionary Update (PM)
  • Dynamic Form - Admission - Client
  • Dynamic Form - Individual Cash Posting - Alert
  • Dynamic Form - Individual Cash Posting - Client
  • Dynamic Form - Individual Cash Posting - Information
  • Electronic Billing
  • Financial Eligibility
  • Individual Cash Posting (PM)
  • Registry Settings (PM)
Scenario 1: 837 Professional - 2330A-N3 Other Subscriber Address
Specific Setup:
  • Guarantors/Payors 1: The '837' section has:
  • Any value in 'Claim Filing Indicator Code (2000B/2320-SBR-09)'.
  • 'Yes' in 'Bill As Primary Guarantor (837)'.
  • Will be assigned as 'Guarantor # 1' in 'Financial Eligibility'.
  • Guarantors/Payors 2: The '837' section has:
  • Any value in 'Claim Filing Indicator Code (2000B/2320-SBR-09)'.
  • 'No' in 'Bill As Primary Guarantor (837)'.
  • Will be assigned as 'Guarantor # 2' in 'Financial Eligibility'.
  • Client: identify a client with an unclaimed service where liability was transferred from Guarantors/Payors 1 to Guarantors/Payors 2,
  • Dictionary Update: Other Tabled Files - (13150) Select Segments To Suppress (P):
  • Code '2330A-N3' equals desired values, such as 'Other Sub Address'.
  • Code '2330A-N4' equals desired values, such as 'Other Sub City State'.
  • Guarantor/Program Billing Defaults: '837 Professional':
  • 'Select Segments To Suppress': 'Other Sub Address' & 'Other Sub City State' are selected.
Steps
  1. Open 'Electronic Billing'.
  2. Create an 837 Professional bill for the client and the secondary guarantor.
  3. Review the dump file to verify that the 2430 segment does not include the 'Other Sub Address' and 'Other Sub City State'.
  4. Close the report.
  5. Close the form.
  6. If desired, change the 'Guarantor/Program Billing Defaults' template to not suppress the 'Other Sub Address' and 'Other Sub City State' and submit the form.
  7. Open 'Electronic Billing'.
  8. Create an 837 Professional bill for the client and the secondary guarantor.
  9. Review the dump file to verify that the 2430 segment does include the 'Other Sub Address' and 'Other Sub City State'.
  10. Close the report.
  11. Close the form.
Topics
• 837 Professional • NX