Skip to main content

Avatar PM 2024 Monthly Release 2024.00.00 Acceptance Tests

  1. Last updated
  2. Save as PDF
Update 1 Summary | Details
2024 Update installation
Scenario 1: Validate Upgrading Avatar PM 2023 to 2024 is successful when 2023.04.00 is loaded
Steps
  1. Open the "Product Updates" form.
  2. Select the appropriate [Namespace] from the Application dropdown list
  3. Click [Select Update/Customization Pack].
  4. Browse to the location for the updates and select the Update 1.
  5. Click [OK] on the "File Upload Complete" window.
  6. Click [Review Update/Customization Pack Contents].
  7. Verify Update 1 is included.
  8. Click [Install Update/Customization Pack].
  9. Click [OK] when the install completes.
  10. Click [Close Form].
Topics
• Upgrade
Update 6 Summary | Details
Client Lookup - Sub-System Codes
Internal Test Only
Topics
n/a
Update 12 Summary | Details
Dictionary Update - 'Unit' dictionary
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Dictionary Update (PM)
Scenario 1: Dictionary Update - Validate the 'Unit' dictionary
Steps
  1. Access the 'Dictionary Update' PM form.
  2. Select "Client" in the 'File' field.
  3. Select "Data Element Number" in the 'Data Element' field.
  4. Select "(202) Unit" in the 'Data Element' field.
  5. Enter the desired value in the 'Dictionary Code' field.
  6. Enter the desired value in the 'Dictionary Value' field.
  7. Validate the 'Extended Dictionary Data Element' field contains the following new values:
  8. (22055) Facility Abbreviation
  9. (22056) Level of Care
  10. Select "(22055) Facility Abbreviation" in the 'Extended Dictionary Data Element' field.
  11. Validate the 'Extended Dictionary Value (Free Text)' field is now enabled. Enter the desired value.
  12. Select "(22056) Level of Care" in the 'Extended Dictionary Data Element' field.
  13. Validate the 'Extended Dictionary Value (Single Dictionary)' field is now enabled and contains the following values:
  14. Inpatient
  15. Observation
  16. Outpatient
  17. Select the desired value in the 'Extended Dictionary Value (Single Dictionary)' field.
  18. Click [Apply Changes].
  19. Select the "Print Dictionary" section.
  20. Select "Client" in the 'File' field.
  21. Select "Data Element Number" in the 'Data Element' field.
  22. Select "(202) Unit" in the 'Data Element' field.
  23. Click [Print Dictionary].
  24. Validate the unit dictionary is displayed with the 'Facility Abbreviation' and 'Level of Care' values filed in the previous steps.
  25. Click [Close] and close the form.
Topics
• Dictionary
Update 14 Summary | Details
Site Specific Section Modeling - 'Admission' form
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Site Specific Section Modeling (PM)
  • Discharge
Scenario 1: Avatar PM - Site Specific Section Modeling - Admission
Specific Setup:
  • A client is enrolled in an existing episode (Client A).
Steps
  1. Access the 'Site Specific Section Modeling' PM form.
  2. Validate the 'Site Specific Section' field contains only the following options for the 'Admission' form:
  3. PATIENT510 (Admission) Site Specific Admission
  4. PATIENT510 (Admission) Demographics
  5. Select "PATIENT510 (Admission) Site Specific Admission" in the 'Site Specific Section' field.
  6. Click [OK].
  7. Validate the 'Site Specific Section Modeling' form is displayed as expected.
  8. Select "Yes" in the 'Enable Site Specific Section' field.
  9. Navigate to the "Prompt Definition" section.
  10. Click [Add New Item].
  11. Select the desired SS field in the 'Site Specific Field', for example "SS Admission Date 1".
  12. Select "No" in the 'Initially Required' field.
  13. Select the desired value in the 'Display Future Date Warning' field.
  14. Submit the form.
  15. Select "Client A" and access the 'Admission' form.
  16. Select any existing episode and click [Edit].
  17. Validate the "Site Specific Admission" section is displayed and select it.
  18. Validate the SS field selected in the previous steps is displayed, for example "SS Admission Date 1".
  19. Close the form.
Topics
• Site Specific Section Modeling
Update 15 Summary | Details
'Update Client Data' quick action
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Quick Actions Page
  • Update Client Data
Scenario 1: Validate the 'Update Client Data' quick action
Specific Setup:
  • Please note: this is for Avatar NX only.
  • The 'Update Client Data' Quick Action must be assigned to the user's myDay view in the 'NX View Definition' form.
  • A client is enrolled in an existing episode (Client A).
Steps
  1. Select "Client A" and navigate to the 'Quick Actions' widget.
  2. Click [Update Client Data - Add].
  3. Populate all required and desired fields.
  4. Enter "1" in the 'Home Phone' field.
  5. Validate a message is displayed stating: Invalid phone format specified. Valid phone formats are: '000-0000', '000-0000 X 0000', '000-000-0000', '000-000-0000 X - 0000'.
  6. Click [OK].
  7. Validate the 'Home Phone' field is cleared out.
  8. Enter "111-111-1111" in the 'Home Phone' field.
  9. Enter "abcdefg" in the 'Work Phone' field.
  10. Validate a message is displayed stating: Invalid phone format specified. Valid phone formats are: '000-0000', '000-0000 X 0000', '000-000-0000', '000-000-0000 X - 0000'.
  11. Click [OK].
  12. Validate the 'Work Phone' field is cleared out.
  13. Enter "222-2222" in the 'Work Phone' field.
  14. Enter "555" in the 'Cell Phone' field.
  15. Validate a message is displayed stating: Invalid phone format specified. Valid phone formats are: '000-0000', '000-0000 X 0000', '000-000-0000', '000-000-0000 X - 0000'.
  16. Click [OK].
  17. Validate the 'Cell Phone' field is cleared out.
  18. Enter "333-3333 X - 3333" in the 'Cell Phone' field.
  19. Click [Save].
  20. Select "Client A" and access the 'Update Client Data' form.
  21. Validate the 'Home Phone' field contains "111-111-1111".
  22. Validate the 'Work Phone' field contains "222-2222".
  23. Validate the 'Cell Phone' field contains ""333-3333 X - 3333".
  24. Validate all other previously filed data is displayed.
  25. Close the form.
  26. Select "Client A" and navigate to the 'Quick Actions' widget.
  27. Click [Update Client Data - Add].
  28. Validate all previously filed data is displayed.
  29. Clear out the value in the 'Home Phone' field.
  30. Clear out the value in the 'Cell Phone' field.
  31. Clear out the value in the 'Work Phone' field.
  32. Click [Save].
  33. Select "Client A" and access the 'Update Client Data' form.
  34. Validate the 'Home Phone' field does not contain any value.
  35. Validate the 'Work Phone' field does not contain any value.
  36. Validate the 'Cell Phone' field does not contain any value.
  37. Close the form.
Topics
• Update Client Data • NX
2023 Update 156 Summary | Details
CCBHC PPS Compile - Edit PPS Service
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Client Charge Input
  • Client Ledger
  • CCBHC PPS Compile
Scenario 1: CCBHC PPS Compile - Edit PPS1 service.
Specific Setup:
  • Service Codes:
  • Service 1:
  • A PPS enumerated service code. This will be the service used in client charge input, and it will trigger Service 2 during the CCBHC PPS Compile.
  • Service 2:
  • A PPS non-enumerated service code.
  • CCBHC PPS Service definition:
  • PPS-1 definition:
  • The other definition would have an effective date that is the day after the end date in the PPS-2 definition.
  • PPS-1 Service Code is the enumerated service code (Service 1).
  • Review the dates before admitting the client so you know what admission date you want to use.
  • Dictionary Update:
  • For the 'Client' File type -> '(10006) Location' Data element, Pick a dictionary code of a location (Location 1) and set its value as 'Yes' for the Extended Dictionary Data Element-> 'CCBHC Location '
  • Guarantors/Payors:
  • Find an existing or create a Guarantor with the "CCBHC Guarantor" set as "Yes".
  • Client 1 has the following:
  • Is enrolled in a program on or after the CCBHC PPS Service Definition effective date.
  • A financial eligibility record for the CCBHC guarantor.
Steps
  1. Open the 'Client Charge Input' form.
  2. Set the 'Date Of Service' field with a date.
  3. Select Client 1 in the 'Client ID' field.
  4. Select 'Service 1' in the 'Service Code' field.
  5. Select a practitioner from the 'Practitioner' field.
  6. Select 'Location 1' from the 'Location' field.
  7. Select [Submit].
  8. Click [No].
  9. Open 'Close Charges'.
  10. Select 'Close Charges' from 'Liability Update Or Close Charges'.
  11. Select 'T' to set today's date in the 'Thru Date' field.
  12. Select 'Individual' from 'Individual, All, Or Interim Batch Cycle'.
  13. Select 'Client 1' in the 'Client ID' field.
  14. Select the episode from the 'Episode Number' field.
  15. Select [Submit].
  16. Open 'Client Ledger'.
  17. Select 'Client 1' in the 'Client ID' field.
  18. Select 'All Episodes' from 'Claim/Episode/All Episodes'.
  19. Select 'Simple' from 'Ledger Type'.
  20. Set 'From Date' and 'To Date' with the date of 'Service 1' used in Step 2.
  21. Select [Process].
  22. Validate that 'Service 1' is shown in the client's ledger.
  23. Close the report.
  24. Click [No].
  25. Open 'CCBHC PPS Compile'.
  26. Enter the first date of service with the date of 'Service 1' of 'Client 1' in 'Start Date' used in Step 2.
  27. Enter the last date of service with the date of 'Service 1' of 'Client 1' in 'Start Date' used in Step 2.
  28. Enter the 'Client ID' for 'Client 1'.
  29. Click [Compile & Post Services].
  30. Validate that the 'CCBHC Compile Complete' message is received.
  31. Click [OK].
  32. Select [Discard].
  33. Click [Yes].
  34. Open 'Client Ledger'.
  35. Select 'Client 1' in the 'Client ID' field.
  36. Select 'All Episodes' from 'Claim/Episode/All Episodes'.
  37. Select 'Simple' from 'Ledger Type'.
  38. Set 'From Date' and 'To Date' with the date of 'Service 1' used in Step 2.
  39. Select [Process].
  40. Validate that 'Service 2' is created by the 'CCBHC PPS Compile' process and shown in the client's ledger along with 'Service 1'.
  41. Close the report.
  42. Click [No].
  43. Open 'Edit Service Information'.
  44. Select 'Client 1' in the 'Client ID' field.
  45. Validate that the Episode field is populated with the corresponding Episode.
  46. Set the 'Service Start Date' and 'Service End Date' with the date of 'Service 1' used in Step 2.
  47. Click [Select Service(s) To Edit].
  48. Validate that we see both Service 1 and 2 in the 'Select Service(s) To Edit' grid.
  49. Select 'Service 2' from the grid.
  50. Click [OK].
  51. Edit the 'Modifiers text' field and set it to any desired value.
  52. Select [Submit].
  53. Click [No].
  54. Open 'CCBHC PPS Compile'.
  55. Enter the first date of service with the date of Service 1 of 'Client 1' in 'Start Date' used in Step 2.
  56. Enter the last date of service with the date of Service 1 of 'Client 1' in 'Start Date' used in Step 2.
  57. Enter the 'Client ID' for 'Client 1'.
  58. Click [Compile & Post Services].
  59. Validate that the 'CCBHC Compile Complete' message is received.
  60. Click [OK].
  61. Select [Discard].
  62. Click [Yes].
  63. Open 'Client Ledger'.
  64. Select 'Client 1' in the 'Client ID' field.
  65. Select 'All Episodes' from 'Claim/Episode/All Episodes'.
  66. Select 'Simple' from 'Ledger Type'.
  67. Set 'From Date' and 'To Date' with the date of 'Service 1' used in Step 2.
  68. Select [Process].
  69. Validate that there are no new entries added for 'Service 2' by the 'CCBHC PPS Compile' process and make sure that we still have the Services 1 and 2 alone in the client's ledger.
  70. Close the report.
  71. Click [No].
CCBHC PPS Compile
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Client Charge Input
  • Delete Service
  • Client Ledger
  • Open Closed Charges
  • CCBHC PPS Compile
Scenario 1: CCBHC PPS Compile - posting the CCBHC service.
Specific Setup:
  • Service Codes:
  • Service 1:
  • Is a PPS-enumerated service code. This will be the service used in client charge input, and it will trigger Service 2 during the CCBHC PPS Compile.
  • Service 2:
  • Is a PPS non-enumerated service code.
  • CCBHC PPS Service definition:
  • PPS-1 definition:
  • The other definition would have an effective date that is the day after the end date in the PPS-2 definition.
  • PPS-1 Service Code is the enumerated service code (Service 1).
  • Review the dates before admitting the client so you know what admission date you want to use.
  • PPS-2 definition:
  • Have this definition, with an effective date and end date.
  • Should contain data in the Service Code By Population section for the Population and Service Code at a minimum.
  • Dictionary Update:
  • For the 'Client' File type -> '(10006) Location' Data element, Pick a dictionary code of a location (Location 1) and set its value as 'Yes' for the Extended Dictionary Data Element-> 'CCBHC Location '
  • Guarantors/Payors:
  • Find an existing or create a Guarantor with the "CCBHC Guarantor" set as "Yes".
  • Client 1 has the following:
  • Is enrolled in a program on or after the CCBHC PPS Service Definition effective date.
  • A financial eligibility record for the CCBHC guarantor.
Steps
  1. Open the 'Client Charge Input' form.
  2. Set the 'Date Of Service' field with a date.
  3. Select 'Client 1' in the 'Client ID' field.
  4. Select 'Service 1' in the 'Service Code' field.
  5. Select a practitioner from the 'Practitioner' field.
  6. Select 'Location 1' from the 'Location' field.
  7. Select [Submit].
  8. Click [No].
  9. Open 'Close Charges'.
  10. Select 'Close Charges' from 'Liability Update Or Close Charges'.
  11. Select 'T' to set today's date in the 'Thru Date' field.
  12. Select 'Individual' from 'Individual, All, Or Interim Batch Cycle'.
  13. Select 'Client 1' in the 'Client ID' field.
  14. Select the episode from the 'Episode Number' field.
  15. Select [Submit].
  16. Open 'Client Ledger'.
  17. Select 'Client 1' in the 'Client ID' field.
  18. Select 'All Episodes' from 'Claim/Episode/All Episodes'.
  19. Select 'Simple' from 'Ledger Type'.
  20. Set 'From Date' and 'To Date' with the date of 'Service 1' used in Step 2.
  21. Select [Process].
  22. Validate that 'Service 1' is shown in the client's ledger.
  23. Close the report.
  24. Click [No].
  25. Open 'CCBHC PPS Compile'.
  26. If using a PPS-1 definition, enter the date range of services in the service date fields.
  27. If using a PPS-2 definition, enter the first and last date of the month in the service date fields.
  28. Enter the 'Client ID' for 'Client 1'.
  29. Click [Compile & Post Services].
  30. Validate that the 'CCBHC Compile Complete' message is received.
  31. Click [OK].
  32. Select [Discard].
  33. Click [Yes].
  34. Open 'Client Ledger'.
  35. Select 'Client 1' in the 'Client ID' field.
  36. Select 'All Episodes' from 'Claim/Episode/All Episodes'.
  37. Select 'Simple' from 'Ledger Type'.
  38. Set 'From Date' and 'To Date' with the date of 'Service 1' used in Step 2.
  39. Select [Process].
  40. Validate that 'Service 2' is created by the 'CCBHC PPS Compile' process and shown in the client's ledger along with 'Service 1'.
  41. Close the report.
  42. Click [No].
  43. Open 'Open Closed Charges'.
  44. Select 'Individual Client' from 'Individual Client Or Interim Batch'.
  45. Select 'Client 1' in the 'Client ID' field.
  46. Select the episode from the 'Episode Number' field.
  47. Set 'Start Date' and 'End Date' with the date of 'Service 1' used in Step 2.
  48. Click [Select Charges To Open].
  49. Validate that the 'Open Closed Charges' window contains 'Service 1'.
  50. Select 'Service 1'.
  51. Click [OK].
  52. Select [Submit].
  53. Click [Yes].
  54. Click [No].
  55. Open 'Edit Service Information'.
  56. Select 'Client 1' in the 'Client ID' field.
  57. Validate that the Episode field is populated with the corresponding Episode.
  58. Set the 'Service Start Date' and 'Service End Date' with the date of 'Service 1' used in Step 2.
  59. Click [Select Service(s) To Edit].
  60. Validate that we see both Service 1 and 2 in the 'Select Service(s) To Edit' grid.
  61. Select 'Service 1' from the grid.
  62. Click [OK].
  63. Edit the 'Modifiers text' field and set it to any desired value.
  64. Select [Submit].
  65. Click [No].
  66. Open 'Close Charges'.
  67. Select 'Close Charges' from 'Liability Update Or Close Charges'.
  68. Select 'T' to set today's date in the 'Thru Date' field.
  69. Select 'Individual' from 'Individual, All, Or Interim Batch Cycle'.
  70. Select 'Client 1' in the 'Client ID' field.
  71. Select the episode from the 'Episode Number' field.
  72. Select [Submit].
  73. Open 'Delete Service'.
  74. Select 'Client 1' in the 'Client ID' field.
  75. Set the 'Start Date' and 'End Date' with the date of 'Service 1' used in Step 2.
  76. Click [Display Client].
  77. Validate that we see 'Service 2' in the 'Service Delete' window.
  78. Select 'Service 2' from the grid.
  79. Click [OK].
  80. Click [Delete].
  81. Validate that a 'The following services will be deleted.' window displays with the 'Service 2' we selected in Step 78.
  82. Click [OK].
  83. Click [Yes].
  84. Click [OK].
  85. Select [Discard].
  86. Click [Yes].
  87. Open 'Client Ledger'.
  88. Select 'Client 1' in the 'Client ID' field.
  89. Select 'All Episodes' from 'Claim/Episode/All Episodes'.
  90. Select 'Simple' from 'Ledger Type'.
  91. Set 'From Date' and 'To Date' with the date of 'Service 1' used in Step 2.
  92. Select [Process].
  93. Validate that Services 1 and 2 are shown in the client's ledger, with 'Service 2' marked as 'DELETE' under the 'SERV' column of the report.
  94. Close the report.
  95. Click [No].
  96. Open 'CCBHC PPS Compile'.
  97. If using a PPS-1 definition, enter the date range of services in the service date fields.
  98. If using a PPS-2 definition, enter the first and last date of the month in the service date fields.
  99. Enter the 'Client ID' for 'Client 1'.
  100. Click [Compile & Post Services].
  101. Validate that the 'CCBHC Compile Complete' message is received.
  102. Click [OK].
  103. Select [Discard].
  104. Click [Yes].
  105. Open 'Client Ledger'.
  106. Select 'Client 1' in the 'Client ID' field.
  107. Select 'All Episodes' from 'Claim/Episode/All Episodes'.
  108. Select 'Simple' from 'Ledger Type'.
  109. Set 'From Date' and 'To Date' with the date of 'Service 1' used in Step 2.
  110. Select [Process].
  111. Validate that a new row is created for the 'PPS Service 2' by the 'CCBHC PPS Compile' process and shown in the client's ledger along with 'Service 1'.
  112. Close the report.
  113. Click [No].
Topics
• CCBHC • NX
2023 Update 161 Summary | Details
Purge Billing Files
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Purge Billing Files
  • Quick Billing
Scenario 1: Validate 'Purge Billing Files' when '271 Batch' is selected to purge.
Specific Setup:
  • At least two 'Posted' 271 batch(es) are identified. Note the batch numbers.
Steps
  1. Open 'Purge Billing Files'.
  2. Select '271 Batch' in 'Billing List to Purge'.
  3. Enter a date in 'Date Created Start Date'.
  4. Enter a date in 'Date Created End Date'.
  5. Select 'None' in 'File Selection Default'.
  6. Click [Select File(s) to Purge].
  7. Verify that the file list contains both the 'Posted' batches along with the 'Compiled' batches.
  8. Select the first row, noting the 'Date Created' and 'Batch Name'.
  9. Click [OK].
  10. Click [Submit].
  11. Click [OK].
  12. Repeat steps 1 - 7.
  13. Verify that the batch that was deleted is not present by confirming that the deleted 'Date Created' and 'Batch Name' are not included in the grid.
  14. Run the SQL query and verify that the purged files are only removed from the file lists and not from the system.
Scenario 2: Validate 'Purge Billing Files' when '835 Batch' is selected to purge.
Specific Setup:
  • At least two 835 batch(es) are identified for this test.
  • Note down the batch numbers.
Steps
  1. Open 'Purge Billing Files'.
  2. Select '835 Batch' in 'Billing List to Purge'.
  3. Enter a date in 'Date Created Start Date'.
  4. Enter a date in 'Date Created End Date'.
  5. Select 'None' in 'File Selection Default'.
  6. Click [Select File(s) to Purge].
  7. Verify that the file list contains both the 'Posted' batches along with the 'Compiled' batches.
  8. Select the first row, noting the 'Date Created' and 'Batch Name'.
  9. Click [OK].
  10. Click [Submit].
  11. Click [OK].
  12. Repeat steps 1 - 7.
  13. Verify that the batch that was deleted is not present by confirming that the deleted 'Date Created' and 'Batch Name' are not included in the grid.
  14. Run the SQL query and verify that the purged files are only removed from the file lists and not from the system.
Scenario 3: Validate 'Purge Billing Files' when 'Quick Billing Batch' is selected to purge.
Specific Setup:
  • At least two Quick Billing batches are identified. Note the batch numbers.
Steps
  1. Open 'Purge Billing Files'.
  2. Select 'Quick Billing Batch' in 'Billing List to Purge'.
  3. Enter a date in 'Date Created Start Date'.
  4. Enter a date in 'Date Created End Date'.
  5. Select 'None' in 'File Selection Default'.
  6. Click [Select File(s) to Purge].
  7. Select the first row, noting the 'Date Created' and 'Batch Number'.
  8. Click [OK].
  9. Click [Submit].
  10. Click [OK].
  11. Repeat steps 1 - 7.
  12. Verify that the batch that was deleted is not present by confirming that the deleted 'Date Created' and 'Batch Number' are not included in the list.
  13. If desired, SQL query the 'SYSTEM.billing_quick_batch' table specific to the purged batch, and verify that the associated 837 compiles do not display.
Topics
• Purge Billing Files
2023 Update 164 Summary | Details
Pre Admit
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Site Specific Section Modeling (PM)
  • Pre Admit
Scenario 1: Pre-Admit Form : Add new fields to the form
Specific Setup:
  • Site Specific Section Modeling: 'Patient 554 (Pre Admit) Site Specific Pre Admission:
  • The site specific section has been modified to include the desired prompt definitions for 'SS Pre Adm Dictionary 15 - 34. Make at least one prompt required,
  • The site specific section has been modified to include the desired prompt definitions for 'SS Pre Adm Multiple Select Dictionary 8 - 27. Make at least one prompt required,
  • Dictionary Update:
  • Client dictionary is used to add values for the prompts selected above - SS Pre Adm Dictionary 15 - 34.
  • Client dictionary is used to add values for the prompts selected above - SS Pre Adm Multiple Select Dictionary 8 - 27.
Steps
  1. Open 'Pre Admit'.
  2. Enter desire data for all sections, including the 'Site Specific Pre Admission'. section. Do not add a value to at least one required field in the 'Site Specific Pre Admission' section.
  3. Click [Submit].
  4. Validate that an error dialog is received regarding the missing required data.
  5. Click [OK].
  6. Add data to the field(s) that are required and are missing data.
  7. Click [Submit].
  8. Open 'Pre Admit' for the same client and select 'Edit'.
  9. Review the submitted data for accuracy.
  10. Change the data is at least one field in the 'Site Specific Pre Admission' section.
  11. Submit the form.
  12. Open 'Pre Admit' for the same client and select 'Edit'.
  13. Review the submitted data to verify that the edited field(s) contain the new data.
  14. Close the form.
  15. If desired, query the 'SYSTEM.site_specific_pre_admission' table to verify the data filed successfully.
Topics
• Pre Admit • Site Specific Section Modeling • NX
2023 Update 167 Summary | Details
Support for other products and modules
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Site Specific Section Modeling (CWS)
  • Progress Notes (Group and Individual)
  • CareFabric Monitor
Scenario 1: Progress Notes - Validate the 'EncounterResourceUpdated' SDK event
Specific Setup:
  • A client is enrolled in an existing episode (Client A).
  • The 'Progress Notes (Group and Individual)' form must have a 'SS Note Staff Member' field enabled in 'Site Specific Section Modeling' with "Assign as Primary Care Provider" selected in the 'Product Custom Logic Definition' field. This field will be referred to as the 'Assign as Primary Care Provider' field.
Steps
  1. Access the 'Progress Notes (Group and Individual)' form.
  2. Select "Client A" in the 'Select Client' field.
  3. Select the desired episode in the 'Select Episode' field.
  4. Select "Independent Note" in the 'Progress Note For' field.
  5. Select the desired value in the 'Note Type' field.
  6. Enter the desired value in the 'Notes Field'.
  7. Select the desired practitioner in the 'Assign as Primary Care Provider' field.
  8. Select "Final" in the 'Draft/Final' field.
  9. File the note.
  10. Access Crystal Reports or other SQL Reporting tool.
  11. Select the PM namespace.
  12. Create a report using the 'SYSTEM.client_practitioner_assignment' SQL table.
  13. Validate a row is displayed for the note finalized in the previous steps with PCL.
  14. Validate the 'PATID' field contains the client ID for "Client A".
  15. Validate the 'practitioner' field contains the ID for the practitioner selected in the previous steps.
  16. Validate the 'date_of_assignment' and 'time_of_assignment' fields contain the date/time the note was filed.
  17. Close the report.
  18. Access the 'CareFabric Monitor' form.
  19. Enter the current date in the 'From Date' and 'Through Date' fields.
  20. Select "Client A" in the 'Client ID' field.
  21. Click [View Activity Log].
  22. Validate the 'CareFabric Monitor Report' is displayed and contains an "EncounterResourceUpdated" record. Please note: this may be an "EncounterResourceCreated" record if a "Created" message has not yet been triggered for the client. In addition, it may take a few minutes for the event record to display on the report.
  23. Click [Click To View Record].
  24. Validate the last 'individualPractitionerResourceID' - 'id' field contains the ID for the practitioner selected in the previous steps.
  25. Validate the last 'period' - 'fromDate' field contains the date/time the note was filed, which can be found in the 'SYSTEM.client_practitioner_assignment' SQL table.
  26. Validate the last 'typeCodes' - 'codes' - 'code' field contains "PCP".
  27. Validate the last 'typeCodes' - 'codes' - 'displayName' field contains "Primary Care Physician".
  28. Close the report and the form.
Topics
• Progress Notes • CareFabric Monitor
2023 Update 176 Summary | Details
835 Healthcare Claim Payment/ Advice - PLB Total
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Financial Eligibility
  • Diagnosis
  • Client Charge Input (Charge Fee Access)
  • Service Fee/Cross Reference Maintenance
  • Client Ledger
  • Create Interim Billing Batch File
  • Electronic Billing
  • Claim Adjustment Group/Reason Code Definition
  • Guarantors/Payors
Scenario 1: 835 Health Care Claim Payment/Advice - Work Screen Grid
Specific Setup:
  • Claim Adjustment Group/ reason code Definition:
  • A group code is selected for the credit adjustment code and debit adjustment reversal code. Note the adjustment codes and group code setup.
  • Admission:
  • Admit a client into an outpatient episode. Note the Client id/name, Admission date/program.
  • Guarantor/Payors:
  • Three existing commercial guarantors are identified. Note the guarantors codes/names.
  • Financial Eligibility:
  • Three guarantors identified above are assigned to the client. Note the primary, secondary and tertiary guarantor.
  • Client Charge Input:
  • Three services rendered to the client in a same month. Note the service dates.
  • Client Ledger:
  • Make sure the services are distributed to the primary guarantors assigned to the client.
  • Close charges.
  • Electronic Billing:
  • The services are claimed using the 837 Professional bill for the primary guarantor.
  • Create an 835 file based on the claim information found in the 837 professional bill.
Steps
  1. Open the '835 Health Care Claim Payment/Advice' form.
  2. Load and compile the 835 file created that includes the claim for the defined guarantor in the setup.
  3. Verify the 835 file loads/compiles successfully.
  4. Select the 'Work Compile' option.
  5. Select the compiled 835 file.
  6. Click [Launch Work Screen].
  7. Verify the 'PLB Amount' cell includes all the monetary amounts in the PLB to generate a correct total.
  8. Click [Save].
  9. Validate message "Save Successful' is displayed.
  10. Click [Yes] to exit the grid.
  11. Close the form.
Scenario 2: 835 Healthcare Claim Payment/Advise - Validating liability distribution after 'Monthly Maximum Responsibility' distributed
Specific Setup:
  • Claim Adjustment Group/ reason code Definition:
  • The desired group code is selected for the credit adjustment code and credit transfer code. Note the adjustment codes and group code setup.
  • Admission:
  • Admit a client into an outpatient episode. Note the Client id/name, Admission date/program.
  • Guarantor/Payors:
  • Three existing commercial guarantors are identified. Note the guarantors codes/names.
  • Financial Eligibility:
  • Three guarantors identified above are assigned to the client. Note the primary, secondary and tertiary guarantor.
  • The secondary guarantor is customized such that Monthly Maximum Responsibility field has a desired value. This means that once the amount entered in the Monthly Maximum Responsibility is distributed to the secondary guarantor for the month, anything else go to tertiary guarantor.
  • Client Charge Input:
  • Three services rendered to the client in a same month. Note the service dates.
  • Client Ledger:
  • Make sure the services are distributed to the primary guarantors assigned to the client.
  • Close charges.
  • Electronic Billing:
  • The services are claimed using the 837 Professional bill for the primary guarantor.
  • Create an 835 file based on the claim information found in the 837 professional bill.
Steps
  1. Open the '835 Health Care Claim Payment/Advice' form.
  2. Load and compile the 835 file created that includes the claims for the defined guarantor in the setup.
  3. Verify the 835 file loads/compiles successfully.
  4. Select 'Post File' option.
  5. Select the file that is recently compiled successfully.
  6. Populate all the required fields with desired value.
  7. Verify the file posts successfully.
  8. Open the 'Client Ledger' for the client.
  9. Verify the amount entered in the 'Monthly Maximum Responsibility' is distributed to the secondary guarantor for the month and remaining amount distributed to the tertiary guarantor.
835 Healthcare Claim Payment/ Advice - Liability Distribution
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Financial Eligibility
  • Diagnosis
  • Client Charge Input (Charge Fee Access)
  • Service Fee/Cross Reference Maintenance
  • Client Ledger
  • Create Interim Billing Batch File
  • Electronic Billing
  • Claim Adjustment Group/Reason Code Definition
  • Guarantors/Payors
Scenario 1: 835 Health Care Claim Payment/Advice - Work Screen Grid
Specific Setup:
  • Claim Adjustment Group/ reason code Definition:
  • A group code is selected for the credit adjustment code and debit adjustment reversal code. Note the adjustment codes and group code setup.
  • Admission:
  • Admit a client into an outpatient episode. Note the Client id/name, Admission date/program.
  • Guarantor/Payors:
  • Three existing commercial guarantors are identified. Note the guarantors codes/names.
  • Financial Eligibility:
  • Three guarantors identified above are assigned to the client. Note the primary, secondary and tertiary guarantor.
  • Client Charge Input:
  • Three services rendered to the client in a same month. Note the service dates.
  • Client Ledger:
  • Make sure the services are distributed to the primary guarantors assigned to the client.
  • Close charges.
  • Electronic Billing:
  • The services are claimed using the 837 Professional bill for the primary guarantor.
  • Create an 835 file based on the claim information found in the 837 professional bill.
Steps
  1. Open the '835 Health Care Claim Payment/Advice' form.
  2. Load and compile the 835 file created that includes the claim for the defined guarantor in the setup.
  3. Verify the 835 file loads/compiles successfully.
  4. Select the 'Work Compile' option.
  5. Select the compiled 835 file.
  6. Click [Launch Work Screen].
  7. Verify the 'PLB Amount' cell includes all the monetary amounts in the PLB to generate a correct total.
  8. Click [Save].
  9. Validate message "Save Successful' is displayed.
  10. Click [Yes] to exit the grid.
  11. Close the form.
Scenario 2: 835 Healthcare Claim Payment/Advise - Validating liability distribution after 'Monthly Maximum Responsibility' distributed
Specific Setup:
  • Claim Adjustment Group/ reason code Definition:
  • The desired group code is selected for the credit adjustment code and credit transfer code. Note the adjustment codes and group code setup.
  • Admission:
  • Admit a client into an outpatient episode. Note the Client id/name, Admission date/program.
  • Guarantor/Payors:
  • Three existing commercial guarantors are identified. Note the guarantors codes/names.
  • Financial Eligibility:
  • Three guarantors identified above are assigned to the client. Note the primary, secondary and tertiary guarantor.
  • The secondary guarantor is customized such that Monthly Maximum Responsibility field has a desired value. This means that once the amount entered in the Monthly Maximum Responsibility is distributed to the secondary guarantor for the month, anything else go to tertiary guarantor.
  • Client Charge Input:
  • Three services rendered to the client in a same month. Note the service dates.
  • Client Ledger:
  • Make sure the services are distributed to the primary guarantors assigned to the client.
  • Close charges.
  • Electronic Billing:
  • The services are claimed using the 837 Professional bill for the primary guarantor.
  • Create an 835 file based on the claim information found in the 837 professional bill.
Steps
  1. Open the '835 Health Care Claim Payment/Advice' form.
  2. Load and compile the 835 file created that includes the claims for the defined guarantor in the setup.
  3. Verify the 835 file loads/compiles successfully.
  4. Select 'Post File' option.
  5. Select the file that is recently compiled successfully.
  6. Populate all the required fields with desired value.
  7. Verify the file posts successfully.
  8. Open the 'Client Ledger' for the client.
  9. Verify the amount entered in the 'Monthly Maximum Responsibility' is distributed to the secondary guarantor for the month and remaining amount distributed to the tertiary guarantor.
Topics
• 835 Health Care Claim Payment/Advice • NX
2023 Update 177 Summary | Details
File import: Guarantor/Program Billing Defaults
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • File Import
Scenario 1: File Import: Guarantor/Program Billing Defaults - Assign Template
Specific Setup:
  • File import
  • A file import file of 'GPBD Assign Template' file type is created to assign a template.
Steps
  1. Open the "File Import" form.
  2. Select the 'GPBD Assign Template' File Type.
  3. Click on 'Upload New File' radio button.
  4. Select file for 'GPBD assign template'.
  5. Compile the 'GPBD assign template' file.
  6. Verify that the file compiles successfully.
  7. Post the file.
  8. Verify that the file posts successfully.
  9. Select the 'Print File' option, review the report, and ensure that all data added in the text file is displayed correctly.
  10. Close the report.
  11. Close the form.
  12. Open the 'Guarantor/Program Billing Defaults' form.
  13. Verify all data imported correctly.
Topics
• File Import • Guarantor / Program Billing Defaults • NX
2023 Update 181 Summary | Details
Client Search
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Financial Eligibility
Scenario 1: Financial Eligibility - Client Search Change Subscriber Policy#
Specific Setup:
  • Admit a test client.
  • Using the "Financial Eligibility" form:
  • Populate all required fields.
  • Populate "Subscriber Policy#. Note the data.
  • Populate "Subscriber Medicaid#". Note the data.
Steps
  1. Using the "Financial Eligibility" form:
  2. Change the "Subscriber Policy#" and "Subscriber Medicaid# values. Note the values.
  3. File the form.
  4. From the Home View, enter the value that was entered into "Subscriber Policy#" from Step 1.
  5. Validate the correct result returns from the search on that value.
  6. From the Home View, enter the value that was entered into "Subscriber Medicaid#" from Step 1.
  7. Validate the correct result returns from the search on that value.
Topics
• Client Search • NX
 

Avatar_PM_2024_Monthly_Release_2024.00.00_Details.csv