Avatar PM 2024 Monthly Release 2024.01.02 Acceptance Tests

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Update 19 Summary \| Details Payor based Authorization Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Payor Based Authorizations Scenario 1: Payor Based Authorizations - Add/Edit/Delete payor based authorization Specific Setup: Registry Settings: Payor Based Authorizations >> Enable Payor Based Authorizations = Y. Payor Based Authorizations >> Enable CPT Based Payor Authorizations Registry Setting Value = N. Authorization Group >> Require Authorizations at Guarantors/Payors Level Registry Setting Value = Y. Authorization Group Definition: New Authorization group(s) created. Note the authorization group number/names. Steps Open 'Payor Based Authorizations’ form. Select 'Add' in the 'Add/Edit/Delete' field. Select desired guarantor from the 'Guarantor' field. Select desired program(s) from the 'Program' field. Enter desired date in the 'Effective Date' field. Note the date. Leave the 'Expiration Date' field empty. Select desired group number from the 'Authorization Group' field. Validate 'Service Codes' selected based on the selected 'Authorization Group'. Enter desired authorization number in the 'Authorization Number' field. Click [Submit]. Open the 'Crystal Report' or any other SQL data viewer. Locate the PM namespace of the system. Query - select * from SYSTEM.table_payor_auths where GUARANTOR_ID=[desired guarantor id]. Verify the 'effective_date' displays the correct date that is entered during creating a payor based authorization record. Verify the 'expiration_date' displays "NONE" because the field was blank during creating a payor based authorization record. Verify the 'authorization_number' field displays the correct authorization number. Open the 'Payor Based Authorizations’ form. Select 'Edit' from the 'Add/Edit/Delete' field. Click [Select Authorization To Edit/Delete]. Select desired authorization record from the 'Edit Entry' list box. Click [OK]. Update the 'Effective Date' field to different date. Note the date. Enter desired date in the 'Expiration Date' field. Note the date. Click [Submit]. Open the 'Crystal Report' or any other SQL data viewer. Locate the PM namespace of the system. Query - select * from SYSTEM.table_payor_auths where GUARANTOR_ID=[desired guarantor id]. Verify the 'effective_date' displays correct date that is changed during updating a payor based authorization record. Verify the 'expiration_date' displays correct date that is changed during updating a payor based authorization record. Verify the 'authorization_number' field displays the correct authorization number. Open the 'Payor Based Authorizations’ form. Select 'Edit' from the 'Add/Edit/Delete' field. Click [Select Authorization To Edit/Delete]. Select desired authorization record from the 'Edit Entry' list box. Click [OK]. Update the 'Effective Date' field to different date. Note the date. Enter same date in the 'Expiration Date' field. Note the date. Click [Submit]. Open the 'Crystal Report' or any other SQL data viewer. Locate to the PM namespace of the system. Query - 'select * from SYSTEM.table_payor_auths where GUARANTOR_ID=[desired guarantor id]'. Verify the 'effective_date' displays correct date that is changed during updating a payor based authorization record. Verify the 'expiration_date' displays correct date that is changed during updating a payor based authorization record. Verify the 'authorization_number' field displays the correct authorization number. Open the 'Payor Based Authorizations’ form. Select 'Delete' from the 'Add/Edit/Delete' field. Click [Select Authorization To Edit/Delete]. Select desired authorization record from the 'Edit Entry' list box. Click [OK]. Click [Submit]. Open the 'Crystal Report' or any other SQL data viewer. Locate to the PM namespace of the system. Query - 'select * from SYSTEM.table_payor_auths where GUARANTOR_ID=[desired guarantor id]'. Verify the 'effective_date' displays correct date that is changed during updating a payor based authorization record. Verify the 'expiration_date' displays correct date that is changed during updating a payor based authorization record. Verify the 'authorization_number' field displays the correct authorization number. Close the report.	Topics • Payor Based Authorizations • Database Tables
Update 42 Summary \| Details File Import Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: File Import Service Codes Scenario 1: File Import - Service Codes Specific Setup: File Import: Create an import file for adding new Service Code "File A". Create an import file for editing the above Service Code: "File B". Steps Open the "File Import" form. Select the 'Service Codes' in the 'File Type' field. Select 'Upload New File' in the 'Action' field. Click [Process Action]. Select "File A". Select 'Compile/Validate File' in the 'Action' field. Select "File A" in the 'Files(s)' field. Click [Process Action]. Validate the message = 'Compiled'. Click [OK]. Select 'Post File' in the 'Action' field. Select "File A" in the 'Files(s)' field. Click [Process Action]. Validate the message = 'Posted'. Click [OK]. Select 'Print File' in the 'Action' field. Select "File A" in the 'Files(s)' field. Click [Process Action]. Validate the Report. Click [Close Report]. Click [Discard] Click [Yes] Open the "Service Codes" form. Click [Edit]. Enter the 'Service Code'. Validate the fields of the form. Close the form. Repeat Steps 1-27 for Service Code Edit -'File B'.	Topics • Service Codes • File Import
Update 43 Summary \| Details Quick Billing Rule Definition Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Quick Billing Rule Definition Scenario 1: Quick Billing Rule Definition - Help Message on File Description Steps Open the "Quick Billing Rule Definition" form. Click the [File Description] help button. Validate in the field description that the special characters '<' and '>' display correctly. Click the [Return To Form] link. Click the [Discard] button.	Topics • Quick Billing
Update 48 Summary \| Details The 'Age Display Format' registry setting Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Call Intake Pre Admit Family Registration Client Medical Conditions Scenario 1: Admission - Validate the 'Age Display Format' registry setting Steps Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Validate the 'Registry Setting Details' field contains: This registry setting accepts the values "1", "2", or "3", to customize the format of age across various forms and widgets, including 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit', 'Call Intake', 'Client Header', and the 'Client Information' widget. Selecting "1" enables a simplified age display, presenting only the clients' age in years across all specified forms and widgets. Selecting "2", a more detailed age field is made visible and the display of age only in years is hidden on the 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit' and 'Call Intake' forms. For clients older than three years, age is shown in months and years, while for those under three, age is shown in days, months, and years. Selecting "3" allows for clients under 3 years old to display their age in months, and those under 2 years to display their age in months and days. All clients aged 3 and above will display age in years only. Enter "1" in the 'Registry Setting Value' field. Submit the form. Access the 'Admission' form. Populate all required fields to admit a new client. This will be referred to as "Client A". Enter the desired value in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years. Submit the form. Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Enter "2" in the 'Registry Setting Value' field. Submit the form. Select "Client A" and access the 'Admission' form. Click [Edit]. Enter a date making the client older than 3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years and months. Enter a date making the client less than 3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years, months, and days. Close the form. Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Enter "3" in the 'Registry Setting Value' field. Submit the form. Select "Client A" and access the 'Admission' form. Click [Edit]. Enter a date making the client older than 3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years. Enter a date making the client between 2-3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in months. Enter a date making the client less than 2 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in months and days. Close the form. Scenario 2: Admission (Outpatient) - Validate the 'Age Display Format' registry setting Steps Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Validate the 'Registry Setting Details' field contains: This registry setting accepts the values "1", "2", or "3", to customize the format of age across various forms and widgets, including 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit', 'Call Intake', 'Client Header', and the 'Client Information' widget. Selecting "1" enables a simplified age display, presenting only the clients' age in years across all specified forms and widgets. Selecting "2", a more detailed age field is made visible and the display of age only in years is hidden on the 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit' and 'Call Intake' forms. For clients older than three years, age is shown in months and years, while for those under three, age is shown in days, months, and years. Selecting "3" allows for clients under 3 years old to display their age in months, and those under 2 years to display their age in months and days. All clients aged 3 and above will display age in years only. Enter "1" in the 'Registry Setting Value' field. Submit the form. Access the 'Admission (Outpatient)' form. Populate all required fields to admit a new client. This will be referred to as "Client A". Enter the desired value in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years. Submit the form. Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Enter "2" in the 'Registry Setting Value' field. Submit the form. Select "Client A" and access the 'Admission (Outpatient)' form. Click [Edit]. Enter a date making the client older than 3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years and months. Enter a date making the client less than 3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years, months, and days. Close the form. Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Enter "3" in the 'Registry Setting Value' field. Submit the form. Select "Client A" and access the 'Admission (Outpatient)' form. Click [Edit]. Enter a date making the client older than 3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years. Enter a date making the client between 2-3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in months. Enter a date making the client less than 2 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in months and days. Close the form. Scenario 3: Call Intake - Validate the 'Age Display Format' registry setting Specific Setup: The 'Add Demographics To Call Intake' registry setting must be set to "Y" in Cal-PM systems. Steps Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Validate the 'Registry Setting Details' field contains: This registry setting accepts the values "1", "2", or "3", to customize the format of age across various forms and widgets, including 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit', 'Call Intake', 'Client Header', and the 'Client Information' widget. Selecting "1" enables a simplified age display, presenting only the clients' age in years across all specified forms and widgets. Selecting "2", a more detailed age field is made visible and the display of age only in years is hidden on the 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit' and 'Call Intake' forms. For clients older than three years, age is shown in months and years, while for those under three, age is shown in days, months, and years. Selecting "3" allows for clients under 3 years old to display their age in months, and those under 2 years to display their age in months and days. All clients aged 3 and above will display age in years only. Enter "1" in the 'Registry Setting Value' field. Submit the form. Access the 'Call Intake' form. Populate all required fields to admit a client into a 'Call Intake' program. This will be referred to as "Client A". Enter the desired value in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years. Submit the form. Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Enter "2" in the 'Registry Setting Value' field. Submit the form. Select "Client A" and access the 'Call Intake' form. Click [Edit]. Enter a date making the client older than 3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years and months. Enter a date making the client less than 3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years, months, and days. Close the form. Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Enter "3" in the 'Registry Setting Value' field. Submit the form. Select "Client A" and access the 'Call Intake' form. Click [Edit]. Enter a date making the client older than 3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years. Enter a date making the client between 2-3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in months. Enter a date making the client less than 2 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in months and days. Close the form. Scenario 4: Pre Admit - Validate the 'Age Display Format' registry setting Steps Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Validate the 'Registry Setting Details' field contains: This registry setting accepts the values "1", "2", or "3", to customize the format of age across various forms and widgets, including 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit', 'Call Intake', 'Client Header', and the 'Client Information' widget. Selecting "1" enables a simplified age display, presenting only the clients' age in years across all specified forms and widgets. Selecting "2", a more detailed age field is made visible and the display of age only in years is hidden on the 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit' and 'Call Intake' forms. For clients older than three years, age is shown in months and years, while for those under three, age is shown in days, months, and years. Selecting "3" allows for clients under 3 years old to display their age in months, and those under 2 years to display their age in months and days. All clients aged 3 and above will display age in years only. Enter "1" in the 'Registry Setting Value' field. Submit the form. Access the 'Pre Admit' form. Populate all required fields to admit a new client into a Pre Admit program. This will be referred to as "Client A". Enter the desired value in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years. Submit the form. Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Enter "2" in the 'Registry Setting Value' field. Submit the form. Select "Client A" and access the 'Pre Admit' form. Click [Edit]. Enter a date making the client older than 3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years and months. Enter a date making the client less than 3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years, months, and days. Close the form. Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Enter "3" in the 'Registry Setting Value' field. Submit the form. Select "Client A" and access the 'Pre Admit' form. Click [Edit]. Enter a date making the client older than 3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in years. Enter a date making the client between 2-3 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in months. Enter a date making the client less than 2 years old in the 'Date Of Birth' field. Validate the 'Age' field contains the client's age in months and days. Close the form. Scenario 5: Family Registration - Validate the 'Age Display Format' registry setting Specific Setup: A client is enrolled in an existing episode (Client A). Steps Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Validate the 'Registry Setting Details' field contains: This registry setting accepts the values "1", "2", or "3", to customize the format of age across various forms and widgets, including 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit', 'Call Intake', 'Client Header', and the 'Client Information' widget. Selecting "1" enables a simplified age display, presenting only the clients' age in years across all specified forms and widgets. Selecting "2", a more detailed age field is made visible and the display of age only in years is hidden on the 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit' and 'Call Intake' forms. For clients older than three years, age is shown in months and years, while for those under three, age is shown in days, months, and years. Selecting "3" allows for clients under 3 years old to display their age in months, and those under 2 years to display their age in months and days. All clients aged 3 and above will display age in years only. Enter "1" in the 'Registry Setting Value' field. Submit the form. Access the 'Family Registration' form. Enter the desired value in the 'Select Family' dialog and click [New Family]. This will be referred to as "Family A". Enter the desired value in the 'Family Name' field. Enter the desired date in the 'Family Activation Date' field. Select the "Family Members" section. Click [Add New Item]. Select "Client A" in the 'Client ID#' field. Enter the desired date in the 'Start Date Of Family Membership' field. Enter the desired value in the 'Date Of Birth' field. Validate the 'Age at Time of Data Entry' field contains the client's age in years. Submit the form. Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Enter "2" in the 'Registry Setting Value' field. Submit the form. Access the 'Family Registration' form. Search for and select "Family A" in the 'Select Family' dialog. Select the "Family Members" section. Select "Client A" in the 'Family Membership Information' grid and click [Edit Selected Item]. Enter a date making the client older than 3 years old in the 'Date Of Birth' field. Validate the 'Age at Time of Data Entry' field contains the client's age in years and months. Enter a date making the client less than 3 years old in the 'Date Of Birth' field. Validate the 'Age at Time of Data Entry' field contains the client's age in years, months, and days. Close the form. Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Enter "3" in the 'Registry Setting Value' field. Submit the form. Access the 'Family Registration' form. Search for and select "Family A" in the 'Select Family' dialog. Select the "Family Members" section. Select "Client A" in the 'Family Membership Information' grid and click [Edit Selected Item]. Enter a date making the client older than 3 years old in the 'Date Of Birth' field. Validate the 'Age at Time of Data Entry' field contains the client's age in years. Enter a date making the client between 2-3 years old in the 'Date Of Birth' field. Validate the 'Age at Time of Data Entry' field contains the client's age in months. Enter a date making the client less than 2 years old in the 'Date Of Birth' field. Validate the 'Age at Time of Data Entry' field contains the client's age in months and days. Close the form. Scenario 6: Validate the 'Age Display Format' registry setting in the 'Client Header' and 'Client Information' widget Specific Setup: A client is enrolled in an existing episode (Client A). The 'Client Information' widget must be accessible on the HomeView. Steps Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Validate the 'Registry Setting Details' field contains: This registry setting accepts the values "1", "2", or "3", to customize the format of age across various forms and widgets, including 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit', 'Call Intake', 'Client Header', and the 'Client Information' widget. Selecting "1" enables a simplified age display, presenting only the clients' age in years across all specified forms and widgets. Selecting "2", a more detailed age field is made visible and the display of age only in years is hidden on the 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit' and 'Call Intake' forms. For clients older than three years, age is shown in months and years, while for those under three, age is shown in days, months, and years. Selecting "3" allows for clients under 3 years old to display their age in months, and those under 2 years to display their age in months and days. All clients aged 3 and above will display age in years only. Enter "1" in the 'Registry Setting Value' field. Submit the form. Select "Client A" and access the 'Admission' form. Click [Edit]. Enter the desired value in the 'Date Of Birth' field. Submit the form. Select "Client A" and access the 'Client Information' widget. Validate the 'Age' field contains the client's age in years. Select "Client A" and access the 'Admission' form. Click [Edit]. Validate the 'Client Header' displays the client's age in years. Close the form. Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Enter "2" in the 'Registry Setting Value' field. Submit the form. Select "Client A" and access the 'Client Information' widget. Validate the 'Age' field displays the client's age in: Months and years if the client is older than 3 years old. Months, years, and days if the client is under 3 years old. Select "Client A" and access the 'Admission' form. Click [Edit]. Validate the 'Client Header' displays the client's age in: Months and years if the client is older than 3 years old. Months, years, and days if the client is under 3 years old. Close the form. Access the 'Registry Settings' Form. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Enter "3" in the 'Registry Setting Value' field. Submit the form. Select "Client A" and access the 'Client Information' widget. Validate the 'Age' field displays the client's age in: Years if the client is older than 3 years old. Months if the client is between 2 and 3 years old. Months and days if the client is under 2 years old. Select "Client A" and access the 'Admission' form. Click [Edit]. Validate the 'Client Header' displays the client's age in: Years if the client is older than 3 years old. Months if the client is between 2 and 3 years old. Months and days if the client is under 2 years old. Close the form.	Topics • Registry Settings • Admission • NX • Admission (Outpatient) • Call Intake • Pre Admit • Family Registration • Widgets • Client Header
Update 51 Summary \| Details Dictionary Update - extended dictionary is added for the 'Certification Category' field. Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: BBH Setup Adult/Child Eligibility Category Financial Eligibility Diagnosis Client Charge Input Electronic Billing Scenario 1: Registry Setting - Enable BBH Service Modifiers Steps Open the "Registry Settings" form. Enable the registry setting "Enable BBH Service Modifiers". Open the "User Definition" form. Validate the 2 forms "BBH Setup" and "Adult/Child Eligibility Category" are visible. Give the user access to the "BBH Setup" form and the "Adult/Child Eligibility Category" form. Refresh menus. Validate the "BBH Setup" form can be opened. Validate the "Adult/Child Eligibility Category" form can be opened. Open the "Registry Settings" form. Disable the registry setting "Enable BBH Service Modifiers". Open the "User Definition" form. Validate the 2 forms "BBH Setup" and "Adult/Child Eligibility Category" are no longer visible. Refresh menus. Validate the "BBH Setup" form is no longer available. Validate the "Adult/Child Eligibility Category" is no longer available. Scenario 2: Adult/Child Eligibility Category - Field validations Specific Setup: Open the "Registry Settings" form. Enable the registry setting "Enable BBH Service Modifiers". Open the "User Definition" form. Give the user access to the "BBH Setup" form and the "Adult/Child Eligibility Category" form. Refresh menus. Open the "BBH Setup" form. Select the "Guarantor(s)" to include.in BBH processing by selecting them in the "Avatar Guarantors for BBH". Select any service codes desired to be excluded from BBH processing. Select any programs to excluded from BBH processing. Navigate to the "Certification Category Setup" section and enter all certification categories that apply. Establish effective and lapse dates of this eligibility category. Establish "Modifier 1" and "Modifier 2" for the certification category. At a minimum, establish a "No Eligibility" category to avoid any billing issues with any client assigned to a guarantor that is included in BBH Setup, but for whom there is no specific BBH setup. Admit a test client into any episode that is not excluded in the "BBH Setup" form. Steps Open the "Adult/Child Eligibility Category" form. Add a row by filing in all required fields and submitting the form. Submit the form. Add another row. Edit a row by changing some data. Retrieve the edited row and validate the changes are reflected. Delete a row and validate it's been removed. Scenario 3: 837P - BBH Modifiers Specific Setup: Open the "Registry Settings" form. Enable the registry setting "Enable BBH Service Modifiers". Open the "User Definition" form. Give the user access to the "BBH Setup" form and the "Adult/Child Eligibility Category" form. Refresh menus. Open the "BBH Setup" form. Select the "Guarantor(s)" to include.in BBH processing by selecting them in the "Avatar Guarantors for BBH". Select any service codes desired to be excluded from BBH processing. Select any programs to excluded from BBH processing. Set any modifiers that must be first position modifiers in the SV1 segment of the 837 Professional file. Set any modifiers that must be last position modifiers in the SV1 segment of the 837 Professional file. Navigate to the "Certification Category Setup" section and enter all certification categories that apply. Establish effective and lapse dates of this eligibility category. Establish "Modifier 1" and "Modifier 2" for the certification category. At a minimum, establish a "No Eligibility" category to avoid any billing issues with any client assigned to a guarantor that is included in BBH Setup, but for whom there is no specific BBH setup. Admit a test client into any program. Using the "Adult/Child Eligibility Category" form. Add a row of data for the test client. Select an episode to assign this data to. Select "Adult" in the "Adult or Child" field. Enter a Start date and an End Date. Select a "Certification Category". Using the "Financial Eligibility" form. Assign the test client to a guarantor. Select a guarantor selected in the "BBH Setup" form. Be sure to fill out all required fields. Populate the "Social Security Number" and "Subscriber Policy" fields. Using the "Diagnosis" form. Add diagnosis data for the test client. Using "Client Charge Input" form. Enter in at least one service. Be sure to use a service code that is specified in the "BBH Setup" form. Using the "Close Charges" form. Close charges for the test client. Steps Using the "Electronic Billing" form. Generate an 837 Professional file that includes the BBH covered guarantor, service, and program. Validate the modifiers in the SV1 segment, where the first modifier is equal to Modifier 1 from the appropriate certification category as set up in "BBH Defaults" form. Also, validate the modifiers in the SV1 segment, where the last modifier is equal to Modifier 2 from the appropriate certification category as set up in "BBH Defaults" form. Using the "BBH Setup" form. Edit an existing row to add a value to the "First Modifier" and for the "Last Modifier". Using the "Electronic Billing" form. Generate an 837 Professional file that includes the BBH covered guarantor, service, and program. Validate the modifiers in the SV1 segment, where the first modifier is equal to a modifier from the "First Position Modifiers" field from the appropriate certification category as set up in "BBH Defaults" form. Validate the modifiers in the SV1 segment, where the last modifier is equal to a modifier from the "Last Position Modifiers" field from the appropriate certification category as set up in "BBH Defaults" form. Open the "Registry Settings" form. Disable the registry setting "Enable BBH Service Modifiers" by setting it to "N" for "No". Open the "Electronic Billing" form. Generate an 837 Professional file for the client and service created for this test. Validate there are no modifiers from any "BBH Setup" in the SV1 segment. Scenario 4: BBH Setup Form - Field Validations Specific Setup: Open the "Registry Settings" form. Enable the registry setting "Enable BBH Service Modifiers". Open the "User Definition" form. Give the user access to the "BBH Setup" form. Refresh menus. Steps Open the "BBH Setup" form. Populate each field on the form. Add multiple rows in the "Certification Category" table. File the form. Open the "BBH Setup" form. Validate the fields re display as they were previously filed. Edit one of the rows in the "Certification Category" table. Delete a row from the table. Open the "BBH Setup" form. Ensure that a default eligibility category of "Not Eligible" is established.	Topics • 837 Professional • Registry Settings
Update 55 Summary \| Details Future Functionality Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: HL7 Connection Monitor Delete Last Movement Scenario 1: Admitting a client into a pre-admit program, upgrading to an inpatient program and delete last movement Specific Setup: A generic ADT Outbound connection must exist. (ADT-TEST) An ADT-RXCONNECT Outbound connection must exist. An ADT Outbound connection must exist with a 'Connection Profile' of MATRIXCARE. This can be done via an Avatar HL7 Customization Pack that can be requested via your Netsmart Representative. (ADT-MATRIXCARE) The ‘Avatar PM->Client Management->Movement Options->->->Allow Admission To File/Edit Pre-Admits’ registry setting must be set to "Y". The 'Avatar PM->System Maintenance->Client Maintenance->->->Revert To Pre-Admit When Deleting Admission Movement’ registry setting must be set to "Y". Please log out of the application and log back in after completing the above configuration. Steps Access the 'Admission' form. Enter a 'Last Name', 'First Name', select a 'Sex', enter a 'Social Security #' and a 'Date of Birth' and click [Search] and [New Client]. Validate an 'Auto Assign ID Number' message is displayed and click [Yes]. Set the 'Preadmit/Admission Date' of "01/01/2024", a 'Preadmit/Admit Time' of "09:00 AM", populate the 'Demographics' information, and populate all remaining required fields and click [Submit]. Access the 'HL7 Connection Monitor' form. Select the "ADT-RXCONNECT" Outbound connection in the 'Select Row' field. Validate the 'Last Message Processed' field contains an 'A05' event that contains a 'PID-3'segment which is the PATID with leading zero's and a 'PV1-44' segment of "202401010900". Select the "ADT-TEST" Outbound connection in the 'Select Row' field. Validate the 'Last Message Processed' field contains an 'A05' event that contains 'PID-3' segment which is the PATID with leading zero's and a 'PV1-44' segment of "202401010900". Validate there is no new message for "ADT-MATRIXCARE". Close the form. Access the 'Admission' form for the client selected. Select the existing row in the pre-display and click [Edit]. Change the 'Preadmit/Admission Date' to "02/10/2024", a 'Preadmit/Admit Time' to "01:00 PM". Change the 'Program' field to an Inpatient program. Populate all required fields. Click the 'Inpatient/Partial/Day Treatment' section and populate all required fields and click [Submit]. Access the 'HL7 Connection Monitor' form. Select the "ADT-RXCONNECT" Outbound connection in the 'Select Row' field. Validate the 'Last Message Processed' field contains an 'A08' event that contains a 'PID-3' segment which is the PATID with leading zero's and a 'PV1-44' segment of "202402101300". Select the "ADT-TEST" Outbound connection in the 'Select Row' field. Validate the 'Last Message Processed' field contains an 'A08' event that contains a 'PID-3' segment which is the PATID with leading zero's and a 'PV1-44' segment of "202402101300". Select the "ADT-MATRIXCARE" Outbound connection in the 'Select Row' field. Validate the 'Last Message Processed' field contains an 'A01' event with an 'MSH-4' segment of "98", a 'PID-3' segment of the PATID with no leading zeros, and a 'PV1-44' segment that contains "202402101300". Close the form. Access the 'Delete Last Movement' form. Validate a message is displayed stating "Deletion of any movement will remove the client from any bed they may be in. If a client needs to be in a bed, it needs to be entered via Unit/Room/Bed Assignment." and click [OK]. Select "Episode #1" in the 'Episode Number' field. Validate the 'Client Information' field contains the information for the admission program and click [Submit]. Validate a message is displayed stating " You are about to delete an Admission movement for episode 1. Deleting this movement will revert the episode to the Pre-Admit status. Do you want to continue?" and click [Yes]. Access the 'HL7 Connection Monitor' form. Select the "ADT-RXCONNECT" Outbound connection in the 'Select Row' field. Validate the 'Last Message Processed' field contains an 'A08' event that contains a 'PID-3' segment which is the PATID with leading zero's and a 'PV1-44' segment of "202401010900". Select the "ADT-TEST" Outbound connection in the 'Select Row' field. Validate the 'Last Message Processed' field contains an 'A08' event that contains a 'PID-3' segment which is the PATID with leading zero's and a 'PV1-44' segment of "202401010900". Select the "ADT-MATRIXCARE" Outbound connection in the 'Select Row' field. Validate the 'Last Message Processed' field contains an 'A11' event with a 'PID-3' segment of the PATID with no leading zeros, and a 'PV1-44' segment that contains "202402101300". Close the form.	Topics • HL7 • HL7 Connection Monitor
Update 57 Summary \| Details Service Fee/Cross Reference Maintenance Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: File Import Service Fee Service Fee/Cross Reference Maintenance Service Fee/Cross Reference and Guarantor Definition Export Scenario 1: File Import - 'Service Fee/Cross Reference' and 'Service Guarantor Definitions' file type(s). Specific Setup: An existing service code is identified, or a new one is created. Note the service code. Service code 1. An existing financial class is identified. Note the financial class. Financial Class 1. File Import: Service Fee/Cross Reference Maintenance: File 1: Is created for 'Service code 1' with 'From Date' and contains a value with the below conditions for the new field 'County Where Service is Rendered'. Only having alphanumeric characters. More than 18 characters in length. File 2: Is created for 'Service code 1' with 'From Date' and contains a value with the below conditions for the new field 'County Where Service is Rendered'. Having 1-8 characters. Having non-alphanumeric characters (blank spaces, symbols, etc.). File 3: Is created for 'Service code 1' with 'From Date' and contains a value with the below conditions for the new field 'County Where Service is Rendered'. Having only 1-8 alphanumeric characters. Not having characters like - (blank spaces, symbols, etc.). Service Guarantor Definition: File 4: Is created for 'Service code 1' and 'Financial Class 1' with 'From Date' that contains a value with the below conditions for the new field 'County Where Service is Rendered'. Only having alphanumeric characters. More than 18 characters in length. File 5: Is created for 'Service code 1' and 'Financial Class 1' with 'From Date' that contains a value with the below conditions for the new field 'County Where Service is Rendered'. Having 1-8 characters. Having non-alphanumeric characters (blank spaces, symbols, etc.). File 6: Is created for 'Service code 1' and 'Financial Class 1' with 'From Date' that contains a value with the below conditions for the new field 'County Where Service is Rendered'. Having only 1-8 alphanumeric characters. Not having characters like - (blank spaces, symbols, etc.). Steps Open the 'File Import' form. Select the 'Service Fee/Cross Reference Maintenance' from the 'File Type' field. Select the 'Upload New File' option. Click [Process Action]. Upload 'File 1'. Select the 'Compile/Validate File' option. Select the File from the dropdown that was uploaded. Click [Process Action]. Verify the information message: "File [File Name] contains one or more errors. These errors can be reviewed using 'Print Errors' action". Click [OK]. Select the 'Print Errors' option. Select the File from the dropdown that has errors. Click [Process Action]. Review the error report. Verify the report displays the error: 'Enter up to 18 alphanumeric characters.'. Click [X]. Select the 'Delete File' option. Select the File from the dropdown that has errors. Click [Process Action]. Click [Yes]. Click [OK]. Select the 'Upload New File' option. Click [Process Action]. Upload 'File 2'. Select the 'Compile/Validate File' option. Select the File from the dropdown that was uploaded. Click [Process Action]. Verify the information message: "File [File Name] contains one or more errors. These errors can be reviewed using 'Print Errors' action". Click [OK]. Select the 'Print Errors' option. Select the File from the dropdown that has errors. Click [Process Action]. Review the error report. Verify the report displays the error: 'Enter up to 18 alphanumeric characters.'. Click [X]. Select the 'Delete File' option. Select the File from the dropdown that has errors. Click [Process Action]. Click [Yes]. Click [OK]. Select the 'Upload New File' option. Click [Process Action]. Upload 'File 3'. Select the 'Compile/Validate File' option. Select the File from the dropdown that was uploaded. Click [Process Action]. Verify the success message: "Compiled.". Click [OK]. Select the 'Post File' option. Select the File from the dropdown that was successfully compiled. Click [Process Action]. Review the error report. Verify the warning message displayed: "Posting this file will remove all fee definitions from your system and create new definitions with the information that exists in this file. Are you sure you want to continue?". Click [Yes]. Verify the success message: "Posted.". Click [OK]. Select the 'Print File' option. Select the File from the dropdown that was successfully posted. Click [Process Action]. Search for 'Service code 1'. Verify that the 'County Where Service is Rendered' and its value is only displayed for the service codes that have the data filed. (If there is no data, it will not appear) Click [Close Report]. Click [Discard]. Click [Yes]. Open the 'Service Fee/Cross Reference Maintenance' form. Select the 'Edit Existing' option. Search and select 'Service code 1' in the 'Service Code' field. Enter the date used for 'Service code 1' in 'File 3'. Click [Select Fee/Cross Ref To Edit/Default From Existing Row]. Select the appropriate record from the list. Click [OK]. Verify that the field 'County Where Service is Rendered' has the value posted in 'File 3'. Click [Discard]. Click [Yes]. Open the 'File Import' form. Select the 'Service Guarantor Definitions' from the 'File Type' field. Select the 'Upload New File' option. Click [Process Action]. Upload 'File 4'. Select the 'Compile/Validate File' option. Select the File from the dropdown that was uploaded. Click [Process Action]. Verify the information message: "File [File Name] contains one or more errors. These errors can be reviewed using 'Print Errors' action". Click [OK]. Select the 'Print Errors' option. Select the File from the dropdown that has errors. Click [Process Action]. Review the error report. Verify the report displays the error: 'Enter up to 18 alphanumeric characters.'. Click [X]. Select the 'Delete File' option. Select the File from the dropdown that has errors. Click [Process Action]. Click [Yes]. Click [OK]. Select the 'Upload New File' option. Click [Process Action]. Upload 'File 5'. Select the 'Compile/Validate File' option. Select the File from the dropdown that was uploaded. Click [Process Action]. Verify the information message: "File [File Name] contains one or more errors. These errors can be reviewed using 'Print Errors' action". Click [OK]. Select the 'Print Errors' option. Select the File from the dropdown that has errors. Click [Process Action]. Review the error report. Verify the report displays the error: 'Enter up to 18 alphanumeric characters.'. Click [X]. Select the 'Delete File' option. Select the File from the dropdown that has errors. Click [Process Action]. Click [Yes]. Click [OK]. Select the 'Upload New File' option. Click [Process Action]. Upload 'File 6'. Select the 'Compile/Validate File' option. Select the File from the dropdown that was uploaded. Click [Process Action]. Verify the success message: "Compiled.". Click [OK]. Select the 'Post File' option. Select the File from the dropdown that was successfully compiled. Click [Process Action]. Review the error report. Verify the warning message displayed: "Posting this file will remove all fee definitions from your system and create new definitions with the information that exists in this file. Are you sure you want to continue?". Click [Yes]. Verify the success message: "Posted.". Click [OK]. Click [Discard]. Click [Yes]. Open the 'Service Fee/Cross Reference Maintenance' form. Select the 'Guarantor Definitions' section. Select the 'Edit Existing' option. Search and select 'Service code 1' in the 'Service Code' field. Enter the date used for 'Service code 1' in 'File 6'. Click [Select Definition To Edit/Default From Existing Row]. Select the appropriate record from the list. Click [OK]. Verify that the field 'County Where Service is Rendered' has the value posted in 'File 6'. Click [Discard]. Click [Yes]. Scenario 2: Service Fee/Cross Reference Definition - Guarantor Definition - Form and Report - field validations Specific Setup: An existing service code is identified, or a new one is created. Note the service code. Service code 1. Service Fee/Cross Reference Definition: Has an existing 'Service Fee/Cross Reference Definition'. (note the 'From Date') The 'County Where Service is Rendered' field does not have any value. Guarantor Definition: Does not have any existing 'Guarantor Definition'. Service code 2. Has an existing 'Service Fee/Cross Reference Definition'. (note the 'From Date') The 'County Where Service is Rendered' field does not have any value. Steps Open the 'Service Fee/Cross Reference Maintenance' form. Verify that the new field 'County Where Service is Rendered' is displayed. Initially this field will be empty. This field will be enabled and not required. Select the 'Enter New' option. This field will be empty. This field will be enabled and not required. Select the 'Edit Existing' option. Validate that the new field 'County Where Service is Rendered' is displayed. This field will be disabled now. Search and select 'Service code 1' in the 'Service Code' field. Enter the appropriate date value in the 'From Date' field for 'Service code 1' noted in the setup. Click [Select Fee/Cross Ref To Edit/Default From Existing Row]. Select the appropriate record from the list. Click [OK]. Validate that the new field 'County Where Service is Rendered' is displayed. This field will be empty. This field will be enabled and not required. Try to enter any desired value that is more than 18 characters in length in the field 'County Where Service is Rendered'. Verify that the field is restricted only to accept 18 characters. Enter any desired value in the 'County Where Service is Rendered' field that satisfies the following conditions, The total character length will be 1 - 18. Will have characters other than alphanumeric (Blank spaces). Tab out from the 'County Where Service is Rendered' field. Verify that the error message displayed: "Invalid entry. Please enter 1-18 alphanumeric characters." Click [OK]. Select the 'Service Fee/Cross Reference Maintenance' item. Validate that the value is cleared in the 'County Where Service is Rendered' field. Enter any desired value in the 'County Where Service is Rendered' field that satisfies the following conditions, The total character length will be 1 - 18. Will have characters other than alphanumeric (special characters, symbols, etc.). Tab out from the 'County Where Service is Rendered' field. Verify that the error message displayed: "Invalid entry. Please enter 1-18 alphanumeric characters." Click [OK]. Select the 'Service Fee/Cross Reference Maintenance' item. Validate that the value is cleared in the 'County Where Service is Rendered' field. Enter any desired value in the 'County Where Service is Rendered' field that satisfies the following conditions, The total character length will be 1 - 18. Will have only the alphanumeric characters (without blank spaces, special characters, symbols, etc.). Tab out from the 'County Where Service is Rendered' field. Click [Submit]. Click [Yes]. Validate that the value is cleared in the 'County Where Service is Rendered' field and disabled. Select the 'Edit Existing' option. Search and select 'Service code 2' in the 'Service Code' field. Enter the appropriate date value in the 'From Date' field for 'Service code 2' noted in the setup. Click [Select Fee/Cross Ref To Edit/Default From Existing Row]. Select the appropriate record from the list. Click [OK]. Validate that the new field 'County Where Service is Rendered' does not have any values in it. Click [Submit]. Click [Yes]. Click [Service Fee/Cross Reference Definition Report]. Select 'Service code 1' in the group tree. Click the 'Service Code Cross References' link. Verify that the new field 'County Where Service is Rendered' is displayed with the value. Navigate back to the 'Main report' tab. Select 'Service code 2' in the group tree. Click the 'Service Code Cross References' link. Verify that the new field 'County Where Service is Rendered' is not displayed when there is no value filed. Click [Close Report]. Click [Discard]. Click [Yes]. Open the 'Service Fee/Cross Reference Maintenance' form. Select the 'Guarantor Definitions' item. Verify that the new field 'County Where Service is Rendered' is displayed. Initially this field will be empty. This field will be enabled and not required. Select the 'Edit Existing' option. Validate that the new field 'County Where Service is Rendered' is displayed. This field will be disabled now. Select the 'Enter New' option. This field will be empty. This field will be enabled and not required. Search and select 'Service code 1' in the 'Service Code' field. Enter any desired date value in the 'From Date' field. Enter any desired values in all the required fields. Validate that the new field 'County Where Service is Rendered' is displayed. This field will be empty. This field will be enabled and not required. Try to enter any desired value that is more than 18 characters in length in the field 'County Where Service is Rendered'. Verify that the field is restricted only to accept 18 characters. Enter any desired value in the 'County Where Service is Rendered' field that satisfies the following conditions, The total character length will be 1 - 18. Will have characters other than alphanumeric (Blank spaces). Tab out from the 'County Where Service is Rendered' field. Verify that the error message displayed: "Invalid entry. Please enter 1-18 alphanumeric characters." Click [OK]. Validate that the value is cleared in the 'County Where Service is Rendered' field. Enter any desired value in the 'County Where Service is Rendered' field that satisfies the following conditions, The total character length will be 1 - 18. Will have characters other than alphanumeric (special characters, symbols, etc.). Tab out from the 'County Where Service is Rendered' field. Verify that the error message displayed: "Invalid entry. Please enter 1-18 alphanumeric characters." Click [OK]. Validate that the value is cleared in the 'County Where Service is Rendered' field. Enter any desired value in the 'County Where Service is Rendered' field that satisfies the following conditions, The total character length will be 1 - 18. Will have only the alphanumeric characters (without blank spaces, special characters, symbols, etc.). Tab out from the 'County Where Service is Rendered' field. Click [Submit]. Click [Yes]. Validate that the value is cleared in the 'County Where Service is Rendered' field and disabled. Select the 'Edit Existing' option. Search and select 'Service code1' in the 'Service Code' field. Enter the date that is used in step 2(g) in the 'From Date' field. Click [Select Definition To Edit/Default From Existing Row]. Select the appropriate record from the list. Click [OK]. Validate that the new field 'County Where Service is Rendered' has the value filed in step 2(v). Click [Discard]. Click [Yes]. Scenario 3: Validate 'Service Fee/Cross Reference and Guarantor Definition Export' Specific Setup: An existing service code is identified or a new one is created. Note the service code. Service code 1. Service Fee/Cross Reference Definition: Has an existing 'Service Fee/Cross Reference Definition'. Note the value in 'From Date'. The 'County Where Service is Rendered' field contains a valid value. Note the value in 'County Where Service is Rendered'. Note any other desired values. Guarantor Definition: Has an existing 'Guarantor Definition'. Note the value in 'From Date'. The 'County Where Service is Rendered' field contains a valid value. Note the value in 'County Where Service is Rendered'. Note any other desired values. Service code 2. Service Fee/Cross Reference Definition: Has an existing 'Service Fee/Cross Reference Definition'. Note the value in 'From Date'. The 'County Where Service is Rendered' field does not contain any value. Note any other desired values. Guarantor Definition: Has an existing 'Guarantor Definition'. Note the value in 'From Date'. The 'County Where Service is Rendered' field does not contain any value. Note any other desired values. Steps Note: The crystal report contains all fields available for export, and therefore is not intended to be readable. Process the export to read the data. Open 'Service Fee/Cross Reference and Guarantor Definition Export'. Select 'Guarantor Definition' in the 'Record Type(s) to Export' field. Verify that the 'Export to Crystal Report' is enabled. Verify that the 'Export Service Fee/Cross Reference to File' is disabled. Verify that the 'Export Guarantor Definition to File' is enabled. Click [Export to Crystal Report]. Verify that there are two options as below: Service Fee/Cross Reference Export. Guarantor Definition Export. Click the 'Service Fee/Cross Reference Export' link. Verify that the report shows "No Data Found For Report". Return to the 'Main Report'. Click the 'Guarantor Definition Export' link. Validate that the report is displaying the value for the field 'County Where Service is Rendered', for 'Service code 1'. Validate that there is no value displayed for the field 'County Where Service is Rendered' for 'Service code 2'. Click [Close Report]. Click [Export Guarantor Definition to File]. Verify that the exported .txt file is stored locally. Verify that the file contains 'Service Code 1', 'From Date', and the 'County Where Service is Rendered' values. Close the file and return to the form. Uncheck 'Guarantor Definition' in the 'Record Type(s) to Export' field. Verify that the 'Export to Crystal Report' is disabled. Verify that the 'Export Service Fee/Cross Reference to File' is disabled. Verify that the 'Export Guarantor Definition to File' is disabled. Select 'Service Fee/Cross Reference' in the 'Record Type(s) to Export' field. Verify that the 'Export to Crystal Report' is enabled. Verify that the 'Export Service Fee/Cross Reference to File' is enabled. Verify that the 'Export Guarantor Definition to File' is disabled. Click [Export to Crystal Report]. Verify that there are two options as below: Service Fee/Cross Reference Export. Guarantor Definition Export. Click the 'Guarantor Definition Export' link. Verify that the report shows "No Data Found For Report". Return to the 'Main Report'. Click the 'Service Fee/Cross Reference Export' link. Validate that the report is displaying the value for the field 'County Where Service is Rendered', for 'Service code 1'. Validate that there is no value displayed for the field 'County Where Service is Rendered' for 'Service code 2'. Click [Close Report]. Click [Export Service Fee/Cross Reference to File]. Verify that the exported .txt file is stored locally. Verify that the file contains 'Service Code 1', 'From Date', and the 'County Where Service is Rendered' values. Close the file and return to the form. Click [Discard]. Click [Yes]. Electronic Billing - 837 Institutional Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Service Fee/Cross Reference Maintenance Electronic Billing Scenario 1: Electronic Billing - 837I with and without 'County Where Service is Rendered' field value. Specific Setup: Service code 1. An existing service code is identified or a new one is created. (Note the service code). Service Fee/Cross Reference Definition: Has an existing 'Service Fee/Cross Reference Definition'. (note the 'From Date') The 'County Where Service is Rendered' field does not contain any value. Guarantor Definition: Does not have any existing 'Guarantor Definition'. Guarantor 1: Identify an existing guarantor. Note down the financial class of 'Guarantor 1' Financial class 1. Client 1: A new client is created and admitted to an inpatient program. The client has an active diagnosis and financial eligibility records. The client has the closed charge for 'Service code 1'. Interim batch 1: An interim batch is created that covers the charge for 'Client 1'. Steps Open the 'Service Fee/Cross Reference Maintenance' form. Select 'Edit Existing'. Search and select 'Service code 1' in the 'Service Code' field. Enter the appropriate date value in the 'From Date' field for 'Service code 1' noted in the setup. Click [Select Fee/Cross Ref To Edit/Default From Existing Row]. Select the appropriate record from the list. Click [OK]. Validate that the new field 'County Where Service is Rendered' is displayed and contains no value. Select the 'Guarantor Definitions' item. Select 'Enter New'. Search and select 'Service code 1' in the 'Service Code' field. Enter any desired date value in the 'From Date'. Select 'Financial class 1'. Select 'Guarantor 1'. Select all other required fields. Leave the 'County Where Service is Rendered' field as blank. Click [Submit]. Click [No]. Open the 'Electronic Billing' form. Run the '837-Institutional' compile by selecting the below values: Financial class 1. Guarantor 1. Interim batch 1. Print the compiled 837I bill file. Validate that the 2300-HI-11 segment displays correctly and that no new data is present. Close the report. Click [No]. Open the 'Service Fee/Cross Reference Maintenance' form. Select 'Edit Existing'. Search and select 'Service code 1' in the 'Service Code' field. Enter the appropriate date value in the 'From Date' field for 'Service code 1' noted in the setup. Click [Select Fee/Cross Ref To Edit/Default From Existing Row]. Select the appropriate record from the list. Click [OK]. Enter any desired value in the new field 'County Where Service is Rendered'. Click [Submit]. Click [No]. Open the 'Electronic Billing' form. Run the '837-Institutional' compile by selecting the below values: Financial class 1. Guarantor 1. Interim batch 1. Print the compiled 837I bill file. Validate that there is a new field entry in 2300-HI-11 for the value filed for 'County Where Service is Rendered' in the 'Service Fee/Cross Maintenance' section. For example, It will be listed as "BE:85:::<value>". Close the report. Click [No]. Open the 'Service Fee/Cross Reference Maintenance' form. Select the 'Guarantor Definitions' item. Select 'Edit Existing'. Search and select 'Service code 1' in the 'Service Code' field. Enter the appropriate date value in the 'From Date' field for 'Service code 1' noted in the setup. Click [Select Fee/Cross Ref To Edit/Default From Existing Row]. Select the appropriate record from the list. Click [OK]. Enter any desired value in the new field 'County Where Service is Rendered'. Click [Submit]. Click [No]. Open the 'Electronic Billing' form. Run the '837-Institutional' compile by selecting the below values: Financial class 1. Guarantor 1. Interim batch 1. Print the compiled 837I bill file. Validate that there is a new field entry in 2300-HI-11 for the value filed for 'County Where Service is Rendered' in the 'Guarantor Definitions' section. For example, It will be listed as "BE:85:::<value>". Close the report. Click [No]. Open the 'Service Fee/Cross Reference Maintenance' form. Select 'Edit Existing'. Search and select 'Service code 1' in the 'Service Code' field. Enter the appropriate date value in the 'From Date' field for 'Service code 1' noted in the setup. Click [Select Fee/Cross Ref To Edit/Default From Existing Row]. Select the appropriate record from the list. Click [OK]. Validate that the field 'County Where Service is Rendered' is displayed with the value already in the file. Set the 'County Where Service is Rendered' field as empty. Click [Submit]. Click [No]. Open the 'Electronic Billing' form. Run the '837-Institutional' compile by selecting the below values: Financial class 1. Guarantor 1. Interim batch 1. Print the compiled 837I bill file. Validate that there is a new field entry in 2300-HI-11 for the value filed for 'County Where Service is Rendered' in the 'Guarantor Definitions' section. For example, It will be listed as "BE:85:::<value>". Close the report. Click [No].	Topics • Service Fee/Cross Reference Maintenance • File Import • Claim Follow-up • Service Fee/Cross Reference and Guarantor Definition Export • Electronic Billing • 837 Institutional
Update 60 Summary \| Details 'Service Codes' form Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Service Codes Scenario 1: Service Codes - Add/Edit a Service Code Steps Access the 'Service Codes' form. Select "Add" in the 'Add New or Edit Existing' field. Enter the desired value in the 'New Service Code' field. Enter any value with an equal sign in the 'Service Code Definition' field. Validate a message is displayed stating: Service Code Definition cannot contain an equal sign. Click [OK]. Enter the desired value in the 'Service Code Definition' field. Select the desired value in the 'Service Required By' field. Select the desired value in the 'Type Of Service' field. Select the desired value in the 'Type Of Fee' field. Select the desired value in the 'Group Code' field. Select the desired value in the 'Insurance Charge Category' field. Select the desired value in the 'Is This A Balance Forward Service Code' field. Select the desired value in the 'Does This Code Have a Professional Component' field. Select the desired value in the 'Is This Service a Visit?' field. Select the desired value in the 'Is This Service An Intervention?' field. Populate any other required and desired fields. Click [Submit] and [Yes]. Select "Edit" in the 'Add New Or Edit Existing' field. Select the service code added in the previous steps in the 'Service Code' field. Validate all previously filed data is displayed. Close the form. Client Merge - 'Target Client' Scenario 1: Client Merge - Merge client Specific Setup: Two clients are enrolled in existing episodes (Client A & Client B). "Client A" must have existing services on file for "Episode 1". Steps Access the 'Client Merge' form. Select "Client A" in the 'Source Client' field. Select "Client B" in the 'Target Client' field. Select "Episode 1" in the 'Source Client Episode' field. Validate "Client B" remains selected in the 'Target Client' field. Select "Yes" in the 'Create New Episode On Merge' field. Click [File]. Validate a 'Do you wish to continue with the indicated action?' message is displayed. Click [Yes]. Validate a message stating 'The following new episode has been created for the target client indicated. Episode 2' is displayed. Click [OK] and close the form. Access the 'Client Ledger' form. Select "Client B" in the 'Client ID' field. Select "All Episodes" in the 'Claim/Episode/All Episodes' field. Select "Simple" in the 'Ledger Type' field. Select "Yes" in the 'Include Zero Charges' field. Click [Process]. Validate the service merged from "Client A" is displayed. Close the report and the form.	Topics • Service Codes • Client Merge
Update 63 Summary \| Details Retroactive Payor Change Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Financial Eligibility Client Charge Input Retroactive Payor Change Service Codes Scenario 1: RETROACTIVE PAYOR CHANGE - Compile Individual Client Specific Setup: Admit a Client in Out Patient Program. Note Client ID Program and Admission Date. Financial Eligibility 99999 NTST Default Guarantor acts as the Primary Guarantor. Steps Open the "Admission(Out Patient)" form. Set any value to 'Last Name', 'First Name' and Select any value from the 'Sex' dropdown list. Click [Search] button. Set any value in 'Social Security Number' Click [Search] button. Click [New Client] button. Validate the Client dialog contains “Client No Yes Auto Assign Next ID Number?”. Set any value in 'Date Of Birth' Set any value in 'Pre admit/Admission Date'. Select any value from the 'Program' dropdown list Select any value from the 'Type Of Admission' dropdown list. Set any value in the 'Client’s Address - Street'. Set any value in 'Zip Code'. Select any value from the 'Client Race' dropdown list, Select any value from the 'Ethnic Origin' dropdown list. Select any value from the 'Religion' dropdown list. Click [Submit] button. Open "Client Charge Input" form. Set any value in 'Date Of Service'. Set the 'Client ID' created above. Set any value in 'Service Code'. Set any value in 'Practitioner' Click [Submit] Validate the Form Return dialog. Open the "Close Charges" form. Select the [Close Charges] in 'Liability Update Or Close Charges' radio button. Set any value in 'Thru Date'. Click [Individual] in 'Individual, All, Or Interim Batch Cycle' radio button. Set the 'Client ID' created above. Select any episode from the 'Episode Number' dropdown list. Click [Submit]. Validate the Form Return dialog. Open the "Client Ledger" form. Set the 'Client ID' created above. Click [All Episodes] in 'Claim/Episode/All Episodes' radio button. Click [Simple] in 'Ledger Type' radio button. Click [Process] button. Validate in the CLIENT LEDGER to ensure allocation of charges to the 99999 NTST Default Payor. Click the Client Ledger [X] link. Validate the Form Return dialog. Open the "Retroactive Payor Change" form. Set any value in 'From Date'. Set any value in 'To Date'. Click [Compile] in 'Compile Or Post' radio button Click [No] in 'Compile Interim Billing Batch?' radio button. Click [Individual] in 'Compile Individual or All Clients' radio button. Set the 'Client ID' to created above. Click [Non-Recoverable object] in 'Financial Classes To Transfer Liability From '. Click [NTST Default Payor (99999)] in 'Guarantors To Transfer Liability From' Click [Submit]. Validate the Retroactive Payor Change dialog. Click [Yes] button. Click [Review Previously Compiled Information] button. Validate the Crystal Report page to ensure allocation of charges to the 99999 NTST Default Payor. Click [Close Report] button. Click[Submit] button. Click [Discard] button. Validate Confirm Close dialog. Click [Yes] button. Open "Retroactive Payor Change" form. Click [Post] in 'Compile Or Post' radio button. Select any value from the 'Transfer Code' drop down list. Select any value from the 'Payor To Assign' drop down list. Click [Y] in the 'Date Of Receipt' Click [T] in the 'Posting Date'. Click [Submit]. Validate the Retroactive Payor Change dialog. Confirm the reassignment of liabilities. Validate the records assigned and total amount assigned. Return to the form. Click the [Review Previously Compiled Information] button. Click [Close Report] button. Click [Discard] button Validate the message 'confirm closing without saving'. Click [Yes]. Open the "Client Ledger" form. Set the 'Client ID' created above. Click the [All Episodes] in 'Claim/Episode/All Episodes' radio button. Click the [Simple] in 'Ledger Type' radio button. Click the [Process] button. Validate the CLIENT LEDGER to ensure allocation of charges to the Guarantor selected above in the "Retroactive Payor Change" form. Click the Client Ledger [X] link. Validate the Form Return dialog. Scenario 2: RETROACTIVE PAYOR CHANGE - Compile All Clients* Specific Setup: Admit a Client in Out Patient/ In Patient Program. Note Client ID Program and Admission Date. Financial Eligibility: 99999 NTST Default Guarantor acts as the Primary Guarantor. Steps Open the "Admission(Out Patient)" form. Set any value to 'Last Name', 'First Name' Select any value from the 'Sex' dropdown list. Click the [Search] button. Set any value in 'Social Security Number'. Click the [Search] button. Click the [New Client]. Validate the Client dialog contains “Client No Yes Auto Assign Next ID Number?”. Set any value in 'Date Of Birth'. Set any value in 'Pre admit/Admission Date'. Select any value from the 'Program' dropdown list Select any value from the 'Type Of Admission' dropdown list. Set any value in the 'Client’s Address - Street'. Set any value in 'Zip Code'. Select any value from the 'Client Race' dropdown list, Select any value from the 'Ethnic Origin' dropdown list. Select any value from the 'Religion' dropdown list. Click [Submit] button. Open "Client Charge Input" form. Set any value in 'Date Of Service'. Set the 'Client ID' created above. Set any value in 'Service Code'. Set any value in 'Practitioner'. Click [Submit]. Validate the Form Return dialog. Open the "Close Charges" form. Select the [Close Charges] in 'Liability Update Or Close Charges' radio button. Set any value in 'Thru Date'. Click the [Individual] in 'Individual, All, Or Interim Batch Cycle' radio button. Set the 'Client ID' created above. Select any episode from the 'Episode Number' dropdown list. Click [Submit]. Validate the Form Return dialog. Open the "Client Ledger" form. Set the 'Client ID' created above. Click the [All Episodes] in 'Claim/Episode/All Episodes' radio button. Click the [Simple] in 'Ledger Type' radio button. Click the [Process] button. Validate in the CLIENT LEDGER to ensure allocation of charges to the 99999 NTST Default Payor. Click the Client Ledger [X] link. Validate the Form Return dialog. Open the "Retroactive Payor Change" form. Set any value in 'From Date'. Set any value in 'To Date'. Click [Compile] in 'Compile Or Post' radio button Click [No] in 'Compile Interim Billing Batch?' radio button. Click [All Clients] in 'Compile Individual or All Clients' radio button. Click [Non-Recoverable object] in 'Financial Classes To Transfer Liability From *'. Click [NTST Default Payor (99999)] in 'Guarantors To Transfer Liability From' Click [Submit]. Validate the Retroactive Payor Change dialog. Click [Yes] button. Click the [Review Previously Compiled Information] button. Validate the Crystal Report page to ensure allocation of charges to the 99999 NTST Default Payor. Click [Close Report] button. Click [Submit] button. Click [Discard] button. Validate Confirm Close dialog. Click [Yes] button. Open "Retroactive Payor Change" form. Click [Post] in 'Compile Or Post' radio button. Select any value from the 'Transfer Code' drop down list. Select any value from the 'Payor To Assign' drop down list. Click [Y] in the 'Date Of Receipt' Click [T] in the 'Posting Date'. Click [Submit]. Validate the Retroactive Payor Change dialog. Confirm the reassignment of liabilities. Validate the records assigned and total amount assigned. Return to the form. Click the [Review Previously Compiled Information] button. Click the [Close Report] button. Click the [Discard] button Validate the message 'confirm closing without saving'. Click [Yes]. Open the "Client Ledger" form. Set the 'Client ID' created above. Click [All Episodes] in 'Claim/Episode/All Episodes' radio button. Click [Simple] in 'Ledger Type' radio button. Click [Process] button. Validate the CLIENT LEDGER to ensure allocation of charges to the Guarantor selected above in the "Retroactive Payor Change" form. Click the Client Ledger [X] link. Validate the Form Return dialog.	Topics • Retroactive Payor Change
Update 65 Summary \| Details Compile/Edit/Post/Unpost Roll-Up Services Worklist Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Service Codes Roll-Up Services Definition Client Charge Input Compile/Edit/Post/Unpost Roll-Up Services Worklist Scenario 1: Compile/Edit/Post/Unpost Roll-Up Services Worklist - Post Roll-Up Worklist - Validate Client Ledger Specific Setup: Service Codes: Roll-Up service is identified. Note the service code Roll-Up component service code(s) are identified. Note the service code(s). Roll-Up Services Definition exists with the desired values: 'Roll-Up Service' contains the Roll-Up service code identified above. 'Component Service' contains the Roll-Up component service code(s) identified above. Client 1: Client is identified that will be given Roll-Up component service code(s), using one of the client charge input options. Note the service dates. Client Ledger is used to verify that the component services were created successfully. Steps Open the 'Compile/Edit/Post/Unpost Roll-Up Services Worklist' form. Enter/Select the 'From Date' that includes services start date. Enter/Select the 'Through Date' which includes services end date. Select the 'Roll-Up Definition' noted in Setup. Select desired value in 'Exclude Component Services From Report'. Click [Compile Worklist]. Verify the worklist compiles successfully. Click [Run Report]. Verify the Roll-Up Services Worklist includes the correct services rendered on or after from date and on or before through date. Click the [Post Roll-Up Services Worklist]. Select the compiled worklist in 'Through Date'. Select desired value in 'Default Write Off Posting Code' Click [Post Worklist]. Verify 'Post Complete' information message. Close the form. Open the 'Client Ledger' form for the desired client. Process the report for the desired date range. Verify the Roll-Up services & component are posted correctly. Close the report and the form.	Topics • Compile/Edit/Post/Unpost Roll-up Services Worklist
Update 66 Summary \| Details Edit Service Information Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Registry Settings (CWS) Edit Service Information (Charge Fee Access) Create Interim Billing Batch File Electronic Billing Scenario 1: Edit Service Information Specific Setup: Registry Settings: Set the "Enable Alternative Service Location Fields" Registry setting to "Y". System is set up to allow ‘Add-On’ services to the primary services. Service Codes: Use ‘Service Code Category’ to note the ‘Primary Code’. Note the associated add-on codes. Guarantors/Payors: Guarantor 1: Note the ‘Financial Class’. This will be the client’s primary guarantor. Guarantor/Program Billing Defaults: The ‘Maximum Service Information Per Claim Information (Maximum LX Per CLM)’ = 1. Clients: Client 1: Is enrolled in an outpatient program. Note the program. Client has an active diagnosis record. Client has an active financial eligibility record with the above guarantor. Services have been provided for the above ‘Primary Code’ that include add-on codes. Close Charges was used to close the charges. Client Ledger has been used to verify that the liability distributed to the primary guarantor, and note the dates of service for closed, unclaimed services for the above service codes. Client 2: Is enrolled in an inpatient program. Note the program. Client has an active diagnosis record. Client has an active financial eligibility record with a primary guarantor. Services have been provided for the above ‘Primary Code’ that include add-on codes. Close Charges was used to close the charges. Client Ledger has been used to verify that the liability distributed to the primary guarantor, and note the dates of service for closed, unclaimed services for the above service codes. Steps Open the 'Edit Service Information' form. Select 'Client 1' in ‘Client ID’. Select the 'Service Start Date' and 'Service End Date'. Click [Select Service(s) To Edit]. Select the desired service in the grid. Click [OK]. Verify that the 'Facility Location' fields are not required. Verify that the field ‘Facility Location Code Identifier’ is a text field. Enter a value in one of the 'Facility Location' fields. Verify that the 'Facility Location' fields are now required. Enter desired data in the 'Facility Location' fields. Note the data. Click [Submit]. Click [No]. Open the SQL Querying tool and validate that the filed 'Facility Location' values for the service is stored with a unique 'JOIN_TO_TX_HISTORY' ID value in the below tables: "SYSTEM".billing_tx_address "SYSTEM".billing_claim_address Close the SQL query window. Open the 'Edit Service Information' form. Select 'Client 2' in ‘Client ID’. Select the 'Service Start Date' and 'Service End Date'. Click [Select Service(s) To Edit]. Select the desired service in the grid. Click [OK]. Enter desired data in 'Facility Location' values similar to the above service. Enter desired data in the required fields. Select [Submit]. Select [Yes]. Click [Select Service(s) To Edit]. Select the desired service in the grid. Click [OK]. Enter desired data in the 'Facility Location' values completely different from the Service edited above. Enter desired data in the required fields. Select [Submit]. Select [Yes]. Click [Select Service(s) To Edit]. Select the desired services in the grid. Click the [OK] button. Verify that the 'Facility Location' information field values are populated and displayed in the form when the 'Facility Location' fields of the services are same. If desired, edit one of more of the 'Facility Location' fields. Select [Submit]. Select [Yes]. Click [Select Service(s) To Edit]. Select the desired services in the grid. Click [OK]. Verify that the newly updated location value is being shown. Open the SQL Querying tool and validate that the filed 'Facility Location' values for the service are added with the new value(s) with a unique 'JOIN_TO_TX_HISTORY' ID values in the below tables: "SYSTEM".billing_tx_address "SYSTEM".billing_claim_address Close the SQL query window. Open the 'Edit Service Information' form. Click [Select Service(s) To Edit]. Click [Yes]. Select the desired services in the grid. Click [OK]. Verify that the 'Facility Location' information field values are not displayed in the form when the services selected for edit have different values in the 'Facility Location 'fields. Enter desired data in the 'Facility Location' field(s). Click [Submit]. Click [Yes]. Click [Select Service(s) To Edit]. Click [Yes]. Select the desired services in the grid. Click [OK]. Verify that the 'Facility Location' fields are displayed in the form when the services selected for edit have the same 'Facility Location' values. Click [Discard]. Click [Yes]. Scenario 2: Edit Service Information (Charge Fee Access) - Validation Specific Setup: Registry Settings: Set the "Enable Alternative Service Location Fields" to "Y". System is set up to allow ‘Add-On’ services to the primary services. Service Codes: Use ‘Service Code Category’ to note the ‘Primary Code’. Note the associated add-on codes. Guarantors/Payors: Guarantor 1: Note the ‘Financial Class’. This will be the client’s primary guarantor. Guarantor/Program Billing Defaults: The ‘Maximum Service Information Per Claim Information (Maximum LX Per CLM)’ = 1. Clients: Client 1: Is enrolled in an outpatient program. Note the program. Client has an active diagnosis record. Client has an active financial eligibility record with the above guarantor. Services have been provided for the above ‘Primary Code’ that include add-on codes. Close Charges was used to close the charges. Client Ledger has been used to verify that the liability distributed to the primary guarantor, and note the dates of service for closed, unclaimed services for the above service codes. Client 2: Is enrolled in an inpatient program. Note the program. Client has an active diagnosis record. Client has an active financial eligibility record with a primary guarantor. Services have been provided for the above ‘Primary Code’ that include add-on codes. Close Charges was used to close the charges. Client Ledger has been used to verify that the liability distributed to the primary guarantor, and note the dates of service for closed, unclaimed services for the above service codes. Steps Open the 'Edit Service Information(Charge Fee Access)' form. Select 'Client 1' in 'Client ID'. Select the 'Service Start Date' and 'Service End Date'. Click [Select Service(s) To Edit]. Select the desired service in the grid Click [OK]. Verify that the 'Facility Location' fields are not required. Verify that the field ‘Facility Location Code Identifier’ is a text field. Enter a value in one of the 'Facility Location' fields. Verify that the 'Facility Location' fields are now required. Enter desired data in the 'Facility Location' fields. Note the data. Click [Submit]. Click [No]. Open the SQL Querying tool and validate that the filed Facility Location values for the service is stored with a unique 'JOIN_TO_TX_HISTORY' ID value in the below tables: "SYSTEM".billing_tx_address "SYSTEM".billing_claim_address Close the SQL query window. Open the 'Edit Service Information' form. Select 'Client 2' in 'Client ID'. Select the 'Service Start Date' and 'Service End Date'. Click [Select Service(s) To Edit] button. Select the desired services in the grid. Click [OK]. Enter desired data in 'Facility Location' values similar to the above service. Enter desired data in the required fields. Select [Submit]. Select [Yes]. Click [Select Service(s) To Edit]. Select the desired services in the grid Click [OK]. Enter desired data in the 'Facility Location' values completely different from the Service-2. Enter desired data in the required fields. Click [Submit]. Click [Yes]. Click [Select Service(s) To Edit]. Select the desired services in the grid. Click [OK]. Verify that the 'Facility Location' information field values are populated and displayed in the form when the 'Facility Location' fields of service are same. If desired, edit one of more of the Facility Location fields. Click [Submit]. Click [Yes]. Click [Select Service(s) To Edit]. Select the desired services in the grid Click [OK]. Verify that the newly updated location value is being shown. Open the SQL Querying tool and validate that the filed Facility Location values for the service are added with the new value(s) with a unique 'JOIN_TO_TX_HISTORY' ID values in the below tables: "SYSTEM".billing_tx_address "SYSTEM".billing_claim_address Close the SQL query window. Return to the form. Click [Select Service(s) To Edit] button. Click [Yes]. Select the desired services in the grid. Click [OK]. Verify that the 'Facility Location' information field values are not displayed in the form when the services selected for edit have different values in the Facility Location fields. Enter desired data in the 'Facility Location' fields. Click [Submit]. Click [Yes]. Select the desired services in the grid. Click [OK]. Verify that the 'Facility Location' fields are displayed in the form when the services selected for edit have the same 'Facility Location' values. Click [Discard]. Click [Yes]. Scenario 3: Filing an 837 Institutional and 837 Professional - Add on Services - Validating the service location information of parent and add on remain same Specific Setup: Registry Settings: Set the "Enable Alternative Service Location Fields" Registry setting to "Y". System is set up to allow ‘Add-On’ services to the primary services. Service Codes: Use ‘Service Code Category’ to note the ‘Primary Code’. Note the associated add-on codes. Client 1: Is enrolled in an outpatient program. Note the program. Client has an active diagnosis record. Client has an active financial eligibility record. Services have been provided for the above ‘Primary Code’ that include add-on codes. Close Charges was used to close the charges. Client Ledger has been used to verify that the liability distributed to the primary guarantor, and note the dates of service for closed, unclaimed services for the above service codes. Client 2: Is enrolled in an inpatient program. Note the program. Client has an active diagnosis record. Client has an active financial eligibility record with a primary and secondary guarantor. Services have been provided for the above ‘Primary Code’ that include add-on codes. Close Charges was used to close the charges. Client Ledger has been used to verify that the liability distributed to the primary guarantor, and note the dates of service for closed, unclaimed services for the above service codes. The 'Guarantor/Program Billing Defaults' template for the guarantor and program combination has a value of '1' in '837 Institutional', 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)'. Steps Open 'Electronic Billing' form. Select '837-Institutional' in 'Billing Form'. Select the guarantor 'Financial Class' in 'Type' of Bill'. Select 'Individual' in 'Individual Or All Guarantors'. Select the desired 'Guarantor'. Select 'Inpatient' in 'Billing Type'. Select 'Sort File' in 'Billing Options'. Enter the desired 'File Description'. Select 'Interim Billing Batch' in 'All Clients Or Interim Billing Batch'. Select 'No' in 'Create Claims'. Enter the 'First Date of Service To Include'. Enter the 'Last Date of Service To Include'. Click [Process]. Click [OK]. Select 'Dump File' in 'Billing Options'. Select 'Print' in 'Print Or Delete Report'. Select the desired 'File'. Click [Process]. Validate the facility defaults of primary service is displayed. Close the report. Close the form. Open 'Electronic Billing' form. Select '837-Professional' in 'Billing Form'. Select the guarantor 'Financial Class' in 'Type' of Bill'. Select 'Individual' in 'Individual Or All Guarantors'. Select the desired 'Guarantor'. Select 'Outpatient' in 'Billing Type'. Select 'Sort File' in 'Billing Options'. Enter the desired 'File Description'. Select 'Interim Billing Batch' in 'All Clients Or Interim Billing Batch'. Select 'No' in 'Create Claims'. Enter the 'First Date of Service To Include'. Enter the 'Last Date of Service To Include'. Click [Process]. Click [OK]. Select 'Dump File' in 'Billing Options'. Select 'Print' in 'Print Or Delete Report'. Select the desired 'File'. Click [Process]. Validate the facility defaults of Primary and add-on service are displayed. Close the report. Close the form.	Topics • Edit Service Information • 837 Professional • 837 Institutional
Update 67 Summary \| Details 'All Documents' widget - Diagnosis entries from user modeled forms Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Treatment Plan Financial Eligibility Diagnosis Console Widget Viewer Scenario 1: "All Documents" Widget - Validate diagnosis records submitted via the "Diagnosis" and/or "Modeled" forms Specific Setup: Have a modeled form (Form A), configured in 'Table Definition" to use the "Alias Table", "Diagnosis History (ICD10)", to file 'Diagnosis' table field data. A client is enrolled in an existing episode (Client A) with the following: A diagnosis record submitted via the 'Diagnosis' form A diagnosis record submitted via "Form A" with all required diagnosis alias fields populated. The 'All Documents' widget must be configured to a view and contains the 'Diagnosis' form, "Form A", and the 'Admission' form. The logged in user must have this widget accessible. Steps Select "Client A" and navigate to the 'All Documents' widget. Select "All" in the 'Form Description' field. Validate the 'Diagnosis' record from the setup are displayed. Please note: any diagnosis records filed via the 'Diagnosis' form and "Form A" will display under the 'Diagnosis' form description. Validate the data is displayed in the 'Form Description', 'Episode (Program Name)', 'Date', 'Time', 'Data Entry By' columns as expected. Validate the "Form A" record from the setup are displayed. Validate the data is displayed in the 'Form Description', 'Episode (Program Name)', 'Date', 'Data Entry By' columns as expected. Validate the 'Admission' record from the setup are displayed. Validate the data is displayed in the 'Form Description', 'Episode (Program Name)', 'Date', 'Time', 'Data Entry By' columns as expected. Select any 'Diagnosis' record and click [Open]. Validate the 'Diagnosis' form is launched as expected. Close the form and click [Close All]. Select only "Diagnosis" in the 'Form Description' field. Validate the results include the records filed in the 'Diagnosis' form and the diagnosis record filed in "Form A". Validate the data is displayed in the 'Form Description', 'Episode (Program Name)', 'Date', 'Time', 'Data Entry By' columns as expected. Select only "Form A" in the 'Form Description' field. Validate the results only include diagnosis record(s) filed in "Form A". Validate the data is displayed in the 'Form Description', 'Episode (Program Name)', 'Date', 'Data Entry By' columns as expected. Select only "Admission" in the 'Form Description' field. Validate the results only include the 'Admission' record. Validate the data is displayed in the 'Form Description', 'Episode (Program Name)', 'Date', 'Time', 'Data Entry By' columns as expected. Select both "Diagnosis" and "Form A" in the 'Form Description' field. Validate the 'Form Description' column contains results for the 'Diagnosis' form and "Form A". Validate the 'Admission' record is not displayed.	Topics • Modeling • Diagnosis • Widgets
Update 68 Summary \| Details Self Pay Payment Redistribution Process Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Service Codes Guarantors/Payors Posting/Adjustment Codes Definition Financial Eligibility Client Charge Input Self Pay Payment Redistribution Registry Settings (CWS) Deposit Entry Scenario 1: Self Pay Payment Redistribution includes System Financial Class of Self Pay Specific Setup: Service Codes: Identify an existing 'prepayment' service code or create a new service code. Posting/Adjustment Codes Definition: An existing payment posting code (credit) is identified and posting code also has a reversal posting code associated to it to be used for the 'Self Pay Payment Redistribution' process. Select 'Yes' for the 'Include in Self Pay Redistribution Payment Process' field. Registry Settings: Set the 'Limit Registry Settings to the Following Search Criteria' : Pre Payment Service Code. Set the Pre Payment Service Code Registry Setting Value: Service Code identified or created above. Set the 'Limit Registry Settings to the Following Search Criteria' : Self Pay Payment redistribution. Set the 'Self Pay Payment Redistribution Posting Code' Registry Setting Value: Posting Code identified above. Guarantors/Payors: Add or identify a guarantor with the 'Self Pay' financial class. Add a new guarantor with the new financial class added through dictionary update given below. Dictionary Update: File - Payor Data Element - (1000) Financial Class Dictionary Code - The dictionary code for the financial class of the guarantor identified above to be used as secondary guarantor. Extended Dictionary Data Element - (1500) System Financial Class Extended Dictionary Value - Self Pay. Admission: Two new clients are admitted, or existing clients are identified. Note the client id, admission date and admission program. Financial Eligibility: Client 1: Assigned a Primary third party guarantor where the benefit plan includes a co-insurance amount. Assigned self-pay guarantor defined above (with the 'Self Pay' financial class). Client 2: Assigned a Primary third party guarantor where the benefit plan includes a co-insurance amount. Assigned new guarantor defined above (with the new financial class defined above that has a system financial class of self-pay). Client Charge Input: Services are rendered to the clients. Note the service date and service code. Steps Open the “Registry Settings” form. Set the 'Limit Registry Settings' to 'Self Pay Payment Redistribution'. Click [Yes] in 'Include Hidden Registry Settings'. Click [View Registry Settings]. Select 'Include Guarantors with Self Pay System Financial Class Registry Setting Value: N' item. Validate the message displayed : 'When set to 'Y', the 'Self Pay Payment Redistribution' process will consider guarantors that have a Financial Class value where the System Financial Class is set to Self Pay. When 'N' is selected, only text contains 'When set to 'Y', the 'Self Pay Payment Redistribution' process will consider guarantors that have a Financial Class value where the System Financial Class is set to Self Pay. When 'N' is selected, only guarantors with a base Financial Class of Self Pay will be considered during the 'Self Pay Payment Redistribution' process. This is the default behavior of the system'. Click [OK]. Set the 'Registry Setting Value' to 'N'. Click [Submit]. Validate the message displays: 'Include Guarantors with Self Pay System Financial Class Successful filing in 'xx'. Validate the form return dialog contains [Yes] [No]. Click [No]. Open the “Self Pay Payment Redistribution” form. Click [Individual] in 'All Or Individual Client'. Enter 'Client 1' created in setup in 'Client ID'. Click [Run Self Pay Payment Redistribution]. Validates the message displays: 'The process is complete for Client 1'. Click [OK]. Click [Discard]. Validate that Confirm Close dialog message displays: 'Are you sure you want to close without saving? [Yes] [No].' Click [Yes]. Open the "Client Ledger" form. Enter 'Client 1' created in setup in 'Client ID'. Click [All Episodes] in 'Claim/Episode/All Episodes'. Click [Simple] in 'Ledger Type'. Click [Process]. Validate in the report if 'self pay amount paid using the service code created in setup has now been applied to each of the individual services for the self-pay guarantor and that each self-pay guarantor has a zero line balance'. Click [X]. Click [No]. Repeat Steps 13 - 29 for 'Client 2' from setup. Repeat Steps 1- 12 with the 'Registry Setting Value Y' Repeat Steps 13-26 for 'Client 2' from setup. Validate in the report if 'self pay amount paid using the service code created in setup has now been applied to each of the individual services for the self-pay guarantor and that each self-pay guarantor has a zero line balance'. Open “Client Charge Input” form. Enter any value in 'Date Of Service'. Enter 'Client 1' created in setup in 'Client ID'. Enter any valid 'Service Code' in 'Service Code'. Enter any valid 'Practitioner' in 'Practitioner'. Click [Submit]. Enter any valid 'Service Code' in 'Service Code'. Click [Submit]. Close the form. Open "Deposit Entry" form. Click [Y] in 'Date Of Receipt Or Adjustment'. Enter 'Client 1' created in setup in 'Client ID'. Select any Episode # from 'Episode Number'. Enter the Service Code created in setup in 'Service Code'. Select appropriate Guarantor from 'Guarantor'. Enter any value in 'Amount To Post'. Select Posting Code created in setup from 'Posting Code'. Click [Submit]. Validate the report displays: 'Deposit Amount'. Click [Close Report]. Repeat Steps 13-29.	Topics • Self Pay Payment Redistribution
Update 70 Summary \| Details AR Roll Forward Report Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: AR Roll Forward Report Client Charge Input Scenario 1: AR Roll Forward Report Specific Setup: User Definition has been used to give the tester access to the report and table: Report = Avatar PM->Billing->AR Management->AR Roll Forward Report. Table = SYSTEM.ar_roll_forward_rpt. Refresh the forms. Clients: Client 1 has an outstanding balance, with all services being at least 90 days old. Use the Client Ledger' to run a report for the client and save the report. Client 2 has no services. Use the Client Ledger' to verify that the client has no services. Steps Open the "AR Roll Forward Report" form. Validate that the form opened in the 'AR Roll Forward Compile' section. Enter desired date in 'Accounting Period End Date' that is two months in the past. Note that the date will default to the last day of the month/year entered. Select desired value in 'Data Export Format'. If 'No' is selected, data is prepared in a Crystal report. If 'Yes' is selected, is prepared in a Crystal report which can be exported Click [Compile] and [OK]. A message is received that the report will run in the background. You can exit the form or log out of the system while the form is running in the background as the length of time varies based on the number of active clients. Once completed, you can reopen the 'AR Roll Forward Report' to view the report. Click the 'AR Roll Forward Report' section. Click [Run Report]. The report opens and contains: 'Print Report' and 'Export' buttons. A left side panel that lists each client in the report. The body of the report contains data for the clients and may be more than one page. Click [Print Report]. The report opens as a .pdf file. Click [Export]. Select the desired format. Click [OK] to generate the export or [Cancel] to cancel the selection. If [OK] was clicked the report will open in the desired format and can be saved. If [Cancel] was clicked the 'Print Report' and 'Export' buttons display again. Verify that the data for 'Client 1' is correct. Verify that 'Client 2' is not included in the report. Click [Close Report] to close the report. Click [Discard] and click [Yes]. Using a client charge input form enter a minimum of one service for 'Client 2' that is in the previous month, after the month the selected in the 'AR Roll Forward Report' created above. Open 'Client Ledger' and process the rep port for 'Client 2'. Verify that the client now has a balance due. Open the "AR Roll Forward Report" form. Enter desired date in 'Accounting Period End Date' that for the month of the service for 'Client 2'. Note that the date will default to the last day of the month/year entered. Select desired value in 'Data Export Format'. Click [Compile] and [OK]. A message is received that the report will run in the background. You can exit the form or log out of the system while the form is running in the background as the length of time varies based on the number of active clients. Once completed, you can reopen the 'AR Roll Forward Report' to view the report. Click the 'AR Roll Forward Report' section. Click [Run Report]. Verify that the data for 'Client 1' is still correct because no services, payments, adjustments, or transfers were added. Verify that the data for 'Client 2' is correct. Click [Close Report] to close the report. Click [Discard] and click [Yes]. If desired, query the 'SYSTEM.ar_roll_forward_rpt' table specific to a client in the report using the 'PATID'. Validate the data in the following fields: EPISODE_NUMBER; FACILITY; ID; PATID; account_balance; admission_date; patient_name; patient_type; prior_account_balance; prior_account_balance; total_adjustments; total_charges; and total_payments. Close the query.	Topics • AR Roll Forward Report
Update 72 Summary \| Details Remittance Processing Widget Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Remittance Processing Widget Scenario 1: NTST_Remittance_Processing Widget - Installation Specific Setup: Registry Settings: Set the 'Limit Registry Settings to the Following Search Criteria': Enable Payment Acknowledgement Set the 'Enable Payment Acknowledgement' Registry Setting Value: Y. Set the 'Limit Registry Settings to the Following Search Criteria': Prevent Posting Payments Unless Payment Set the 'Prevent Posting Payments Unless Payment' Registry Setting Value:7. User Definition: Note the current home view for the logged in user. Posting/Adjustment Codes Definition: Existing posting code(s) are identified to be used for Payment, Adjustment, and Transfer. Admission: Client 1: An existing client is identified, or a new client is admitted. Note the client's id/name, episode number, and admission program. Guarantors/Payors: Guarantors are identified, or new guarantors are created to be assigned to the client. Note the guarantor's code/name. Financial Eligibility: The guarantors identified above are assigned to the client. Recurring Client Charge Input: 5-6 services are rendered to the client. Note the service start/ end date and service code used. Steps Open the "View Definition" form. Select the home view identified in the setup section. Click [Launch View Designer]. Search for the NTST_ Remittance_Processing widget in the list of Available Widgets under the 'Billing' --> 'Remittance Processing'. Select NTST_Remittance_Processing widget from 'Available Widgets'. Click [>] to move NTST_Remittance_Processing widget to 'Assigned Widgets'. Configure the home view to include the widget. Click [Submit]. Click [Submit] in View Definition form to save the widget. Validate that the Form Return dialog contains 'Form Return View Definition has completed.' Click [No]. Click [My Activity]. Please note: It is located in the top right corner. Select 'VIEW/ADD WIDGETS'. Click [Reload View]. Validate that the Confirm Reload dialog contains 'Confirm Reload: Are you sure you want to discard current changes and reload layout from the server?'. Click [Yes]. Review the home view. Open "Registry Settings" form. Set the 'Limit Registry Settings to the Following Search Criteria': Prevent Posting Payments Unless Payment Set the 'Prevent Posting Payments Unless Payment' Registry Setting Value:1&3&5. Validate the registry setting text area. Click [Submit]. Validate the message 'Successfully filing in the system'. Click [OK]. Verify the NTST_ Remittance_Processing widget is included in the home view. Click [Create] in 'Action For Batch'. Enter any value in 'Description'. Select any value from 'Default Payment Code'. Select any value from 'Default Adjustment Code'. Select any value from 'Default Transfer Code'. Select any date in 'Receipt Date'. Select any date in 'Deposit Date'. Select any date in 'Posting Date'. Click [Remittance Details]. Click [Add Row]. Enter 'Client 1' created in setup. Select appropriate Guarantor assigned to Client 1 in 'Guar ID'. In any of Service Rows, enter any payment amount in 'Pmt amt' . Validate the 'Pmt Code' defaults to default Payment Code selected in above batch. Enter any Adjustment Amount in 'Adj amt'. Validate the 'Adj Code' defaults to default Adjustment Code selected in above batch. Enter any Transfer Amount in 'Xfr amt'. Validate the 'Xfr Code' defaults to default Transfer Code selected in above batch. Select any Guarantor in 'Xfr to Guar'. Click [Save and Exit]. Validate the dialog contains 'Remittance Batch Saved'. Click [OK]. Click [Yes] in 'Remittance Ready To Post'. Click [Post Batch]. Validate the message 'Remittance batch posted. Number of transactions: 1'. Click [OK].	Topics • Widgets • Remittance Processing
Update 76 Summary \| Details 'ClientAdmisison' web service Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Pre Admit SOAPUI - ClientAdmission - UpdateAdmission Scenario 1: The 'ClientAdmission' - 'UpdateAdmission' web service: Change a Pre-Admission Program to an Outpatient Program Specific Setup: A client must be enrolled in an existing pre-admit episode (Client A). The 'Allow Admission To File/Edit Pre-Admits' registry setting must be set to "Y". The 'Duplicate Date/Time Checking' registry setting must be set to "Y". The 'Enable Program Search' registry setting must be set to "1". An outpatient program must be defined in the 'Program Maintenance' form. Steps Access SoapUI for the 'ClientAdmission' - 'UpdateAdmission' web service, Enter the system code that will be used to access Avatar in the 'SystemCode' field. Enter the user name that will be used to access Avatar in the 'UserName' field. Enter the password that will be used to access Avatar in the 'Password' field. Enter the desired date in the 'AdmissionDate' field. Enter the desired time in the 'AdmissionTime' field. Enter the desired practitioner in the 'AdmittingPractitioner' field. Enter the desired practitioner in the 'AttendingPractitioner' field. Enter "Client A's" name in the format of LAST,FIRST in the 'ClientName' field. Enter "Client A's" existing episode number in the 'EpisodeNumber' field. Enter the desired outpatient program in the 'Program' field. Enter the desired value in the 'SocialSecurityNumber' field. Enter the desired value in the 'TypeOfAdmission' field. Enter "Client A's" ID in the 'ClientID' field. Enter "Client A's" existing episode in the 'Episode' field. Populate any other desired fields. Click [Run]. Validate the 'Confirmation' field contains "Client Unique ID : # Episode Number : #". Validate the 'Message' field contains "Client Admission web service has been filed successfully. Validate the 'Status' field contains "1". Select "Client A" and access the 'Admission' form. Select the existing episode and click [Edit]. Validate the 'Client Name' field contains "Client A's" name. Validate the 'Preadmit/Admission Date' field contains the date entered in the previous steps. Validate the 'Preadmit/Admission Time' field contains the time entered in the previous steps. Validate the 'Program' field contains the outpatient program entered in the previous steps. Validate the 'Type of Admission' field contains the value entered in the previous steps. Validate the 'Admitting Practitioner' field contains the practitioner entered in the previous steps. Validate the 'Attending Practitioner' field contains the practitioner entered in the previous steps. Validate the 'Social Security Number' field contains the value entered in the previous steps. Validate all other filed data displays as expected. Click [Submit]. Scenario 2: The 'ClientAdmission' - 'UpdateAdmission' web service: Change a Pre-Admission Program to an Inpatient Program Specific Setup: A client must be enrolled in an existing pre-admit episode (Client A). The 'Allow Admission To File/Edit Pre-Admits' registry setting must be set to "Y". The 'Duplicate Date/Time Checking' registry setting must be set to "Y". The 'Enable Program Search' registry setting must be set to "1". An inpatient program must be defined in the 'Program Maintenance' form. Units, beds, and rooms must be defined. Steps Access SoapUI for the 'ClientAdmission' - 'UpdateAdmission' web service, Enter the system code that will be used to access Avatar in the 'SystemCode' field. Enter the user name that will be used to access Avatar in the 'UserName' field. Enter the password that will be used to access Avatar in the 'Password' field. Enter the desired date in the 'AdmissionDate' field. Enter the desired time in the 'AdmissionTime' field. Enter the desired practitioner in the 'AdmittingPractitioner' field. Enter the desired practitioner in the 'AttendingPractitioner' field. Enter the desired value in the 'Bed' field. Enter "Client A's" name in the format of LAST,FIRST in the 'ClientName' field. Enter "Client A's" existing episode number in the 'EpisodeNumber' field. Enter the desired inpatient program in the 'Program' field. Enter the desired room in the 'Room' field. Enter the desired value in the 'RoomAndBoardBillingCode' field. Enter the desired value in the 'SocialSecurityNumber' field. Enter the desired value in the 'TypeOfAdmission' field. Enter the desired value in the 'SourceOfAdmission' field. Enter the desired unit in the 'Unit' field. Enter "Client A's" ID in the 'ClientID' field. Enter "Client A's" existing episode in the 'Episode' field. Populate any other desired fields. Click [Run]. Validate the 'Confirmation' field contains "Client Unique ID : # Episode Number : #". Validate the 'Message' field contains "Client Admission web service has been filed successfully. Validate the 'Status' field contains "1". Select "Client A" and access the 'Admission' form. Select the existing episode and click [Edit]. Validate the 'Client Name' field contains "Client A's" name. Validate the 'Preadmit/Admission Date' field contains the date entered in the previous steps. Validate the 'Preadmit/Admission Time' field contains the time entered in the previous steps. Validate the 'Program' field contains the inpatient program entered in the previous steps. Validate the 'Type of Admission' field contains the value entered in the previous steps. Validate the 'Source of Admission' field contains the value entered in the previous steps. Validate the 'Admitting Practitioner' field contains the practitioner entered in the previous steps. Validate the 'Attending Practitioner' field contains the practitioner entered in the previous steps. Validate the 'Social Security Number' field contains the value entered in the previous steps. Select the "Inpatient/Partial/Day Treatment" section. Validate the 'Unit' field contains the unit entered in the previous steps. Validate the 'Room' field contains the room entered in the previous steps. Validate the 'Bed' field contains the bed entered in the previous steps. Validate the 'Room And Board Billing Code' field contains the value entered in the previous steps. Validate all other filed data displays as expected. Click [Submit]. Scenario 3: The 'ClientAdmission' - 'UpdateAdmission' web service: Change a Pre-Admission Program to a Partial Hospitalization Program Specific Setup: A client must be enrolled in an existing pre-admit episode (Client A). The 'Allow Admission To File/Edit Pre-Admits' registry setting must be set to "Y". The 'Duplicate Date/Time Checking' registry setting must be set to "Y". The 'Enable Program Search' registry setting must be set to "1". A partial hospitalization program must be defined in the 'Program Maintenance' form. Steps Access SoapUI for the 'ClientAdmission' - 'UpdateAdmission' web service, Enter the system code that will be used to access Avatar in the 'SystemCode' field. Enter the user name that will be used to access Avatar in the 'UserName' field. Enter the password that will be used to access Avatar in the 'Password' field. Enter the desired date in the 'AdmissionDate' field. Enter the desired time in the 'AdmissionTime' field. Enter the desired practitioner in the 'AdmittingPractitioner' field. Enter the desired practitioner in the 'AttendingPractitioner' field. Enter "Client A's" name in the format of LAST,FIRST in the 'ClientName' field. Enter "Client A's" existing episode number in the 'EpisodeNumber' field. Enter the desired value in the 'PartialHospHours' field. Enter the desired value in the 'PartialHospBillingCode' field. Enter the desired value in the 'PartialHospDays' field. Enter the desired value in the 'PartialHospEffectiveDate' field. Enter the desired partial hospitalization program in the 'Program' field. Enter the desired value in the 'SocialSecurityNumber' field. Enter the desired value in the 'TypeOfAdmission' field. Enter the desired value in the 'SourceOfAdmission' field. Enter "Client A's" ID in the 'ClientID' field. Enter "Client A's" existing episode in the 'Episode' field. Populate any other desired fields. Click [Run]. Validate the 'Confirmation' field contains "Client Unique ID : # Episode Number : #". Validate the 'Message' field contains "Client Admission web service has been filed successfully. Validate the 'Status' field contains "1". Select "Client A" and access the 'Admission' form. Select the existing episode and click [Edit]. Validate the 'Client Name' field contains "Client A's" name. Validate the 'Preadmit/Admission Date' field contains the date entered in the previous steps. Validate the 'Preadmit/Admission Time' field contains the time entered in the previous steps. Validate the 'Program' field contains the partial hospitalization program entered in the previous steps. Validate the 'Type of Admission' field contains the value entered in the previous steps. Validate the 'Source of Admission' field contains the value entered in the previous steps. Validate the 'Admitting Practitioner' field contains the practitioner entered in the previous steps. Validate the 'Attending Practitioner' field contains the practitioner entered in the previous steps. Validate the 'Social Security Number' field contains the value entered in the previous steps. Select the "Inpatient/Partial/Day Treatment" section. Validate the 'Partial Hospitalization Days' field contains the value entered in the previous steps. Validate the 'Partial Hospitalization Effective Date' field contains the value entered in the previous steps. Validate the 'Partial Hospital Billing Code' field contains the value entered in the previous steps. Validate the 'Partial Hospitalization Hours' field contains the value entered in the previous steps. Validate all other filed data displays as expected. Click [Submit].	Topics • Pre Admit • Web Services • Admission
Update 77 Summary \| Details Registry Settings Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Service Codes Client Charge Input File Import Scenario 1: Registry Setting = Unit Calculation with Minimum Duration - Client Charge Input. Specific Setup: Registry Settings: Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'. Set the 'Registry Setting Value' to 'Y'. Client 1: Identify an existing client or create a new client (Client 1). Note the client’s admission date. Service Code: ‘An existing service code (Service Code 1) is identified that has a value defined for the 'Minimum Duration for Unit Calculation' field. Steps Open "Client Charge Input" form. Enter any value in 'Date Of Service'. Enter 'Client 1' created in setup in 'Client ID'. Enter 'Service Code 1' in 'Service Code'. Enter any value in 'Practitioner'. Enter any value in 'Duration' that is below the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form. Click [Submit]. Click [No]. Open "Client Ledger" form. Enter 'Client 1' created in setup in 'Client ID'. Click [All Episodes] in 'Claim/Episode/All Episodes'. Click [Simple] in 'Ledger Type'. Click [Yes] in 'Include Zero Charges'. Click [Process]. Validate the Client Ledger. Click [X]. Click [No]. Repeat Steps 1-17 with value in Duration greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form. Open the "Registry Settings" form. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'. Set the 'Registry Setting Value' to 'YE'. Repeat Steps 1-6. Validate the error message displayed: 'The service [Service Code 1] does not meet the minimum duration requirements for unit calculation and cannot be filed. A unit will only be calculated once the duration is at least X minutes. Click [OK]. Enter any value in 'Duration' that is greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form. Click [Submit]. Repeat Steps 9-17. Open the "Registry Settings" form. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'. Set the 'Registry Setting Value' to 'YW'. Repeat Steps1-6. Validate the error message displayed: 'The service [Service Code 1] does not meet the minimum duration requirements for unit calculation. A unit will only be calculated once the duration is at least X minutes. Click [OK]. Enter any value in 'Duration' that is greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form. Click [Submit]. Repeat Steps 9-17 to validate Client Ledger. Scenario 2: File Import - Client Charge Input Specific Setup: Registry Settings : Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'. Set the 'Registry Setting Value' to : 'Y'. Service Code: ‘An existing service code is identified that has a value defined for the 'Minimum Duration for Unit Calculation' field (Service Code 1). File Import: Create an import file with Duration in Client Charge Input less than the 'Minimum Duration for Unit Calculation' field in service codes form -"File A". Create an import file with Duration in Client Charge Input more than the 'Minimum Duration for Unit Calculation' field in service codes form -"File B". Client 1: Identify an existing client or create a new client (Client 1). Note the client’s admission date. Steps Open the "File Import" form. Select "Client Charge Input" in the 'File Type'. Select "Upload New File" in the 'Action'. Click [Process Action]. Select "File A". Select "Compile/Validate File" in the 'Action'. Select "File A" in the 'Files(s)'. Click [Process Action]. Select "File A". Select "Compile/Validate File" in the 'Action'. Select "File A" in the 'Files(s)'. Click [Process Action]. Validate the message = 'Compiled'. Click [OK]. Select "Print File" in the 'Action'. Select "File A" in the 'Files(s)'. Click [Process Action]. Validate the report data. Click [Close Report]. Select "Post File" in the 'Action' field. Select "File A" in the 'Files(s)' field. Click [Process Action]. Validate the message = 'Posted'. Click [OK]. Click [Discard] Click [Yes]. Open ''Client Ledger'' form. Enter the Client ID. Click [All Episodes] in 'Claim/Episode/All Episodes'. Click [Simple] in 'Ledger Type'. Click [Yes] in 'Include Zero Charges'. Click [Process]. Validate the report data. Click [X]. Click [No]. Repeat Steps 7- 41 using "File B". Open the "Registry Settings" form. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'. Set the 'Registry Setting Value' to : 'YW'. Repeat Steps 1-42. Open the "Registry Settings" form. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'. Set the 'Registry Setting Value' to : 'YE'. Repeat Steps 1-18. Validate the error message: File A contains one or more errors. These errors can be reviewed using 'Print Errors' action. Click [OK]. Select "Print Errors" in the 'Action'. Select "File A" in the 'Files(s)'. Click [Process Action]. Validate the report shows 'The service [Service Code 1] does not meet the minimum duration requirements for unit calculation and cannot be filed. A unit will only be calculated once the duration is at least X minutes.'. Click [Close Report]. Select "Delete File" in the 'Action'. Select "File A" in the 'Files(s)' field. Click [Process Action]. Click [Yes]. Click [OK]. Repeat Steps 3- 26 using "File B". Scenario 3: Registry Setting = Unit Calculation with Minimum Duration - Edit Service Information Specific Setup: Registry Settings: Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'. Set the 'Registry Setting Value' to 'Y'. Client 1: Identify an existing client or create a new client (Client 1). Note the client’s admission date. Service Code: ‘An existing service code is identified that has a value defined for the 'Minimum Duration for Unit Calculation' field (Service Code 1). Steps Open "Edit Service Information" Form. Enter 'Client 1' in 'Client ID'. Click [Select Service(s) To Edit]. Select desired service. Click [OK]. Enter any value in 'Duration' that is below the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form. Click [Submit]. Click [No]. Open "Client Ledger" form. Enter 'Client 1' in 'Client ID'. Click [All Episodes] in 'Claim/Episode/All Episodes'. Click [Simple] in 'Ledger Type'. Click [Yes] in 'Include Zero Charges'. Click [Process]. Validate the Client Ledger. Click [X]. Click [Yes]. Click [Discard]. Repeat Steps 1-18, with value in Duration greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form. Open the "Registry Settings" form. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'. Set the 'Registry Setting Value' to 'YW'. Repeat Steps 1-18. Open the "Registry Settings" form. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'. Set the 'Registry Setting Value' to 'YE'. Repeat Steps1-6. Validate the error message: The service [Service Code 1] does not meet the minimum duration requirements for unit calculation and cannot be filed. A unit will only be calculated once the duration is at least X minutes. Enter any value in Duration greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form. Click [Submit]. Click [No]. Repeat Steps 9-18 to validate Client Ledger. Scenario 4: Client Charge Input via WEBSVC ClientChargeInput Specific Setup: Registry Settings: Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'. Set the 'Registry Setting Value' to : 'YE'. Client 1: Identify an existing client or create a new client (Client 1). Note the client’s admission date. Service Code: ‘An existing service code is identified that has a value defined for the 'Minimum Duration for Unit Calculation' field (Service Code 1). Steps Using desired web service tool, create a request for 'WEBSVC ClientChargeInput'. Enter the System Code in 'System Code' Field. Enter the user name in the 'User Name' field. Enter the password in the 'Password' field. Enter any value in 'ClientID'. Enter any value in 'Date of Service'. Enter value in 'Duration' less than Minimum Duration for Unit Calculation in Service Codes form. Enter any value in 'Episode Number'. Enter any value in 'Location'. Enter any value in 'Practitioner'. Enter any value in 'Program'. Enter any Value in 'Service Code'. Click[Run]. Verify Response :'Duration (Minutes) : The service [test code (1121)] does not meet the minimum duration requirements for unit calculation and cannot be filed. A unit will only be calculated once the duration is at least 20 minutes'. Enter value in 'Duration' greater than Minimum Duration for Unit Calculation in Service Codes form. Click[Run]. Verify Response :Client Charge Input web service has been filed successfully. Open "Client Ledger" form. Enter the 'Client ID'. Click [All Episodes] in 'Claim/Episode/All Episodes'. Click [Simple] in 'Ledger Type'. Click [Yes] in 'Include Zero Charges'. Click [Process]. Validate the Client Ledger. Click [X]. Click [Yes]. Click [Discard]. Open the "Registry Settings" form. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'. Set the 'Registry Setting Value' to : 'Y'. Repeat Steps 7- 33. Open the "Registry Settings" form. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'. Set the 'Registry Setting Value' to : 'YW'. Repeat Steps 7- 33.	Topics • Registry Settings • Service Codes • Client Charge Input • File Import • Edit Service Information
Update 80 Summary \| Details Payment by Posting Date Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Remittance Processing Widget Payment by Posting Date Scenario 1: Remittance Processing widget - Creating / Saving / Editing / Posting a remittance batch - Unclaimed services Specific Setup: Home View: The 'Remittance Processing' widget is added in the home view. Registry Setting: The registry setting ‘Prevent Posting Payments Unless Payment has been Acknowledged’ does not include the value ‘7’. Posting/Adjustment Codes Definition: Existing posting code(s) are identified to be used for Payment, Adjustment, and Transfer. Admission: An existing client is identified, or a new client is admitted. Note the client's id/name, episode number, and admission program. Client A. Guarantors/Payors: Guarantors are identified, or new guarantors are created to be assigned to the client. Note the guarantor's code/name. Guarantor 1 Guarantor 2 Financial Eligibility: The guarantors identified above are assigned to the client. Recurring Client Charge Input: 5-6 services are rendered to the client. Note the service start/ end date and service code used. The charges are closed. Client Ledger: The services are distributed to the guarantor assigned to the client in the financial eligibility record. Steps Open 'Client Ledger'. Run the ledger for 'Client A'. Verify that there are services charged and they are closed. Close the report. Select [No]. Locate the 'Remittance Processing' widget on the home view. Select 'Create Batch' in the 'Action for Batch' field. Enter a description in the 'Description' field. Note the batch description. Enter the desired date in the 'Posting Date' field. Enter the desired date in the 'Receipt Date' field. Enter the desired date in the 'Deposit Date' field. Leave the 'Check/EFT Number' field blank. Enter any desired value in the 'Receipt Number' within the below condition: Only Alphabets. Select all other fields as required. Navigate to the 'Remittance Details' section. Click [Add Row]. Enter 'Client A' in the 'Client' cell. Verify that the system displays all the matching clients. Select 'Client A' from the results. Double-click the 'GuarID#' cell. System displays all the available guarantors of the client. Select 'Guarantor 1'. If the client has 'Claimed' services then search any particular claim number and verify the system returns only the searched 'Claim Number'. If the client has 'Unclaimed' services then the result will be returned as 'No matches found, please refine search.' Verify the 'Start Date' and 'End Date' are auto-populated with the start and end date of the services rendered to the client. Select the desired date of service to post the payment for the service. Enter the desired amount in the 'Pmt Amt' field. Select the desired code in the 'Pmt Code' field. Enter the desired amount in the 'Adj Amt' field. Select the desired code in the 'Adj Code' field. Enter the desired amount in the 'xfr Amt' field. Select the desired code in the 'xfr Code' field. Select the desired guarantor in the 'xfer to Guar' field. Click [Save and Exit]. Click [OK]. Go to the 'Batch' section. Select 'Yes' in the 'Remittance Ready to Post'. Click [Post Batch]. Validate the successful posting message. Open the 'Crystal report' or any other SQL data viewer tool. Query the 'remittance_batch' table for 'Client A'. Validate the below in the table: Verify the 'ID' column displays the correct batch ID. Verify the 'batch_description' column displays the description of the batch created. Verify the 'deposit_date' column displays the correct deposit date as entered while creating the batch. Verify the 'receipt_date' column displays the correct deposit date as entered while creating the batch. Query the 'billing_pay_adj_history table for Client A'. Validate the table displays all the information including the below correctly for the posted batch: Verify the 'reciept_number' column displays the correct receipt number. Verify the 'check_number' column displays the correct receipt number. Verify the 'date_of_receipt' column displays the correct receipt date as entered while creating the batch. Verify the 'date_of_payment' column displays the correct posting date as entered while creating the batch. Repeat Steps 2 and 3 for 'Client A' for the below combination of value(s) for 'Check/EFT Number' and 'Receipt Number': Case 1: In step 2(f): Without any value entered in the 'Check/EFT Number' field. In step 2(g): With the value of Alphabet, Numbers, and Special characters. Example: "ALPHANUM123@". Case 2: In step 2(f): Without any value entered in the 'Check/EFT Number' field. In step 2(g): Without any value entered in the 'Receipt Number' field. Case 3: In step 2(f): With the value of Alphabet, Numbers, and Special characters. Example: "ALPHANUM123@". In step 2(g): Without any value entered in the 'Receipt Number' field. Case 4: In step 2(f): With the value of only Alphabets. Example: "ONLYALPHA". In step 2(g): Without any value entered in the 'Receipt Number' field.	Topics • Remittance Processing
2023 Update 108 Summary \| Details Financial Transaction Posting Summary Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Financial Transaction Posting Summary Report Scenario 1: 'Financial Transaction Posting Summary' Form - Field Validations. Specific Setup: Client A: A new client is admitted or an existing client is identified. User should have access to the new form 'Financial Transaction Posting Summary'. Steps Set the 'What can I help you find?' input box to “Financial” and click the “Financial Transaction Posting Summary” from the list. Validate that the 'Type of Date' text contains “Type of Date.” Validate that the 'Type of Date' text is required. Validate that the '1st Accounting Period End Date - Type of Date' label contains “Accounting Period End Date” and is not disabled. Validate that the '3rd Accounting Period End Date - Type of Date' text is not selected. Validate that the '2nd Posting Date - Type of Date' label contains “Posting Date” and is not disabled. Validate that the '2nd Posting Date - Type of Date' label is not selected. Validate that the '3rd Transaction Date - Type of Date' label contains “Transaction Date” and is not disabled. Validate that the '3rd Transaction Date - Type of Date' label is not selected. Click 'Accounting Period End Date - Type of Date'. Click 'Posting Date - Type of Date'. Click 'Transaction Date - Type of Date'. Validate that the 28th 'Start Date' text contains “Start Date” and is required. Enter any desired date from the past. Validate that the 'Start Date' date input box is populated with the entered date value. Enter any desired date from the future. Validate that the “‘Start Date’ does not allow future dates.” text is displayed. Click [OK]. Validate that the 'Start Date' date input box reverted to the last valid date value entered. Validate that the 3rd 'End Date' text contains “End Date” and is required. Enter any desired date that is greater than the 'Start Date' value. Validate that the 'End Date' date input box is populated with the entered date value. Enter any desired date that is lesser than the 'Start Date' value. Validate that the 'Start Date must be on or before End Date' text is displayed. Click [OK]. Validate that the 'End Date' date input box reverted to the last valid date value entered. Validate that the 'Use Data Export Format' text contains “Use Data Export Format” and is required. Validate that the 1st 'Yes - Use Data Export Format' label contains “Yes” and is not disabled. Validate that the 2nd 'No - Use Data Export Format' label contains “No” and is not disabled. Click 'Yes - Use Data Export Format'. Click 'No - Use Data Export Format'. Validate that the 11th 'Client ID' text contains “Client ID” and is not required. Validate that the 'Client ID' search input box is not disabled. Set the 'Client ID' search input box to “Client A” and select from the 'Client ID' list box. Validate that the 'Client ID' search input box contains “Client A” Validate that the 2nd 'Record Type' text contains “Record Type” and is not required. Validate that the 1st 'Adjustments - Record Type' label contains “Adjustments” and is not disabled. Validate that the 2nd 'Charges - Record Type' label contains “Charges” and is not disabled. Validate that the 3rd 'Payments - Record Type' label contains “Payments” and is not disabled. Validate that the 4th 'Transfers - Record Type' label contains “Transfers” and is not disabled. Click 1st 'Adjustments - Record Type'. Click 2nd 'Charges - Record Type'. Click 3rd 'Payments - Record Type'. Click 4th 'Transfers - Record Type'. Validate that the 4th 'Adjustments - Record Type' text is checked. Validate that the 5th 'Charges - Record Type' text is checked. Validate that the 6th 'Payments - Record Type' text is checked. Validate that the 7th 'Transfers - Record Type' text is checked. Verify that the 'Run Compile' button exists and is not disabled. Verify that the 'Run Report' button exists and is not disabled. Click [Run Report]. Validate that the “No compiles found.” text is displayed. Click [OK]. Click [Discard]. Validate that the “Nx Yes No Dialog Body” text contains “Are you sure you want to Close without saving?” Click [Yes] and verify that the 'What can I help you find?' input box exists. Financial Transaction Posting Summary - Run Compile Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Financial Transaction Posting Summary Report Financial Transaction Posting Summary - Popup Scenario 1: 'Financial Transaction Posting Summary Report' - Compile report. Specific Setup: Client A: Client is admitted to any desired program. The client has an active diagnosis and financial eligibility records. Financial eligibility has more than one guarantor. (Here we add three) Guarantor 1 Guarantor 2 Guarantor 3 Charges: Ten different charges are created for "Client A" for the different services and dates. Using any one of the posting forms, multiple Payments, Adjustments, and Transfers are made for "Client A". Steps Set the 'What can I help you find?' input box to “Financial” and click “Financial Transaction Posting Summary” from the list. Click [Run Compile] Validate that the text contains “The following fields are required:Type of DateStart DateEnd DateUse Data Export Format”. Click "Accounting Period End Date" in 'Type of Date'. Enter desired values in 'Start Date' and 'End Date'. Click "No" in 'Use Data Export Format'. Enter "Client A" in 'Client ID' and select the desired value in the search results. Validate that the 1st 'Adjustments - Record Type' checkbox is not checked Validate the 2nd 'Charges - Record Type' checkbox is not checked Validate the 3rd 'Payments - Record Type' checkbox is not checked Validate the 4th 'Transfers - Record Type' checkbox is not checked. Click [Run Compile] and validate that the label contains “Compile started". Click [Run Report] Validate that the generated report contains a header, and additional report information specific to the compiled data, and that the column ‘Accounting Period’ is shown in the report. Click [Close Report]. Open the SQL querying tool and run the following query, “SELECT * FROM “SYSTEM”.fin_tran_post_summ_rpt;” Validate that there are records showing in the table Validate column “PATID” has the value of “Client A” Validate column “accounting_period” contains values for all rows and the values are within the Start and End dates entered in the form. Close the SQL window and return to the ‘Financial Transaction Posting Summary’ form. Click "Posting Date" in 'Type of Date'. Enter desired values in 'Start Date' and 'End Date'. Click "Yes" in 'Use Data Export Format'. Enter "Client A" in 'Client ID' and select the desired value in the search results. Click the '3rd Payments - Record Type' checkbox Validate that the 1st 'Adjustments - Record Type' checkbox is not checked Validate the 2nd 'Charges - Record Type' checkbox is not checked Validate the 4th 'Transfers - Record Type' checkbox is not checked. Click [Run Compile] and validate that the label contains "Compile started". Click [Run Report]. Validate that the Crystal Report page contains the compiled content. Validate that the records are grouped by the service code in the report. Validate that the report shows the ‘Record Type(s)’ selected as ‘Transfers’. Click [Close Report]. Open the SQL querying tool and run the specified query. Validate that the column “PATID” contains “Client A”. Validate that the column “transaction_date” contains values for all the rows and the values are within the entered Start and End date range in the form. Click "Transaction Date" in 'Type of Date'. Enter desired values in 'Start Date' and 'End Date'. Click "No" in 'Use Data Export Format'. Leave the 'Client ID' empty. Click 4th 'Transfers - Record Type'. Validate the 1st 'Adjustments - Record Type' checkbox is not checked. Validate the 2nd 'Charges - Record Type' checkbox is not checked. Validate the 3rd 'Payments - Record Type' checkbox is not checked. Validate the 4th 'Transfers - Record Type' checkbox is not checked. Click [Run Compile]. Validate the label contains “Compile started”. Click [OK]. Click [Run Report]. Validate the text about the compile status exists. Click [OK]. Validate that the Crystal Report page contains the compiled content. Validate that the report shows the ‘Record Type(s)’ selected as "Adjustments, Charges, Payments, Transfers". Validate the records are grouped by the service code in the report. Click [Export]. Select “Microsoft Excel (XLS)” from the Format Options dropdown list. Click [OK]. Click [Close Report]. Open the exported .xls file and validate the compiled records with the header and additional report-specific data. Open the SQL querying tool and run the specified query. Validate there are records showing in the table. Validate that the column “PATID” includes all other client IDs including "Client A". Validate that the column “transaction_date” values are within the form's entered Start and End dates. Click [Discard]. Click [Yes]. Verify that the What can I help you find? input box exists. Financial Transaction Posting Summary - Run Report Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Financial Transaction Posting Summary Report Financial Transaction Posting Summary - Popup Scenario 1: 'Financial Transaction Posting Summary Report' - Compile report. Specific Setup: Client A: Client is admitted to any desired program. The client has an active diagnosis and financial eligibility records. Financial eligibility has more than one guarantor. (Here we add three) Guarantor 1 Guarantor 2 Guarantor 3 Charges: Ten different charges are created for "Client A" for the different services and dates. Using any one of the posting forms, multiple Payments, Adjustments, and Transfers are made for "Client A". Steps Set the 'What can I help you find?' input box to “Financial” and click “Financial Transaction Posting Summary” from the list. Click [Run Compile] Validate that the text contains “The following fields are required:Type of DateStart DateEnd DateUse Data Export Format”. Click "Accounting Period End Date" in 'Type of Date'. Enter desired values in 'Start Date' and 'End Date'. Click "No" in 'Use Data Export Format'. Enter "Client A" in 'Client ID' and select the desired value in the search results. Validate that the 1st 'Adjustments - Record Type' checkbox is not checked Validate the 2nd 'Charges - Record Type' checkbox is not checked Validate the 3rd 'Payments - Record Type' checkbox is not checked Validate the 4th 'Transfers - Record Type' checkbox is not checked. Click [Run Compile] and validate that the label contains “Compile started". Click [Run Report] Validate that the generated report contains a header, and additional report information specific to the compiled data, and that the column ‘Accounting Period’ is shown in the report. Click [Close Report]. Open the SQL querying tool and run the following query, “SELECT * FROM “SYSTEM”.fin_tran_post_summ_rpt;” Validate that there are records showing in the table Validate column “PATID” has the value of “Client A” Validate column “accounting_period” contains values for all rows and the values are within the Start and End dates entered in the form. Close the SQL window and return to the ‘Financial Transaction Posting Summary’ form. Click "Posting Date" in 'Type of Date'. Enter desired values in 'Start Date' and 'End Date'. Click "Yes" in 'Use Data Export Format'. Enter "Client A" in 'Client ID' and select the desired value in the search results. Click the '3rd Payments - Record Type' checkbox Validate that the 1st 'Adjustments - Record Type' checkbox is not checked Validate the 2nd 'Charges - Record Type' checkbox is not checked Validate the 4th 'Transfers - Record Type' checkbox is not checked. Click [Run Compile] and validate that the label contains "Compile started". Click [Run Report]. Validate that the Crystal Report page contains the compiled content. Validate that the records are grouped by the service code in the report. Validate that the report shows the ‘Record Type(s)’ selected as ‘Transfers’. Click [Close Report]. Open the SQL querying tool and run the specified query. Validate that the column “PATID” contains “Client A”. Validate that the column “transaction_date” contains values for all the rows and the values are within the entered Start and End date range in the form. Click "Transaction Date" in 'Type of Date'. Enter desired values in 'Start Date' and 'End Date'. Click "No" in 'Use Data Export Format'. Leave the 'Client ID' empty. Click 4th 'Transfers - Record Type'. Validate the 1st 'Adjustments - Record Type' checkbox is not checked. Validate the 2nd 'Charges - Record Type' checkbox is not checked. Validate the 3rd 'Payments - Record Type' checkbox is not checked. Validate the 4th 'Transfers - Record Type' checkbox is not checked. Click [Run Compile]. Validate the label contains “Compile started”. Click [OK]. Click [Run Report]. Validate the text about the compile status exists. Click [OK]. Validate that the Crystal Report page contains the compiled content. Validate that the report shows the ‘Record Type(s)’ selected as "Adjustments, Charges, Payments, Transfers". Validate the records are grouped by the service code in the report. Click [Export]. Select “Microsoft Excel (XLS)” from the Format Options dropdown list. Click [OK]. Click [Close Report]. Open the exported .xls file and validate the compiled records with the header and additional report-specific data. Open the SQL querying tool and run the specified query. Validate there are records showing in the table. Validate that the column “PATID” includes all other client IDs including "Client A". Validate that the column “transaction_date” values are within the form's entered Start and End dates. Click [Discard]. Click [Yes]. Verify that the What can I help you find? input box exists.	Topics • Financial Transaction Posting Summary
2023 Update 160 Summary \| Details Roll-Up Services Definition - Bill component and roll-up services on one claim Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Roll-Up Services Definition Electronic Billing Compile/Edit/Post/Unpost Roll-Up Services Worklist Create Interim Billing Batch File Client Charge Input With Diagnosis Entry File Import Scenario 1: Roll-Up Services Definition - Form / Field Validation for new Fields Specific Setup: Service Codes: Service Code 1: Roll-Up service code. 'Type of 'Fee' = desired value. Minutes Per Unit = desired value. Note the service code/value, Minutes Per Unit, and 'Covered Charge Category' for the service code. Service Code 2: Component service code. 'Type of 'Fee' = desired value, Minutes Per Unit = desired value. Note the service. Service Fee/Cross Reference Maintenance: All service codes have a 'Fee', 'UB-04 Revenue Code', and/or 'CPT-4 / HCPCS Code' defined in 'Service Fee/Cross Reference Maintenance'. Note the fees. Steps Open 'Roll-Up Services Definition'. Select 'Add' in 'Add/Edit/Delete Roll-Up Services Definition'. Enter a 'Roll-Up Description'. Select a 'Roll-Up Service'. Select desired 'Component Services'. Select desired 'Required Component Service(s) for Roll-Up to Occur'. Select desired 'Component Service Date Rules'. Select desired value in 'Is This Roll-Up Services Dependent On Units, Duration, Or None'. Select desired 'Date Of Service For Roll-Up Service'. Enter data in the remaining required fields, noting the values. Validate that the 'Service Start Time For Roll-Up Service' field is available with the 'Time Of First Component Service' option to the 'Roll-Up Services Definition' form. Verify the 'Time Of First Component Service' option is unchecked in the 'Service Start Time For Roll-Up Service' field. Select the 'Time Of First Component Service' in the Service Start Time For Roll-Up Service' field. Verify the new field 'Bill Roll-Up Service, Component Service(s), or Both' exists and is enabled with the below options. Roll-Up Service. Component Services. Both. Verify that there is a help text shown when selecting the light bulb. Click the [Return To Form] link. Verify that the new field 'Force Component Service(s) and Roll-Up Service on the Same Claim' exists and is disabled with the below options. Yes. No. Select 'Roll-Up Service' in 'Bill Roll-Up Service, Component Service(s), or Both'. Verify that the 'Force Component Service(s) and Roll-Up Service on the Same Claim' field is disabled. Select 'Component Services' in 'Bill Roll-Up Service, Component Service(s), or Both'. Verify that the 'Force Component Service(s) and Roll-Up Service on the Same Claim' field is still disabled. Select 'Both' in 'Bill Roll-Up Service, Component Service(s), or Both'. Verify that now the 'Force Component Service(s) and Roll-Up Service on the Same Claim' field is enabled and required. Select 'Yes'. Click [Submit]. Click [Yes] to return to the form. Select 'Edit' in 'Add/Edit/Delete Roll-Up Services Definition'. Select the same definition. Verify the fields retained the submitted values. Click [Submit]. Click [No] to return to the form. Query the below SQL table and validate that the values added for the new fields are present in the table along with their associated values. SYSTEM.rollup_services_def Field 1 - bill_rollup_code, bill_rollup_value Field 2 - force_same_claim_code, force_same_claim_value Close the SQL window. Scenario 2: Validate the ability to bill component and roll-up services on Same and Different claim(s)-837 Professional. Specific Setup: Posting/Adjustment Code Definition: New code created, or an existing code is identified for the below type: Adjustment - "Adj Post Code 1" Service Codes: Using the 'Service Codes' form add or identify an individual roll-up service code and at least two service codes that will be considered as the component services for it. Rollup 1 Comp 1(a) Comp 1(b) Roll-Up Services Definition: Add or identify roll-up service definitions, for each of the roll-up service codes and its associated component services. Rollup Def 1 Rollup 1 Comp 1(a) Comp 1(b) Client A: The client is admitted to an outpatient program. The client has active Diagnosis and Financial Eligibility - (Guarantor 1) records. Make a note on the "Financial Class' of "Guarantor 1". The charges are created for the roll-up component services on various dates, for "Rollup 1". Guarantor/Program Billing Defaults: Add or identify a template, that includes the guarantor used in the Financial Eligibility record of 'Client A". Template 1 Steps Open 'Roll-Up Services Definition'. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 1" in 'Existing Roll-Up Definition'. Select 'Both' in the 'Bill Roll-Up Service, Component Service(s), or Both' field. Verify that the 'Force Component Service(s) and Roll-Up Service on the Same Claim' become enabled and required. Select 'Yes' in the 'Force Component Service(s) and Roll-Up Service on the Same Claim' field. Click [Submit]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the charges for the roll-up component services are displayed for "Client A". Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1" and select it. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for "Client A". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the worklist compiled in step 17. Select "Adj Post Code 1" in 'Default Write Off Posting Code'. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 1" was used for each of the component services. Verify that the roll-up service was created. Click [X]. Click [No]. Open 'Close Charges'. Select 'Close Charges' in 'Liability Update Or Close Charges'. Select the desired Thru Date that covers all the services of "Client A" that require closure. Select 'Individual'. Search and select "Client A" in 'Client ID'. Select the Episode. Click [Submit]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up service and verify that is closed and marked as 'UNBILL'. Click [X]. Click [No]. Open 'Create Interim Billing Batch File'. Select 'Create Batch'. Set the desired value in 'Batch Description'. Set the 'From Date' and 'Through Date' that cover the charges of "Client A". Select 'Yes' in 'Include Zero Charge Services'. Search and select "Client A" in 'Client ID'. Select the below values that are relevant to "Client A", noted in setup. Guarantor. Program. Service Codes. Practitioner. Click [Process]. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Professional'. Set the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field value to "1". Select 'Yes' in 'Include Zero Dollar Services'. Select 'No' in 'Suppress Claim Level Adjustments/Service Level Adjustments When Total Is Zero'. Click [Submit]. Click [No]. Open 'Electronic Billing'. Select '837-Professional' in 'Billing Form'. Select the financial class of "Guarantor 1" in 'Type Of Bill'. Select 'Individual' in 'Individual Or All Guarantors'. Select "Guarantor 1". Select 'Outpatient' in 'Billing Type'. Select 'Sort File' in 'Billing Options'. Set a desired value in 'File Description'. Select 'Interim Batch' in 'All Clients Or Interim Billing Batch'. Select the Interim Batch that is created above. Select 'No' in 'Create Claims'. Set the desired date values in 'First Date Of Service To Include' and 'Last Date Of Service To Include date' that includes the services we have for "Client A". Select 'All' in 'Include Primary and/or Secondary Billing'. Click [Process]. Click [OK]. Select 'Dump File' in 'Billing Options'. Select 'Print'. Select the file in the 'File' field. Click [Process]. Verify that the dump file generated has only one "CLM' segment and a separate 'LX' loop for the roll-up parent service (which should be first) and each of the roll-up component services. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Professional'. Remove the value in the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field. Click [Submit]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select 'Unpost Last Roll-Up Services Worklist'. Select the worklist posted in step above. Click [Unpost Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Roll-Up Services Definition'. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 1" in 'Existing Roll-Up Definition'. Select 'Both' in the 'Bill Roll-Up Service, Component Service(s), or Both' field. Select 'No' in the 'Force Component Service(s) and Roll-Up Service on the Same Claim' field. Click [Submit]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the component services are reverted to 'Open' and the roll-up service is removed for "Client A". Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1" and select it. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for "Client A". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the worklist compiled in step 118. Select "Adj Post Code 1" in 'Default Write Off Posting Code'. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 1" was used for each of the component services. Verify that the roll-up service was created. Click [X]. Click [No]. Open 'Close Charges'. Select 'Close Charges' in 'Liability Update Or Close Charges'. Select the desired Thru Date that covers all the services of "Client A" that require closure. Select 'Individual'. Search and select "Client A" in 'Client ID'. Select the Episode. Click [Submit]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up service and verify that is closed and marked as 'UNBILL'. Click [X]. Click [No]. Open 'Create Interim Billing Batch File'. Select 'Create Batch'. Set the desired value in 'Batch Description'. Set the 'From Date' and 'Through Date' that cover the charges of "Client A". Select 'Yes' in 'Include Zero Charge Services'. Search and select "Client A" in 'Client ID'. Select the below values that are relevant to "Client A", noted in setup. Guarantor. Program. Service Codes. Practitioner. Click [Process]. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Professional'. Set the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field value to "1". Select 'Yes' in 'Include Zero Dollar Services'. Select 'No' in 'Suppress Claim Level Adjustments/Service Level Adjustments When Total Is Zero'. Click [Submit]. Click [No]. Open 'Electronic Billing'. Select '837-Professional' in 'Billing Form'. Select the financial class of "Guarantor 1" in 'Type Of Bill'. Select 'Individual' in 'Individual Or All Guarantors'. Select "Guarantor 1". Select 'Outpatient' in 'Billing Type'. Select 'Sort File' in 'Billing Options'. Set a desired value in 'File Description'. Select 'Interim Batch' in 'All Clients Or Interim Billing Batch'. Select the Interim Batch that is created in step 150. Select 'No' in 'Create Claims'. Set the desired date values in 'First Date Of Service To Include' and 'Last Date Of Service To Include date' that includes the services we have for "Client A". Select 'All' in 'Include Primary and/or Secondary Billing'. Click [Process]. Click [OK]. Select 'Dump File' in 'Billing Options'. Select 'Print'. Select the file in the 'File' field. Click [Process]. Verify that the roll-up parent service and the roll-up component services are included in the file, but they are not included in the same claim. Each service should be on a separate claim. Click [X]. Click [No]. Scenario 3: Validate the ability to bill component and roll-up services on Same and Different claim(s)-837 Institutional. Specific Setup: Posting/Adjustment Code Definition: New ones are created or existing codes are identified for the below type, Adjustment - "Adj Post Code 1" Service Codes: Using the 'Service Codes' form add or identify an individual roll-up service code and at least two service codes that will be considered as the component services for it. Rollup 1 Comp 1(a) Comp 1(b) Roll-Up Services Definition: Add or identify roll-up service definitions, for each of the roll-up service codes and its associated component services. Rollup Def 1 Rollup 1 Comp 1(a) Comp 1(b) Client A: The client is admitted to an Inpatient program. The client has active Diagnosis and Financial Eligibility-(Guarantor 1) records. Make a note on the "Financial Class' of "Guarantor 1". The charges are created for the roll-up component services on various dates, for "Rollup 1". Guarantor/Program Billing Defaults: Add or identify a template, that includes the guarantor used in the Financial Eligibility record of 'Client A". Template 1 Steps Open 'Roll-Up Services Definition'. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 1" in 'Existing Roll-Up Definition'. Select 'Both' in the 'Bill Roll-Up Service, Component Service(s), or Both' field. Verify that the 'Force Component Service(s) and Roll-Up Service on the Same Claim' become enabled and required. Select 'Yes' in the 'Force Component Service(s) and Roll-Up Service on the Same Claim' field. Click [Submit]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the charges for the roll-up component services are displayed in the report. Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1" and select it. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for "Client A". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the desired compiled worklist. Select "Adj Post Code 1" in 'Default Write Off Posting Code'. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 1" was used for each component service. Verify that the roll-up service was created. Click [X]. Click [No]. Open 'Close Charges'. Select 'Close Charges' in 'Liability Update Or Close Charges'. Select the desired Thru Date that covers all the services of "Client A" that require closure. Select 'Individual'. Search and select "Client A" in 'Client ID'. Select the Episode. Click [Submit]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up service and verify that is closed and marked as 'UNBILL'. Click [X]. Click [No]. Open 'Create Interim Billing Batch File'. Select 'Create Batch'. Set the desired value in 'Batch Description'. Set the 'From Date' and 'Through Date' that cover the charges of "Client A". Select 'Yes' in 'Include Zero Charge Services'. Search and select "Client A" in 'Client ID'. Select the below values that are relevant to "Client A", noted in setup. Guarantor. Program. Service Codes. Practitioner. Click [Process]. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Institutional'. Set the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field value to "1". Select 'Yes' in 'Include Zero Dollar Services'. Select 'No' in 'Suppress Claim Level Adjustments/Service Level Adjustments When Total Is Zero'. Click [Submit]. Click [No]. Open 'Electronic Billing'. Select '837-Institutional' in 'Billing Form'. Select the financial class of "Guarantor 1" in 'Type Of Bill'. Select 'Individual' in 'Individual Or All Guarantors'. Select "Guarantor 1". Select 'Inpatient' in 'Billing Type'. Select 'Sort File' in 'Billing Options'. Set a desired value in 'File Description'. Select 'Interim Batch' in 'All Clients Or Interim Billing Batch'. Select the desired Interim Batch. Select 'No' in 'Create Claims'. Set the desired date values in 'First Date Of Service To Include' and 'Last Date Of Service To Include date' that includes the services we have for "Client A". Select 'All' in 'Include Primary and/or Secondary Billing'. Click [Process]. Click [OK]. Select 'Dump File' in 'Billing Options'. Select 'Print'. Select the file in the 'File' field. Click [Process]. Verify that the roll-up service and the roll-up component services are included in the same claim (CLM segment). Verify that the 837 Institutional files summarize services (SV2) segments by consecutive days If consecutive-day component services. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Institutional'. Remove if there is any value in the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field. Click [Submit]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select 'Unpost Last Roll-Up Services Worklist'. Select the desired posted worklist. Click [Unpost Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Roll-Up Services Definition'. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 1" in 'Existing Roll-Up Definition'. Select 'Both' in the 'Bill Roll-Up Service, Component Service(s), or Both' field. Select 'No' in the 'Force Component Service(s) and Roll-Up Service on the Same Claim' field. Click [Submit]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the component services are reverted to 'Open', and the roll-up service is removed for "Client A". Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1" and select it. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for "Client A". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the desired compiled worklist. Select "Adj Post Code 1" in 'Default Write Off Posting Code'. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 1" was used for each of the component services. Verify that the roll-up service was created. Click [X]. Click [No]. Open 'Close Charges'. Select 'Close Charges' in 'Liability Update Or Close Charges'. Select the desired Thru Date that covers all the services of "Client A" that require closure. Select 'Individual'. Search and select "Client A" in 'Client ID'. Select the Episode. Click [Submit]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up service and verify that is closed and marked as 'UNBILL'. Click [X]. Click [No]. Open 'Create Interim Billing Batch File'. Select 'Create Batch'. Set the desired value in 'Batch Description'. Set the 'From Date' and 'Through Date' that cover the charges of "Client A". Select 'Yes' in 'Include Zero Charge Services'. Search and select "Client A" in 'Client ID'. Select the below values that are relevant to "Client A", noted in setup. Guarantor. Program. Service Codes. Practitioner. Click [Process]. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Institutional'. Set the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field value to "1". Select 'Yes' in 'Include Zero Dollar Services'. Select 'No' in 'Suppress Claim Level Adjustments/Service Level Adjustments When Total Is Zero'. Click [Submit]. Click [No]. Open 'Electronic Billing'. Select '837-Institutional' in 'Billing Form'. Select the financial class of "Guarantor 1" in 'Type Of Bill'. Select 'Individual' in 'Individual Or All Guarantors'. Select "Guarantor 1". Select 'Inpatient' in 'Billing Type'. Select 'Sort File' in 'Billing Options'. Set a desired value in 'File Description'. Select 'Interim Batch' in 'All Clients Or Interim Billing Batch'. Select the desired Interim Batch. Select 'No' in 'Create Claims'. Set the desired date values in 'First Date Of Service To Include' and 'Last Date Of Service To Include date' that includes the services we have for "Client A". Select 'All' in 'Include Primary and/or Secondary Billing'. Click [Process]. Click [OK]. Select 'Dump File' in 'Billing Options'. Select 'Print'. Select the file in the 'File' field. Click [Process]. Verify that the roll-up parent service and the roll-up component services are included in the file, but they are not included in the same claim. Each service should be on a separate claim. Click [X]. Click [No]. Scenario 4: Validate the ability to bill component and roll-up services on same claim with Medical Diagnoses-837 Professional. Specific Setup: Registry Settings: Set 'Use Diagnosis Form for Medical Diagnosis Bills' to "Y". Posting/Adjustment Code Definition: New ones are created, or existing codes are identified for the below type, Adjustment - "Adj Post Code 1" Service Codes: Using the 'Service Codes' form add or identify an individual roll-up service code and at least two service codes that will be considered as the component services for it: Rollup 1 Comp 1(a) Comp 1(b) Roll-Up Services Definition: Add or identify roll-up service definitions, for each of the roll-up service codes and its associated component services: Rollup Def 1 Rollup 1 Comp 1(a) Comp 1(b) Client A: The client is admitted to an outpatient program. The client has active Diagnosis and Financial Eligibility-(Guarantor 1) records. Make a note on the "Financial Class' of "Guarantor 1". Diagnosis: Identify an active diagnosis. Diagnosis 1 Diagnosis 2 Guarantor/Program Billing Defaults: Add or identify a template which includes the guarantor used in the Financial Eligibility record of 'Client A". Template 1. Steps Open 'Roll-Up Services Definition'. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 1" in 'Existing Roll-Up Definition'. Select 'Both' in the 'Bill Roll-Up Service, Component Service(s), or Both' field. Verify that the 'Force Component Service(s) and Roll-Up Service on the Same Claim' become enabled and required. Select 'Yes' in the 'Force Component Service(s) and Roll-Up Service on the Same Claim' field. Click [Submit]. Click [No]. Open 'Client Charge Input With Diagnosis Entry'. Add new component services on different dates for "Client A". Comp 1(a). Comp 1(b). Enter a minimum of one diagnosis for each service. (make sure that different diagnoses are entered for each service) Make a note of the diagnoses for each component service and date of service, for later validation(s). Diagnosis 1. Diagnosis 2. Click [Submit]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the charges for the roll-up component services are displayed. Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1" and select it. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for "Client A". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the worklist compiled in step 23. Select "Adj Post Code 1" in 'Default Write Off Posting Code'. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 1" was used for each of the component services. Verify that the roll-up service was created. Click [X]. Click [No]. Open 'Close Charges'. Select 'Close Charges' in 'Liability Update Or Close Charges'. Select the desired Thru Date that covers all the services of "Client A" that require closure. Select 'Individual'. Search and select "Client A" in 'Client ID'. Select the Episode. Click [Submit]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up service and verify that is closed and marked as 'UNBILL'. Click [X]. Click [No]. Open 'Create Interim Billing Batch File'. Select 'Create Batch'. Set the desired value in 'Batch Description'. Set the 'From Date' and 'Through Date' that cover the charges of "Client A". Select 'Yes' in 'Include Zero Charge Services'. Search and select "Client A" in 'Client ID'. Select the below values that are relevant to "Client A", noted in setup. Guarantor. Program. Service Codes. Practitioner. Click [Process]. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Professional'. Set the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field value to "1". Select 'Yes' in 'Include Zero Dollar Services'. Select 'No' in 'Suppress Claim Level Adjustments/Service Level Adjustments When Total Is Zero'. Click [Submit]. Click [No]. Open 'Electronic Billing'. Select '837-Professional' in 'Billing Form'. Select the financial class of "Guarantor 1" in 'Type Of Bill'. Select 'Individual' in 'Individual Or All Guarantors'. Select "Guarantor 1". Select 'Outpatient' in 'Billing Type'. Select 'Sort File' in 'Billing Options'. Set a desired value in 'File Description'. Select 'Interim Batch' in 'All Clients Or Interim Billing Batch'. Select the Interim Batch that is created in step 55. Select 'No' in 'Create Claims'. Set the desired date values in 'First Date Of Service To Include' and 'Last Date Of Service To Include date' that includes the services we have for "Client A". Select 'All' in 'Include Primary and/or Secondary Billing'. Click [Process]. Click [OK]. Select 'Dump File' in 'Billing Options'. Select 'Print'. Select the file in the 'File' field. Click [Process]. Verify that the dump file generated has only one "CLM" segment and a separate "LX" loop for the roll-up parent service (which should be first- LX1) and each of the roll-up component services. Verify that all the various diagnoses for the individual services are included in the HI segment at the claim level. Verify that the SV1 segments in each LX loop have correct pointers set for the diagnoses that pertain to those services. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Professional'. Remove if there is any value in the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field. Click [Submit]. Click [No]. Repeat 'Electronic Billing' steps and verifications. Scenario 5: Validate the ability to bill component services only and Roll-Up service only -837 Professional. Specific Setup: Posting/Adjustment Code Definition: New ones are created, or existing codes are identified for the below type: Adjustment - "Adj Post Code 1" Service Codes: Using the 'Service Codes' form add, or identify an individual roll-up service code and at least two service codes that will be considered as the component services for it: Rollup 1 Comp 1(a) Comp 1(b) Roll-Up Services Definition: Add or identify roll-up service definitions, for each of the roll-up service codes and its associated component services: Rollup Def 1 Rollup 1 Comp 1(a) Comp 1(b) Client A: The client is admitted to an outpatient program. The client has active Diagnosis and Financial Eligibility-(Guarantor 1) records. Make a note on the "Financial Class' of "Guarantor 1". The charges are created for the roll-up component services on various dates, for "Rollup 1". Guarantor/Program Billing Defaults: Add or identify a template which includes the guarantor used in the Financial Eligibility record of 'Client A". Template 1. Steps Open 'Roll-Up Services Definition'. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 1" in 'Existing Roll-Up Definition'. Select 'Component Services' in the 'Bill Roll-Up Service, Component Service(s), or Both' field. Verify that the 'Force Component Service(s) and Roll-Up Service on the Same Claim' stays disabled and not required. Click [Submit]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the charges for the roll-up component services are displayed. Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1" and select it. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for "Client A". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the desired compiled worklist. Select "Adj Post Code 1" in 'Default Write Off Posting Code'. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 1" was used for each of the component services. Verify that the roll-up service was created. Click [X]. Click [No]. Open 'Close Charges'. Select 'Close Charges' in 'Liability Update Or Close Charges'. Select the desired Thru Date that covers all the services of "Client A" that require closure. Select 'Individual'. Search and select "Client A" in 'Client ID'. Select the Episode. Click [Submit]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up service and verify that is closed and marked as 'UNBILL'. Click [X]. Click [No]. Open 'Create Interim Billing Batch File'. Select 'Create Batch'. Set the desired value in 'Batch Description'. Set the 'From Date' and 'Through Date' that cover the charges of "Client A". Select 'Yes' in 'Include Zero Charge Services'. Search and select "Client A" in 'Client ID'. Select the below values that are relevant to "Client A", noted in setup. Guarantor. Program. Service Codes. Practitioner. Click [Process]. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Professional'. Set the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field value to "1". Select 'Yes' in 'Include Zero Dollar Services'. Select 'No' in 'Suppress Claim Level Adjustments/Service Level Adjustments When Total Is Zero'. Click [Submit]. Click [No]. Open 'Electronic Billing'. Select '837-Professional' in 'Billing Form'. Select the financial class of "Guarantor 1" in 'Type Of Bill'. Select 'Individual' in 'Individual Or All Guarantors'. Select "Guarantor 1". Select 'Outpatient' in 'Billing Type'. Select 'Sort File' in 'Billing Options'. Set a desired value in 'File Description'. Select 'Interim Batch' in 'All Clients Or Interim Billing Batch'. Select desired Interim Batch. Select 'No' in 'Create Claims'. Set the desired date values in 'First Date Of Service To Include' and 'Last Date Of Service To Include date' that includes the services we have for "Client A". Select 'All' in 'Include Primary and/or Secondary Billing'. Click [Process]. Click [OK]. Select 'Dump File' in 'Billing Options'. Select 'Print'. Select the file in the 'File' field. Click [Process]. Verify that the dump file generated has only the roll-up component services, but not the roll-up parent service. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Professional'. Remove if there is any value in the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field. Click [Submit]. Click [No]. Repeat 'Electronic Billing' steps and validations. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select 'Unpost Last Roll-Up Services Worklist'. Select the worklist posted above. Click [Unpost Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Roll-Up Services Definition'. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 1" in 'Existing Roll-Up Definition'. Select 'Roll-Up Service' in the 'Bill Roll-Up Service, Component Service(s), or Both' field. Verify that the 'Force Component Service(s) and Roll-Up Service on the Same Claim' stays disabled and not required. Click [Submit]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the component services are reverted to 'Open' and the roll-up service is removed. Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1" and select it. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for "Client A". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the desired compiled worklist compiled. Select "Adj Post Code 1" in 'Default Write Off Posting Code'. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 1" was used for each of the component services. Verify that the roll-up service was created. Click [X]. Click [No]. Open 'Close Charges'. Select 'Close Charges' in 'Liability Update Or Close Charges'. Select the desired Thru Date that covers all the services of "Client A" that require closure. Select 'Individual'. Search and select "Client A" in 'Client ID'. Select the Episode. Click [Submit]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up service and verify that is closed and marked as 'UNBILL'. Click [X]. Click [No]. Open 'Create Interim Billing Batch File'. Select 'Create Batch'. Set the desired value in 'Batch Description'. Set the 'From Date' and 'Through Date' that cover the charges of "Client A". Select 'Yes' in 'Include Zero Charge Services'. Search and select "Client A" in 'Client ID'. Select the below values that are relevant to "Client A", noted in setup. Guarantor. Program. Service Codes. Practitioner. Click [Process]. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Professional'. Set the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field value to "1". Select 'Yes' in 'Include Zero Dollar Services'. Select 'No' in 'Suppress Claim Level Adjustments/Service Level Adjustments When Total Is Zero'. Click [Submit]. Click [No]. Open 'Electronic Billing'. Select '837-Professional' in 'Billing Form'. Select the financial class of "Guarantor 1" in 'Type Of Bill'. Select 'Individual' in 'Individual Or All Guarantors'. Select "Guarantor 1". Select 'Outpatient' in 'Billing Type'. Select 'Sort File' in 'Billing Options'. Set a desired value in 'File Description'. Select 'Interim Batch' in 'All Clients Or Interim Billing Batch'. Select the desired Interim Batch. Select 'No' in 'Create Claims'. Set the desired date values in 'First Date Of Service To Include' and 'Last Date Of Service To Include date' that includes the services we have for "Client A". Select 'All' in 'Include Primary and/or Secondary Billing'. Click [Process]. Click [OK]. Select 'Dump File' in 'Billing Options'. Select 'Print'. Select the file in the 'File' field. Click [Process]. Verify that only the roll-up parent service is included in the file, but not the roll-up component services. Click [X]. Click [No]. Scenario 6: Validate the ability to bill component services only and Roll-Up service only -837 Institutional. Specific Setup: Posting/Adjustment Code Definition: New codes are created, or existing codes are identified for the below type, Adjustment - "Adj Post Code 1". Service Codes: Using the 'Service Codes' form add or identify an individual roll-up service code and at least two service codes that will be considered as the component services for it: Rollup 1 Comp 1(a) Comp 1(b) Roll-Up Services Definition: Add or identify roll-up service definitions, for each of the roll-up service codes and its associated component services: Rollup Def 1 Rollup 1 Comp 1(a) Comp 1(b) Client A: The client is admitted to an Inpatient program. The client has active Diagnosis and Financial Eligibility-(Guarantor 1) records. Make a note on the "Financial Class' of "Guarantor 1". The charges are created for the roll-up component services on various dates, for "Rollup 1". Guarantor/Program Billing Defaults: Add or identify a template which includes the guarantor used in the Financial Eligibility record of 'Client A". Template 1. Steps Open 'Roll-Up Services Definition'. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 1" in 'Existing Roll-Up Definition'. Select 'Component Services' in the 'Bill Roll-Up Service, Component Service(s), or Both' field. Verify that the 'Force Component Service(s) and Roll-Up Service on the Same Claim' stays disabled and not required. Click [Submit]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the charges for the roll-up component services are displayed. Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1" and select it. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for "Client A". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the desired compiled worklist. Select "Adj Post Code 1" in 'Default Write Off Posting Code'. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 1" was used for each of the component services. Verify that the roll-up service was created. Click [X]. Click [No]. Open 'Close Charges'. Select 'Close Charges' in 'Liability Update Or Close Charges'. Select the desired Thru Date that covers all the services of "Client A" that require closure. Select 'Individual'. Search and select "Client A" in 'Client ID'. Select the Episode. Click [Submit]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up service and verify that is closed and marked as 'UNBILL'. Click [X]. Click [No]. Open 'Create Interim Billing Batch File'. Select 'Create Batch'. Set the desired value in 'Batch Description'. Set the 'From Date' and 'Through Date' that cover the charges of "Client A". Select 'Yes' in 'Include Zero Charge Services'. Search and select "Client A" in 'Client ID'. Select the below values that are relevant to "Client A", noted in setup: Guarantor. Program. Service Codes. Practitioner. Click [Process]. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Institutional'. Set the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field value to "1". Select 'Yes' in 'Include Zero Dollar Services'. Select 'No' in 'Suppress Claim Level Adjustments/Service Level Adjustments When Total Is Zero'. Click [Submit]. Click [No]. Open 'Electronic Billing'. Select '837-Institutional' in 'Billing Form'. Select the financial class of "Guarantor 1" in 'Type Of Bill'. Select 'Individual' in 'Individual Or All Guarantors'. Select "Guarantor 1". Select 'Inpatient' in 'Billing Type'. Select 'Sort File' in 'Billing Options'. Set a desired value in 'File Description'. Select 'Interim Batch' in 'All Clients Or Interim Billing Batch'. Select the desired Interim Batch. Select 'No' in 'Create Claims'. Set the desired date values in 'First Date Of Service To Include' and 'Last Date Of Service To Include date' that includes the services we have for "Client A". Select 'All' in 'Include Primary and/or Secondary Billing'. Click [Process]. Click [OK]. Select 'Dump File' in 'Billing Options'. Select 'Print'. Select the file in the 'File' field. Click [Process]. Verify that the dump file generated has only the roll-up component services, but not the roll-up parent service. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Institutional'. Remove if there is any value in the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field. Click [Submit]. Click [No]. Repeat 'Electronic Billing' steps and validations. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select 'Unpost Last Roll-Up Services Worklist'. Select the desired posted worklist. Click [Unpost Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Roll-Up Services Definition'. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 1" in 'Existing Roll-Up Definition'. Select 'Roll-Up Service' in the 'Bill Roll-Up Service, Component Service(s), or Both' field. Verify that the 'Force Component Service(s) and Roll-Up Service on the Same Claim' stays disabled and not required. Click [Submit]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the component services are reverted to 'Open', and the roll-up service is removed. Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1" and select it. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for "Client A". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the desired compiled worklist. Select "Adj Post Code 1" in 'Default Write Off Posting Code'. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 1" was used for each of the component services. Verify that the roll-up service was created. Click [X]. Click [No]. Open 'Close Charges'. Select 'Close Charges' in 'Liability Update Or Close Charges'. Select the desired Thru Date that covers all the services of "Client A" that require closure. Select 'Individual'. Search and select "Client A" in 'Client ID'. Select the Episode. Click [Submit]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up service and verify that is closed and marked as 'UNBILL'. Click [X]. Click [No]. Open 'Create Interim Billing Batch File'. Select 'Create Batch'. Set the desired value in 'Batch Description'. Set the 'From Date' and 'Through Date' that cover the charges of "Client A". Select 'Yes' in 'Include Zero Charge Services'. Search and select "Client A" in 'Client ID'. Select the below values that are relevant to "Client A", noted in setup. Guarantor. Program. Service Codes. Practitioner. Click [Process]. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Institutional'. Set the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field value to "1". Select 'Yes' in 'Include Zero Dollar Services'. Select 'No' in 'Suppress Claim Level Adjustments/Service Level Adjustments When Total Is Zero'. Click [Submit]. Click [No]. Open 'Electronic Billing'. Select '837-Institutional' in 'Billing Form'. Select the financial class of "Guarantor 1" in 'Type Of Bill'. Select 'Individual' in 'Individual Or All Guarantors'. Select "Guarantor 1". Select 'Inpatient' in 'Billing Type'. Select 'Sort File' in 'Billing Options'. Set a desired value in 'File Description'. Select 'Interim Batch' in 'All Clients Or Interim Billing Batch'. Select the desired Interim Batch. Select 'No' in 'Create Claims'. Set the desired date values in 'First Date Of Service To Include' and 'Last Date Of Service To Include date' that includes the services we have for "Client A". Select 'All' in 'Include Primary and/or Secondary Billing'. Click [Process]. Click [OK]. Select 'Dump File' in 'Billing Options'. Select 'Print'. Select the file in the 'File' field. Click [Process]. Verify that only the roll-up parent service is included in the file, but not the roll-up component services. Click [X]. Click [No]. Scenario 7: Validate the ability to bill component and roll-up services on same claim with Medical Diagnoses-837 Institutional. Specific Setup: Registry Settings: Set 'Use Diagnosis Form for Medical Diagnosis Bills' to "Y". Posting/Adjustment Code Definition: New codes are created, or existing codes are identified for the below type: Adjustment - "Adj Post Code 1" Service Codes: Using the 'Service Codes' form add or identify an individual roll-up service code and at least two service codes that will be considered as the component services for it: Rollup 1 Comp 1(a) Comp 1(b) Roll-Up Services Definition: Add or identify roll-up service definitions, for each of the roll-up service codes and its associated component services" Rollup Def 1 Rollup 1 Comp 1(a) Comp 1(b) Client A: The client is admitted to an Inpatient program. The client has active Diagnosis and Financial Eligibility-(Guarantor 1) records. Make a note on the "Financial Class' of "Guarantor 1". Diagnosis: Identify an active diagnosis. Diagnosis 1 Diagnosis 2 Guarantor/Program Billing Defaults: Add or identify a template which includes the guarantor used in the Financial Eligibility record of 'Client A". Template 1. Steps Open 'Roll-Up Services Definition'. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 1" in 'Existing Roll-Up Definition'. Select 'Both' in the 'Bill Roll-Up Service, Component Service(s), or Both' field. Verify that the 'Force Component Service(s) and Roll-Up Service on the Same Claim' become enabled and required. Select 'Yes' in the 'Force Component Service(s) and Roll-Up Service on the Same Claim' field. Click [Submit]. Click [No]. Open 'Client Charge Input With Diagnosis Entry'. Add new component services on different dates for "Client A": Comp 1(a). Comp 1(b). Enter a minimum of one diagnosis for each service. (make sure that different diagnoses are entered for each service) Make a note of the diagnoses for each component service and date of service, for later validation(s): Diagnosis 1. Diagnosis 2. Click [Submit]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the charges for the roll-up component services are displayed. Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1" and select it. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for "Client A". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the desired compiled worklist. Select "Adj Post Code 1" in 'Default Write Off Posting Code'. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 1" was used for each of the component services. Verify that the roll-up service was created. Click [X]. Click [No]. Open 'Close Charges'. Select 'Close Charges' in 'Liability Update Or Close Charges'. Select the desired Thru Date that covers all the services of "Client A" that require closure. Select 'Individual'. Search and select "Client A" in 'Client ID'. Select the Episode. Click [Submit]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up service and verify that is closed and marked as 'UNBILL'. Click [X]. Click [No]. Open 'Create Interim Billing Batch File'. Select 'Create Batch'. Set the desired value in 'Batch Description'. Set the 'From Date' and 'Through Date' that cover the charges of "Client A". Select 'Yes' in 'Include Zero Charge Services'. Search and select "Client A" in 'Client ID'. Select the below values that are relevant to "Client A", noted in setup: Guarantor. Program. Service Codes. Practitioner. Click [Process]. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Institutional'. Set the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field value to "1". Select 'Yes' in 'Include Zero Dollar Services'. Select 'No' in 'Suppress Claim Level Adjustments/Service Level Adjustments When Total Is Zero'. Click [Submit]. Click [No]. Open 'Electronic Billing'. Select '837-Institutional' in 'Billing Form'. Select the financial class of "Guarantor 1" in 'Type Of Bill'. Select 'Individual' in 'Individual Or All Guarantors'. Select "Guarantor 1". Select 'Inpatient' in 'Billing Type'. Select 'Sort File' in 'Billing Options'. Set a desired value in 'File Description'. Select 'Interim Batch' in 'All Clients Or Interim Billing Batch'. Select the desired Interim Batch. Select 'No' in 'Create Claims'. Set the desired date values in 'First Date Of Service To Include' and 'Last Date Of Service To Include date' that includes the services we have for "Client A". Select 'All' in 'Include Primary and/or Secondary Billing'. Click [Process]. Click [OK]. Select 'Dump File' in 'Billing Options'. Select 'Print'. Select the file in the 'File' field. Click [Process]. Verify that the dump file generated has only one "CLM" segment and a separate "LX" loop for the roll-up parent service (which should be first- LX1) and each of the roll-up component services. Verify that all the various diagnoses for all the component services are included in the HI segment at the claim level. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" in 'Select Template'. Select '837 Institutional'. Remove if there is any value in the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field. Click [Submit]. Click [No]. Repeat 'Electronic Billing' steps and validations. Scenario 8: File Import - Roll-Up Services Definition - Validations. Specific Setup: Posting/Adjustment Code Definition: New codes are created, or existing codes are identified for the below type: Adjustment - "Adj Post Code 1". Payment - "Pay Post Code 1". Transfer - "Trans Post Code 1". Service Codes: Using the 'Service Codes' form add or identify an individual roll-up service code and at least two service codes that will be considered as the component services for it. Rollup 1 Comp 1(a) Comp 1(b) File Import: Create the below .txt file(s) to have the data that we can validate against the 'File Import' feature for 'Roll-Up Services Definition', as mentioned below, File 1: Field 1 value set as "1". Invalid value for field 55 and Invalid value for field 56. All other needed fields with valid values. File 2: Field 1 value set as "1". Value '3-(Both)' for field 55 and field 56 is left blank. All other needed fields with valid values. File 3: Field 1 value set as "1". Invalid value for field 57. All other needed fields with valid values. File 4: Field 1 value set as "1". Value '3-(No - transfer to next guarantor)' for field 57 and field 58 ('Transfer Code for Component Services') is left blank. All other needed fields with valid values. File 5: Field 1 value set as "1". Value '3-(No - transfer to next guarantor)' for field 57 and field 58 ('Transfer Code for Component Services') has a valid ADJUSTMENT posting code. All other needed fields with valid values. File 6: Field 1 value set as "1". Value '3-(No - transfer to next guarantor)' for field 57 and field 58 ('Transfer Code for Component Services') has a valid PAYMENT posting code. All other needed fields with valid values. File 7: Field 1 value set as "1". Value '3-(No - transfer to next guarantor)' for field 57 and field 58 ('Transfer Code for Component Services') has an INVALID posting code. All other needed fields with valid values. File 8: Field 1 value set as "1". The value of field 57 is anything other than '3' and field 58 has a valid TRANSFER posting code. All other needed fields with valid values. File 9: Field 1 value set as "1". The value of field 57 is '1'. Field 59 ('Write Off Code for Component Services") has a valid ADJUSTMENT posting code. All other needed fields with valid values. File 10: Field 1 value set as "1". The value of field 57 is '1'. Field 59 ('Write Off Code for Component Services") has a valid PAYMENT posting code. All other needed fields with valid values. File 11: Field 1 value set as "1". The value of field 57 is '1'. Field 59 ('Write Off Code for Component Services") has a valid TRANSFER posting code. All other needed fields with valid values. File 12: Field 1 value set as "1". The value of field 57 is '1'. Field 59 ('Write Off Code for Component Services") has an INVALID posting code. All other needed fields with valid values. File 13: Field 1 value set as "1". Field 57 ('Write Off Component Services') has the value '2' or '3' and a valid ADJUSTMENT posting code for field 59. All other needed fields with valid values. File 14: Field 1 value set as "1". Value '3-(Both)' for field 55 and valid dictionary value for field 56. Value '1-(Yes)' for field 57 and valid ADJUSTMENT posting code for field 59. All other needed fields with valid values. File 15: Field 1 value set as "2". Field 2 value set as the Valid roll-up ID created in the above step using "File 14". Value '3-(Both)' for field 55 and valid dictionary value for field 56. Value '2-(No - Keep Liability With Current Guarantor)' for field 57 and No values entered for field 59. All other needed fields with valid values. File 16: Field 1 value set as "2". Field 2 value set as the Valid roll-up ID created in the above step using "File 14". Value '3-(Both)' for field 55 and valid dictionary value for field 56. Value '3-(No - Transfer to Next Guarantor)' for field 57 and valid TRANSFER code entered for field 58. No values were entered for field 59. All other needed fields with valid values. File 17: Field 1 value set as "3". Use all other field values the same as in "File 15". Steps Open 'File Import'. Select 'Roll-Up Services Definition' in 'File Type'. Select 'Upload New File'. Click [Process]. Select 'File 1'. Select 'Compile/Validate File'. Select 'File 1'. Click [Process]. Validate that the error shows with the text "File 1.txt contains one or more errors. These errors can be reviewed using 'Print Errors' action.". Click [OK]. Click [Print Errors]. Select 'File 1'. Click [Process]. Validate that the report shows the appropriate error concerning the 'File 1' from the setup. Click [Close Report]. Repeat the above steps for Files 2 - File 8. Click [Discard]. Click [Yes]. Open 'Registry Settings'. Search and select 'Specify Write Off Posting Code In 'Roll-Up Services Definition'' registry setting. Set the Registry Setting Value to "N". Click [Submit]. Click [OK]. Click [No]. Open 'File Import'. Select 'Roll-Up Services Definition' in 'File Type'. Select 'Upload New File'. Click [Process]. Select 'File 9'. Select 'Compile/Validate File'. Select 'File 9'. Click [Process]. Validate that the error shows with the text "File 9.txt contains one or more errors. These errors can be reviewed using 'Print Errors' action.". Click [OK]. Click [Print Errors]. Select 'File 9'. Click [Process]. Validate that the report shows the appropriate error concerning the 'File 9' from the setup. Click [Close Report]. Click [Discard]. Click [Yes]. Open 'Registry Settings'. Search and select the 'Specify Write Off Posting Code In 'Roll-Up Services Definition'' registry setting. Set the Registry Setting Value to "Y". Click [Submit]. Click [OK]. Click [No]. Open 'File Import'. Select 'Roll-Up Services Definition' in 'File Type'. Select 'Upload New File'. Click [Process]. Select 'File 10'. Select 'Compile/Validate File'. Select 'File 10'. Click [Process]. Validate that the error shows with the text "File 10.txt contains one or more errors. These errors can be reviewed using 'Print Errors' action.". Click [OK]. Click [Print Errors]. Select 'File 10'. Click [Process]. Validate that the report shows the appropriate error concerning the 'File 10' from the setup. Click [Close Report]. Repeat above steps for File 11 - File 13. Select 'Upload New File'. Click [Process]. Select 'File 14'. Select 'Compile/Validate File'. Select 'File 14'. Click [Process]. Validate that the success message contains "Compiled.". Click [OK]. Select 'Post File'. Select 'File 14'. Click [Process]. Validate that the success message contains "Posted.". Click [OK]. Select 'Print File'. Select 'File 14'. Click [Process]. Validate that the report shows the appropriate values passed/ posted in 'File 14' from the setup. Click [Close Report]. Click [Discard]. Click [Yes]. Open 'Roll-Up Services Definition'. Select 'Edit'. Select the Roll-Up Service Definition posted in Step 75 in the 'Existing Roll-Up Definition' field. Validate that all the values are populated correctly. Click [Discard]. Click [Yes]. Open 'File Import'. Select 'Roll-Up Services Definition' in 'File Type'. Select 'Upload New File'. Click [Process]. Select 'File 15'. Select 'Compile/Validate File'. Select 'File 15'. Click [Process]. Validate that the success message contains "Compiled.". Click [OK]. Select 'Post File'. Select 'File 15'. Click [Process]. Validate that the success message contains "Posted.". Click [OK]. Select 'Print File'. Select 'File 15'. Click [Process]. Validate that the report shows the appropriate values passed/ posted in 'File 15' from the setup. Click [Close Report]. Click [Discard]. Click [Yes]. Open 'Roll-Up Services Definition'. Select 'Edit'. Select the Roll-Up Service Definition posted above in the 'Existing Roll-Up Definition' field. Validate that all the values are populated correctly. Click [Discard]. Click [Yes]. Open 'File Import'. Select 'Roll-Up Services Definition' in 'File Type'. Select 'Upload New File'. Click [Process]. Select 'File 16'. Select 'Compile/Validate File'. Select 'File 16'. Click [Process]. Validate that the success message contains "Compiled.". Click [OK]. Select 'Post File'. Select 'File 16'. Click [Process]. Validate that the success message contains "Posted.". Click [OK]. Select 'Print File'. Select 'File 16'. Click [Process]. Validate that the report shows the appropriate values passed/ posted in 'File 16' from the setup. Click [Close Report]. Click [Discard]. Click [Yes]. Open 'Roll-Up Services Definition'. Select 'Edit'. Select the Roll-Up Service Definition posted above in the 'Existing Roll-Up Definition' field. Validate that all the values are populated correctly. Click [Discard]. Click [Yes]. Open 'File Import'. Select 'Roll-Up Services Definition' in 'File Type'. Select 'Upload New File'. Click [Process]. Select 'File 17'. Select 'Compile/Validate File'. Select 'File 17'. Click [Process]. Validate that the success message contains "Compiled.". Click [OK]. Select 'Post File'. Select 'File 17'. Click [Process]. Validate that the success message contains "Posted.". Click [OK]. Select 'Print File'. Select 'File 17'. Click [Process]. Validate that the report shows the appropriate values passed/ posted in 'File 17' from the setup. Click [Close Report]. Click [Discard]. Click [Yes]. Open 'Roll-Up Services Definition'. Select 'Edit'. Search for the Roll-Up Service Definition deleted above in the 'Existing Roll-Up Definition' field. Validate that we get "No results found". Click [Discard]. Click [Yes]. Compile Roll-Up Services Worklist Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Compile/Edit/Post/Unpost Roll-Up Services Worklist Scenario 1: Compile/Edit/Post/Unpost Roll-Up Worklist - Validate the run-time roll-up data stored in table. Specific Setup: Registry Settings: Set the "Allow Multiple Roll-Ups" registry setting to have the value "Y". Set the "Enable New Practitioner Numbers By Guarantor and Program Form" so that is set to "Y". Service Codes: Using the 'Service Codes' form add, or identify an individual roll-up service code and at least two service codes that will be considered as the component services: Rollup 1 Comp 1(a) Comp 1(b) Roll-Up Services Definition: Add or identify a roll-up service definition, for the roll-up service code and its associated component services: Rollup Def 1 Rollup 1 Comp 1(a) Comp 1(b) Client A: The client is an active client. The client has an active diagnosis record. The client has a Financial Eligibility record. Practitioner Numbers by Guarantor and Program: Identify a provider who will be the rendering provider of the roll-up component service(s), Practitioner 1. Fill out the 'Supervising Practitioner' field with a different provider, Practitioner 2. Client Charge Input: Charges are created for the roll-up component services on various dates. The rendering provider that was updated in the 'Practitioner Numbers by Guarantor and Program' form will be used as the practitioner for the charges. Steps Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1". Select "Rollup Def 1" in the 'Roll-Up Definitions' field. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up service and its component services. Click [Close Report]. Click [Discard]. Click [Yes]. Query the table "rollup_services_worklist" and validate that values are showing correctly with the compiled worklist data for the following columns: data_entry_utc data_entry_time data_entry_time_j data_entry_offset data_entry_timezone_short supervising_practitioner in_other_rollups_code in_other_rollups_value Verify that the column "supervising_practitioner" shows "Practitioner 2". Close the SQL window and go back to the NX window. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1". Select "Rollup Def 1" in the 'Roll-Up Definitions' field. Click [Compile Worklist]. Validate that the warning popup shows saying "A compiled roll-up already exists for a selected rule. Continuing will overwrite this compile. Are you sure you want to continue?". Click [Yes]. Click [OK]. Select 'Post Roll-Up Services Worklist'. Select the desired compiled worklist. Validate that the 'Default Write Off Posting Code' field is enabled and required at this point. Select the desired adjustment code from the 'Default Write Off Posting Code' field. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Query the table "rollup_services_worklist" and validate that values are showing correctly with the posted worklist data for the following columns: data_entry_utc data_entry_time data_entry_time_j data_entry_offset data_entry_timezone_short supervising_practitioner in_other_rollups_code in_other_rollups_value Close the SQL window. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select 'Unpost Last Roll-Up Services Worklist'. Select the desired compiled worklist. Click [Unpost Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Query the table "rollup_services_worklist" and validate that values are showing correctly with the un-posted worklist data for the following columns: data_entry_utc data_entry_time data_entry_time_j data_entry_offset data_entry_timezone_short supervising_practitioner in_other_rollups_code in_other_rollups_value Close the SQL window. Roll-Up Services Definition - Write-off or Transfer Roll-up Component Services Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Roll-Up Services Definition Compile/Edit/Post/Unpost Roll-Up Services Worklist Quick Billing Rule Definition Quick Billing File Import Scenario 1: 'Roll-Up Services Definition' - Validate the new Registry Setting - 'Specify Write Off Posting Code In 'Roll-Up Services Definition'. Specific Setup: Posting/Adjustment Code Definition: New ones are created, or existing codes are identified for the below types, Payment - "Pay Post Code 1" Transfer - "Trans Post Code 1" Adjustment - "Adj Post Code 1" Service Codes: Using the 'Service Codes' form add or identify an individual roll-up service code and at least two service codes that will be considered as the component services. Rollup 1 Comp 1(a) Comp 1(b) Steps Open 'Registry Settings'. Search for 'Specify Write Off Posting Code In 'Roll-Up Services Definition'. Click [View Registry Settings]. Verify that the value of the registry setting is set to "N" (disabled) by default. Click [Submit]. Click [OK]. Click [No]. Open 'Roll-Up Services Definition'. Verify that there are two new fields near the bottom of the form, 'Write Off Component Services'. 'Transfer Code for Component Services'. Verify that both the new fields are disabled. Validate that the field 'Write Off Code for Component Services' does not exists. Click [Discard]. Open 'Registry Settings'. Search for 'Specify Write Off Posting Code In 'Roll-Up Services Definition'. Click [View Registry Settings]. Set the value of the registry setting to "Y". Click [Submit]. Click [OK]. Click [No]. Open 'Roll-Up Services Definition'. Verify the new field 'Write Off Code for Component Services' exists near the bottom. Click the help light bulb message for the 'Write Off Code for Component Services' field. Review the message. Click [Return To Form]. Select 'Add' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup 1" as the 'Roll-Up Service'. Select "Comp 1(a)", and "Comp 1(b)" as the 'Component Services'. Enter/ Select all the needed values. Verify that the 'Write Off Component Services' field and its options are enabled: 'Yes'. 'No - Keep Liability With Current Guarantor'. 'No - Transfer to Next Guarantor'. Verify that the 'Transfer Code for Component Services' field is disabled. Verify that the 'Write Off Code For Component Services' field is disabled. Select 'Yes' in the 'Write Off Component Services' field. Verify that the 'Write Off Code For Component Services' field is enabled. Verify that the list of available posting codes in the 'Write Off Code for Component Services' field includes only 'Adjustment' type posting codes as defined in the 'Posting/Adjustment Codes Definition' form. Select 'No - Keep Liability With Current Guarantor' in the 'Write Off Component Services' field. Verify that the 'Write Off Code For Component Services' field is disabled. Verify that the 'Transfer Code for Component Services' field is disabled. Select 'No - Transfer to Next Guarantor' in the 'Write Off Component Services' field. Verify that the 'Write Off Code For Component Services' field is disabled. Verify that the 'Transfer Code for Component Services' field is enabled and required. Verify that the list of available posting codes in the 'Transfer Code for Component Services' field includes only 'Transfer' type posting codes as defined in the 'Posting/Adjustment Codes Definition' form. Select 'Yes' in the 'Write Off Component Services' field. Select "Adj Post Code 1" from the 'Write Off Code For Component Services' field. Click [Submit]. Click [Yes]. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select the roll-up definition created in step 28 in 'Existing Roll-Up Definition'. Verify the below fields are appropriately populated with the values entered in the above steps: 'Write Off Component Services'. 'Write Off Code For Component Services'. 'Transfer Code for Component Services'. Close the form. Query the 'rollup_services_def' table for the definition created in step 28 and validate that the below new fields are present in the table along with their associated values. write_off_comp_svc_code, write_off_comp_svc_value, transfer_posting_code, transfer_post_code_value, write_off_posting_code, write_off_post_code_value. Close the SQL Query window. Scenario 2: Validate Write Off Posting Code for 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'- Individual/Group definitions. Specific Setup: Registry Settings: Set the "Specify Write Off Posting Code in 'Roll-Up Services Definition'" registry setting to have the value "Y". Set the "Allow Roll-Up Rule Selection During Compile" to have the value '1' or the value '1&2'. Remove the value if any, from the 'Default Write Off Posting Code' registry setting. Posting/Adjustment Code Definition: New ones are created, or existing codes are identified for the below type: Adjustment Adj Post Code 1 Adj Post Code 2 Adj Post Code 3 Service Codes: Using the 'Service Codes' form add or identify two individual roll-up service codes and at least two service codes that will be considered as the component services for each: Rollup 1 Comp 1(a) Comp 1(b) Rollup 2 Comp 2(a) Comp 2(b) Roll-Up Services Definition: Add or identify roll-up service definitions, for each of the roll-up service codes and its associated component services: Rollup Def 1 Rollup 1 Comp 1(a) Comp 1(b) Rollup Def 2 Rollup 2 Comp 2(a) Comp 2(b) Roll-Up Group Definition: Using the 'Roll-Up Group Definition' section of the 'Roll-Up Services Definition' form, create a new roll-up group that includes the two roll-up definitions created earlier: Rollup Group Def 1 Rollup Def 1 Rollup Def 2 Client A: The client is admitted to an inpatient/ outpatient program. The client has active Diagnosis and Financial Eligibility records. The charges are created for the roll-up component services on various dates, for "Rollup 1". Client B: The client is admitted to an inpatient/ outpatient program. The client has active Diagnosis and Financial Eligibility records. The charges are created for the roll-up component services on various dates, for "Rollup 2". Steps Open 'Roll-Up Services Definition'. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 1" in 'Existing Roll-Up Definition'. Select 'Yes' in the 'Write Off Component Services' field. Select "Adj Post Code 1" from the 'Write Off Code For Component Services' field. Click [Submit]. Click [Yes]. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 2" in 'Existing Roll-Up Definition'. Select 'Yes' in the 'Write Off Component Services' field. Leave the 'Write Off Code For Component Services' field blank. Click [Submit]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the charges for the roll-up component services are showing for "Client A". Click [X]. Click [Yes]. Run the ledger report for "Client B" Verify that the charges for the roll-up component services are showing for "Client A". Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A" and "Client B". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1" and "Rollup Def 2". Select both definitions in the 'Roll-Up Definitions' field. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for both "Client A" and "Client B". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the worklist compiled in step 27. Select "Adj Post Code 2" in 'Default Write Off Posting Code'. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 1" was used for each of the component services. Verify that the roll-up service is created for "Client A". Click [X]. Click [Yes]. Run the ledger report for "Client B" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 2" was used for each of the component services. Verify that the roll-up service is created for "Client B". Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select 'Unpost Last Roll-Up Services Worklist'. Select the worklist posted in step 35. Click [Unpost Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the component services are reverted to 'Open', and the roll-up service is removed for "Client A". Click [X]. Click [Yes]. Run the ledger report for "Client B" Verify that the component services are reverted to 'Open', and the roll-up service is removed for "Client B". Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A" and "Client B". Select "Rollup Group Def 1" in the 'Roll-Up Group' field. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for both "Client A" and "Client B". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the worklist compiled in step 69. Select "Adj Post Code 2" in 'Default Write Off Posting Code'. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 1" was used for each of the component services. Verify that the roll-up service is created for "Client A". Click [X]. Click [Yes]. Run the ledger report for "Client B" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 2" was used for each of the component services. Verify that the roll-up service is created for "Client B". Click [X]. Click [No]. Open 'Registry Settings'. Search and select the 'Default Write Off Posting Code' registry setting. Set the code of "Adj Post Code 3" in the 'Registry Setting Value' field. Click [Submit]. Click [OK]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select 'Unpost Last Roll-Up Services Worklist'. Select the worklist posted above. Click [Unpost Worklist]. Click [OK]. Select 'Compile Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A" and "Client B". Select "Rollup Group Def 1" in the 'Roll-Up Group' field. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for both "Client A" and "Client B". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the worklist compiled in step 106. Verify that the field 'Default Write Off Posting Code' is populated with "Adj Post Code 3". Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 1" was used for each of the component services. Verify that the roll-up service is created for "Client A". Click [X]. Click [Yes]. Run the ledger report for "Client B" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 3" was used for each of the component services. Verify that the roll-up service is created for "Client B". Click [X]. Click [No]. Scenario 3: Validating the Write Off Posting Code for 'Quick Billing' Specific Setup: Registry Settings: Set the "Specify Write Off Posting Code in 'Roll-Up Services Definition'" registry setting to have the value "Y". Posting/Adjustment Code Definition: New ones are created, or existing codes are identified for the below type: Adjustment Adj Post Code 1 Adj Post Code 2 Service Codes: Using the 'Service Codes' form add or identify two individual roll-up service codes and at least two service codes that will be considered as the component services for each: Rollup 1 Comp 1(a) Comp 1(b) Rollup 2 Comp 2(a) Comp 2(b) Roll-Up Services Definition: Add or identify roll-up service definitions, for each of the roll-up service codes and its associated component services: Rollup Def 1 Rollup 1 Comp 1(a) Comp 1(b) Set 'Yes' for the 'Write Off Component Services' field. Select "Adj Post Code 2" in the 'Write Off Code for Component Services' field. Rollup Def 2 Rollup 2 Comp 2(a) Comp 2(b) Set 'Yes' for the 'Write Off Component Services' field. Leave the 'Write Off Code for Component Services' field EMPTY. Client A: The client is admitted to an inpatient/ outpatient program. The client has active Diagnosis and Financial Eligibility records. The client's Guarantor, Financial class, Treatment setting, and Program are noted for validation. The charges are created for the roll-up component services on various dates, for "Rollup 1". Client B: The client is admitted to an inpatient/ outpatient program. The client has active Diagnosis and Financial Eligibility records. The client's Guarantor, Financial class, Treatment setting, and Program are noted for validation. The charges are created for the roll-up component services on various dates, for "Rollup 2". Steps Open 'Registry Settings'. Search for 'Execute Roll-Up Prior To Quick Billing'. Click [View Registry Settings]. Select 'Execute Roll-Up Prior To Quick Billing Registry Setting Value:'. Set the registry setting value to "Adj Post Code 1". Click [Submit]. Click [OK]. Click [No]. Open 'Quick Billing Rule Definition'. Select 'Add New'. Set any desired value for 'Rule Description'. Select the Roll-up and the Component services in the 'Service Codes' field: "Rollup 1" "Comp 1(a)" "Comp 1(b)" "Rollup 2" "Comp 2(a)" "Comp 2(b)" Select all the required values that are relevant to "Client A" and "Client B" from the setup. Select the roll-up definitions from the setup in 'Roll-Up Definitions To Include' field: "Rollup Def 1" "Rollup Def 2" Click [Submit]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the charges for the roll-up component services are showing for "Client A". Click [X]. Click [Yes]. Run the ledger report for "Client B" Verify that the charges for the roll-up component services are showing for "Client A". Click [X]. Click [No]. Open 'Quick Billing'. Select 'Add New'. Select the 'First Date Of Service To Include' and 'Last Date Of Service To Include', that cover the services of "Client A" and "Client B". Select the Quick Billing rule created in step 11 in the 'Billing Rule To Execute' field. Select the needed tasks in 'Quick Billing Tasks to Execute'. (Minimum selections should be made as listed below) Create Batch. Close Charges. Select the desired value for 'Date Of Claim'. Click [Submit]. Click [OK]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 2" was used for each of the component services. Verify that the roll-up service is created for "Client A". Click [X]. Click [Yes]. Run the ledger report for "Client B" Review the roll-up component services and verify that they are marked as 'Roll-Up' and that "Adj Post Code 1" was used for each of the component services. Verify that the roll-up service is created for "Client B". Click [X]. Click [No]. Scenario 4: Validating Posting Roll-Ups Without Write Off or Transfer of Component Services Specific Setup: Registry Settings: Set the "Specify Write Off Posting Code in 'Roll-Up Services Definition'" registry setting to have the value "Y". Set the "Allow Roll-Up Rule Selection During Compile" to have the value '1' or the value '1&2'. Remove the value if any, from the 'Default Write Off Posting Code' registry setting. Posting/Adjustment Code Definition: New ones are created or existing codes are identified for the below type: Adjustment Adj Post Code 1 Service Codes: Using the 'Service Codes' form add or identify two individual roll-up service codes and at least two service codes that will be considered as the component services for each: Rollup 1 Comp 1(a) Comp 1(b) Rollup 2 Comp 2(a) Comp 2(b) Roll-Up Services Definition: Add or identify roll-up service definitions, for each of the roll-up service codes and its associated component services: Rollup Def 1 Rollup 1 Comp 1(a) Comp 1(b) Rollup Def 2 Rollup 2 Comp 2(a) Comp 2(b) Client A: The client is admitted to an inpatient/ outpatient program. The client has active Diagnosis and Financial Eligibility records. The charges are created for the roll-up component services on various dates, for "Rollup 1". Client B: The client is admitted to an inpatient/ outpatient program. The client has active Diagnosis and Financial Eligibility records. The charges are created for the roll-up component services on various dates, for "Rollup 2". Steps Open 'Roll-Up Services Definition'. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 1" in 'Existing Roll-Up Definition'. Select 'No - Keep Liability With Current Guarantor' in the 'Write Off Component Services' field. Click [Submit]. Click [Yes]. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 2" in 'Existing Roll-Up Definition'. Select 'Yes' in the 'Write Off Component Services' field. Leave the 'Write Off Code For Component Services' field blank. Click [Submit]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A". Verify that the charges for the roll-up component services are displayed. Click [X]. Click [Yes]. Run the ledger report for "Client B". Verify that the charges for the roll-up component services are displayed. Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A" and "Client B". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1" and "Rollup Def 2". Select both definitions in the 'Roll-Up Definitions' field. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for both "Client A" and "Client B". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the worklist compiled in step 26. Select "Adj Post Code 1" in 'Default Write Off Posting Code'. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A". Review the roll-up component services and verify that they are marked as 'Roll-Up'. Verify that there are no adjustments created for the component services. Verify that the roll-up service is created. Click [X]. Click [Yes]. Run the ledger report for "Client B" Review the roll-up component services and verify that they are marked as 'Roll-Up'. Verify that adjustments were posted as expected for the component services using "Adj Post Code 1". Verify that the roll-up service was created. Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select 'Unpost Last Roll-Up Services Worklist'. Select the worklist posted in step 34. Click [Unpost Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the component services are reverted to 'Open', the roll-up charges are removed, and none of the component services are marked 'roll-up'. Click [X]. Click [Yes]. Run the ledger report for "Client B" Verify that the component services are reverted to 'Open', the roll-up charges are removed, all adjustments are removed, and none of the component services are marked 'roll-up'. Click [X]. Click [No]. Scenario 5: Validating Posting Roll-Ups and Transferring Component Service Liability to Next Guarantor Specific Setup: Registry Settings: Set the "Specify Write Off Posting Code in 'Roll-Up Services Definition'" registry setting to have the value "Y". Set the "Allow Roll-Up Rule Selection During Compile" to have the value '1' or the value '1&2'. Remove the value if any, from the 'Default Write Off Posting Code' registry setting. Posting/Adjustment Code Definition: New ones are created, or existing codes are identified for the below types: Transfer - "Trans Post Code 1" Adjustment - "Adj Post Code 1" Service Codes: Using the 'Service Codes' form add or identify two individual roll-up service codes and at least two service codes that will be considered as the component services for each: Rollup 1 Comp 1(a) Comp 1(b) Rollup 2 Comp 2(a) Comp 2(b) Roll-Up Services Definition: Add or identify roll-up service definitions, for each of the roll-up service codes and its associated component services: Rollup Def 1 Rollup 1 Comp 1(a) Comp 1(b) Rollup Def 2 Rollup 2 Comp 2(a) Comp 2(b) Client A: The client is admitted to an inpatient/ outpatient program. The client has active Diagnosis and Financial Eligibility records. The charges are created for the roll-up component services on various dates, for "Rollup 1". Client B: The client is admitted to an inpatient/ outpatient program. The client has active Diagnosis and Financial Eligibility records. The charges are created for the roll-up component services on various dates, for "Rollup 2". Steps Open 'Roll-Up Services Definition'. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 1" in 'Existing Roll-Up Definition'. Select 'No - Keep Liability With Current Guarantor' in the 'Write Off Component Services' field. Click [Submit]. Click [Yes]. Select 'Edit' in the 'Add/Edit/Delete Roll-Up Service Definition' field. Select "Rollup Def 2" in 'Existing Roll-Up Definition'. Select 'No - Transfer to Next Guarantor' in the 'Write Off Component Services' field. Select "Trans Post Code 1" in the 'Transfer Code for Component Services' field. Click [Submit]. Click [No]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the charges for the roll-up component services are displayed. Click [X]. Click [Yes]. Run the ledger report for "Client B" Verify that the charges for the roll-up component services are displayed. Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select the 'From Date' and 'Through Date', that cover the services of "Client A" and "Client B". Verify that the 'Roll-Up Definitions' field shows "Rollup Def 1" and "Rollup Def 2". Select both definitions in the 'Roll-Up Definitions' field. Click [Compile Worklist]. Click [OK]. Click [Run Report]. Verify that the report shows the created Roll-Up services and their component services for both "Client A" and "Client B". Click [Close Report]. Select 'Post Roll-Up Services Worklist'. Select the worklist compiled in step 26. Select "Adj Post Code 1" in 'Default Write Off Posting Code'. Click [Post Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Review the roll-up component services and verify that they are marked as 'Roll-Up'. Verify that there are no adjustments created for the component services. Verify that the roll-up service was created. Click [X]. Click [Yes]. Run the ledger report for "Client B" Review the roll-up component services and verify that they are marked as 'Roll-Up'. Verify that the transfers were posted for the component services and that "Trans Post Code 1" was used for each of the component services. Verify that the roll-up service was created. Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Select 'Unpost Last Roll-Up Services Worklist'. Select the worklist posted in step 34. Click [Unpost Worklist]. Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger'. Run the ledger report for "Client A" Verify that the component services are reverted to 'Open', and the roll-up service is removed. Click [X]. Click [Yes]. Run the ledger report for "Client B" Verify that all the transfers are removed, and none of the component services are marked 'roll-up'. Click [X]. Click [No]. Scenario 6: File Import - Roll-Up Services Definition - Validations. Specific Setup: Posting/Adjustment Code Definition: New codes are created, or existing codes are identified for the below type: Adjustment - "Adj Post Code 1". Payment - "Pay Post Code 1". Transfer - "Trans Post Code 1". Service Codes: Using the 'Service Codes' form add or identify an individual roll-up service code and at least two service codes that will be considered as the component services for it. Rollup 1 Comp 1(a) Comp 1(b) File Import: Create the below .txt file(s) to have the data that we can validate against the 'File Import' feature for 'Roll-Up Services Definition', as mentioned below, File 1: Field 1 value set as "1". Invalid value for field 55 and Invalid value for field 56. All other needed fields with valid values. File 2: Field 1 value set as "1". Value '3-(Both)' for field 55 and field 56 is left blank. All other needed fields with valid values. File 3: Field 1 value set as "1". Invalid value for field 57. All other needed fields with valid values. File 4: Field 1 value set as "1". Value '3-(No - transfer to next guarantor)' for field 57 and field 58 ('Transfer Code for Component Services') is left blank. All other needed fields with valid values. File 5: Field 1 value set as "1". Value '3-(No - transfer to next guarantor)' for field 57 and field 58 ('Transfer Code for Component Services') has a valid ADJUSTMENT posting code. All other needed fields with valid values. File 6: Field 1 value set as "1". Value '3-(No - transfer to next guarantor)' for field 57 and field 58 ('Transfer Code for Component Services') has a valid PAYMENT posting code. All other needed fields with valid values. File 7: Field 1 value set as "1". Value '3-(No - transfer to next guarantor)' for field 57 and field 58 ('Transfer Code for Component Services') has an INVALID posting code. All other needed fields with valid values. File 8: Field 1 value set as "1". The value of field 57 is anything other than '3' and field 58 has a valid TRANSFER posting code. All other needed fields with valid values. File 9: Field 1 value set as "1". The value of field 57 is '1'. Field 59 ('Write Off Code for Component Services") has a valid ADJUSTMENT posting code. All other needed fields with valid values. File 10: Field 1 value set as "1". The value of field 57 is '1'. Field 59 ('Write Off Code for Component Services") has a valid PAYMENT posting code. All other needed fields with valid values. File 11: Field 1 value set as "1". The value of field 57 is '1'. Field 59 ('Write Off Code for Component Services") has a valid TRANSFER posting code. All other needed fields with valid values. File 12: Field 1 value set as "1". The value of field 57 is '1'. Field 59 ('Write Off Code for Component Services") has an INVALID posting code. All other needed fields with valid values. File 13: Field 1 value set as "1". Field 57 ('Write Off Component Services') has the value '2' or '3' and a valid ADJUSTMENT posting code for field 59. All other needed fields with valid values. File 14: Field 1 value set as "1". Value '3-(Both)' for field 55 and valid dictionary value for field 56. Value '1-(Yes)' for field 57 and valid ADJUSTMENT posting code for field 59. All other needed fields with valid values. File 15: Field 1 value set as "2". Field 2 value set as the Valid roll-up ID created in the above step using "File 14". Value '3-(Both)' for field 55 and valid dictionary value for field 56. Value '2-(No - Keep Liability With Current Guarantor)' for field 57 and No values entered for field 59. All other needed fields with valid values. File 16: Field 1 value set as "2". Field 2 value set as the Valid roll-up ID created in the above step using "File 14". Value '3-(Both)' for field 55 and valid dictionary value for field 56. Value '3-(No - Transfer to Next Guarantor)' for field 57 and valid TRANSFER code entered for field 58. No values were entered for field 59. All other needed fields with valid values. File 17: Field 1 value set as "3". Use all other field values the same as in "File 15". Steps Open 'File Import'. Select 'Roll-Up Services Definition' in 'File Type'. Select 'Upload New File'. Click [Process]. Select 'File 1'. Select 'Compile/Validate File'. Select 'File 1'. Click [Process]. Validate that the error shows with the text "File 1.txt contains one or more errors. These errors can be reviewed using 'Print Errors' action.". Click [OK]. Click [Print Errors]. Select 'File 1'. Click [Process]. Validate that the report shows the appropriate error concerning the 'File 1' from the setup. Click [Close Report]. Repeat the above steps for Files 2 - File 8. Click [Discard]. Click [Yes]. Open 'Registry Settings'. Search and select 'Specify Write Off Posting Code In 'Roll-Up Services Definition'' registry setting. Set the Registry Setting Value to "N". Click [Submit]. Click [OK]. Click [No]. Open 'File Import'. Select 'Roll-Up Services Definition' in 'File Type'. Select 'Upload New File'. Click [Process]. Select 'File 9'. Select 'Compile/Validate File'. Select 'File 9'. Click [Process]. Validate that the error shows with the text "File 9.txt contains one or more errors. These errors can be reviewed using 'Print Errors' action.". Click [OK]. Click [Print Errors]. Select 'File 9'. Click [Process]. Validate that the report shows the appropriate error concerning the 'File 9' from the setup. Click [Close Report]. Click [Discard]. Click [Yes]. Open 'Registry Settings'. Search and select the 'Specify Write Off Posting Code In 'Roll-Up Services Definition'' registry setting. Set the Registry Setting Value to "Y". Click [Submit]. Click [OK]. Click [No]. Open 'File Import'. Select 'Roll-Up Services Definition' in 'File Type'. Select 'Upload New File'. Click [Process]. Select 'File 10'. Select 'Compile/Validate File'. Select 'File 10'. Click [Process]. Validate that the error shows with the text "File 10.txt contains one or more errors. These errors can be reviewed using 'Print Errors' action.". Click [OK]. Click [Print Errors]. Select 'File 10'. Click [Process]. Validate that the report shows the appropriate error concerning the 'File 10' from the setup. Click [Close Report]. Repeat above steps for File 11 - File 13. Select 'Upload New File'. Click [Process]. Select 'File 14'. Select 'Compile/Validate File'. Select 'File 14'. Click [Process]. Validate that the success message contains "Compiled.". Click [OK]. Select 'Post File'. Select 'File 14'. Click [Process]. Validate that the success message contains "Posted.". Click [OK]. Select 'Print File'. Select 'File 14'. Click [Process]. Validate that the report shows the appropriate values passed/ posted in 'File 14' from the setup. Click [Close Report]. Click [Discard]. Click [Yes]. Open 'Roll-Up Services Definition'. Select 'Edit'. Select the Roll-Up Service Definition posted in Step 75 in the 'Existing Roll-Up Definition' field. Validate that all the values are populated correctly. Click [Discard]. Click [Yes]. Open 'File Import'. Select 'Roll-Up Services Definition' in 'File Type'. Select 'Upload New File'. Click [Process]. Select 'File 15'. Select 'Compile/Validate File'. Select 'File 15'. Click [Process]. Validate that the success message contains "Compiled.". Click [OK]. Select 'Post File'. Select 'File 15'. Click [Process]. Validate that the success message contains "Posted.". Click [OK]. Select 'Print File'. Select 'File 15'. Click [Process]. Validate that the report shows the appropriate values passed/ posted in 'File 15' from the setup. Click [Close Report]. Click [Discard]. Click [Yes]. Open 'Roll-Up Services Definition'. Select 'Edit'. Select the Roll-Up Service Definition posted above in the 'Existing Roll-Up Definition' field. Validate that all the values are populated correctly. Click [Discard]. Click [Yes]. Open 'File Import'. Select 'Roll-Up Services Definition' in 'File Type'. Select 'Upload New File'. Click [Process]. Select 'File 16'. Select 'Compile/Validate File'. Select 'File 16'. Click [Process]. Validate that the success message contains "Compiled.". Click [OK]. Select 'Post File'. Select 'File 16'. Click [Process]. Validate that the success message contains "Posted.". Click [OK]. Select 'Print File'. Select 'File 16'. Click [Process]. Validate that the report shows the appropriate values passed/ posted in 'File 16' from the setup. Click [Close Report]. Click [Discard]. Click [Yes]. Open 'Roll-Up Services Definition'. Select 'Edit'. Select the Roll-Up Service Definition posted above in the 'Existing Roll-Up Definition' field. Validate that all the values are populated correctly. Click [Discard]. Click [Yes]. Open 'File Import'. Select 'Roll-Up Services Definition' in 'File Type'. Select 'Upload New File'. Click [Process]. Select 'File 17'. Select 'Compile/Validate File'. Select 'File 17'. Click [Process]. Validate that the success message contains "Compiled.". Click [OK]. Select 'Post File'. Select 'File 17'. Click [Process]. Validate that the success message contains "Posted.". Click [OK]. Select 'Print File'. Select 'File 17'. Click [Process]. Validate that the report shows the appropriate values passed/ posted in 'File 17' from the setup. Click [Close Report]. Click [Discard]. Click [Yes]. Open 'Roll-Up Services Definition'. Select 'Edit'. Search for the Roll-Up Service Definition deleted above in the 'Existing Roll-Up Definition' field. Validate that we get "No results found". Click [Discard]. Click [Yes]. Compile/Edit/Post/Unpost Roll-Up Services Worklist - Compile Roll-Up Group Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Client Charge Input Compile/Edit/Post/Unpost Roll-Up Services Worklist Scenario 1: Validate 'Roll-Up-Compile Report' generated with the correct data for both Individual and Group definitions. Specific Setup: Registry settings: Set the "Allow Roll-Up Rule Selection During Compile" registry setting to have the value "1&2". Service Codes: Using the 'Service Codes' form add or identify two individual roll-up service codes and at least two service codes that will be considered component services to each roll-up service code. Rollup 1 Comp 1(a) Comp 1(b) Rollup 2 Comp 2(a) Comp 2(b) Roll-Up Services Definition: Add or identify two different roll-up service definitions, one for each of the two roll-up service codes and their associated component services. Rollup Def 1 Rollup 1 Comp 1(a) Comp 1(b) Rollup Def 2 Rollup 2 Comp 2(a) Comp 2(b) Roll-Up Group Definition: Using the 'Roll-Up Group Definition' section of the 'Roll-Up Services Definition' form, create a new roll-up group that includes the two roll-up definitions created earlier. Rollup Group Def 1 Rollup Def 1 Rollup Def 2 Client A: The client is admitted to an inpatient/ outpatient program. The client has an active diagnosis record. The client has the Financial Eligibility record. Steps Open 'Client Charge Input'. For "Client A" add several days of charges for each of the roll-up component services from the Setup. Comp 1(a) Comp 1(b) Comp 2(a) Comp 2(b) Open 'Client Ledger'. Verify that the charges for the roll-up component services are showing for "Client A". Click [X]. Click [No]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Set the 'Through Date' to today's date by clicking 'T'. Verify that the 'Roll-Up Definitions' field shows the below Roll-Up definitions, Rollup Def 1. Rollup Def 2. Select both the definitions used above. Click [Compile Worklist]. Verify the "Compile complete" message is received. Click [OK]. Click [Run Report]. Verify that the report contains the roll-up services that are created during the compile process along with the component services. Close the report. Click [Discard]. Click [Yes]. Open 'Compile/Edit/Post/Unpost Roll-Up Services Worklist'. Set the 'Through Date' to today's date by clicking 'T'. Verify that the 'Roll-Up Group' field shows the below Roll-Up groups: Rollup Group Def 1. Select the group from Step 21. Click [Compile Worklist]. Verify that the alert message displays: "A compiled roll-up already exists for a selected rule. Continuing will overwrite this compile. Are you sure you want to continue?". Click [Yes]. Verify the "Compile complete" message is received. Click [OK]. Click [Run Report]. Verify that the report contains the roll-up services created during the compile process and the component services for both Roll-Up Definitions. Close the report. Select 'Post Roll-Up Services Worklist'. Select the posted Roll-Up worklist date range in the 'Through Date' field. Select any desired Adjustment code in the 'Default Write Off Posting Code' field. Click [Post Worklist]. Verify the success message says "Post complete.". Click [OK]. Click [Discard]. Click [Yes]. Open 'Client Ledger' for "Client A". Verify that the rollup services are shown along with the component services marked as 'Roll-Up' with their respective posting code. Click [X]. Click [No]. Guarantor/Program Billing Defaults - 837 Professional Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Electronic Billing File Import Scenario 1: Validate 'Guarantor Program Billing Defaults', 'Sort Claims by Date of Service' = Yes. Specific Setup: Guarantor: A new one is created or an existing guarantor is identified. Guarantor 1 Guarantor/Program Billing Defaults Template: A Guarantor/Program Billing Defaults template is identified that includes "Guarantor 1" Template 1 Client A: Client has unbilled, closed services in a three-month date range. The services should be for "Guarantor 1". The tester knows the date range, financial class of the guarantor, and the program. Some of the service dates will have one service only. Some of the service dates will have two services. Some of the service dates will have five services. Create Interim Billing Batch File: An Interim billing batch is created that covers the services of "Client A". Batch 1 Steps Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" from the 'Select Template' field. Select the '837 Professional' section. Set the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field to blank. Select 'Yes' in the 'Sort Claims by Date of Service' field. Click [Submit]. Click [No]. Open 'Open 'Electronic Billing'. Create a bill for the services entering all the dates of service(s) in the billing date range by selecting "Batch 1". Review the dump file. Validate that the client has more than one CLM segment. Validate that the services are grouped into different claims on the bill. Validate that the LX segments after each CLM segment(s) are for all the services that are on the same day. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" from the 'Select Template' field. Select the '837 Professional' section. Set the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field to "2". Select 'Yes' in the 'Sort Claims by Date of Service' field. Click [Submit]. Click [No]. Open 'Open 'Electronic Billing'. Create a bill for the services entering all the dates of service(s) in the billing date range by selecting "Batch 1". Review the dump file. Validate that the client has more than one CLM segment. Validate that the services are grouped into different claims on the bill. All services that are on the same day are grouped into one claim, unless there are more than two services. The system will create three claims when 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field is set to "2" and there are five services. The first two claims will have two LX segments. The third claim will have one LX segment. Click [X]. Click [No]. Scenario 2: Validate 'Guarantor Program Billing Defaults', 'Sort Claims by Date of Service' = No and None is selected. Specific Setup: Guarantor: A new one is created or an existing guarantor is identified. Guarantor 1 Guarantor/Program Billing Defaults Template: A Guarantor/Program Billing Defaults template is identified that includes "Guarantor 1" Template 1 The 'Sort Claims by Date of Service' field in the '837 Professional' section of "Guarantor 1" has no values selected. Client A: Has unbilled, closed, services for a two or three-month(s) date range. The services should be for "Guarantor 1". The tester knows the date range, financial class of the guarantor, and the program. Create Interim Billing Batch File: An Interim billing batch is created that covers the services of "Client A". Batch 1 Steps Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" from the 'Select Template' field. Select the '837 Professional' section. Leave the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field blank. Verify that the 'Sort Claims by Date of Service' field exists and has the below options, Yes No Verify that for the first time when it's accessed no values are selected in the 'Verify the Sort Claims by Date of Service' field. Click [Submit]. Click [No]. Open 'Open 'Electronic Billing'. Create a bill for the services entering all the dates of service(s) in the billing date range by selecting "Batch 1". Review the dump file. Validate that the client has only one CLM segment. Validate that the LX segments after the first CLM segment are for all the dates of services. Click [X]. Click [No]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" from the 'Select Template' field. Select the '837 Professional' section. Leave the 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)' field blank. Select 'No' in the 'Sort Claims by Date of Service' field. Click [Submit]. Click [No]. Open 'Open 'Electronic Billing'. Create a bill for the services entering all the dates of service(s) in the billing date range by selecting "Batch 1". Review the dump file. Validate that the client has only one CLM segment. Validate that the LX segments after the first CLM segment are for all the dates of services. Click [X]. Click [No]. Scenario 3: File Import - GPBD Template - Add/ Edit - Validating the new field 'Sort Claims by Date of Service'. Specific Setup: File Import (Guarantor/Program Billing Defaults Template): Below .txt (file import) files are created, File A. To Add Template 1, with all the required values for 837P. With no values entered for the 'Sort Claims by Date of Service' field. File B. To Edit Template 1. With the value 'N' for the 'Sort Claims by Date of Service' field. File C. To Edit Template 1. With the value 'Y' for the 'Sort Claims by Date of Service' field. Steps Open 'File Import'. Select 'Guarantor/Program Billing Defaults Template' in 'File Type'. Select 'Upload New File' from the 'Action' field. Click [Process Action]. Select "File A" from the setup. Verify that the file loaded successfully. Select 'Compile/Validate File' from the 'Action' field. Select the uploaded file from the 'File(s)' field. Click [Process Action]. Verify the success message shown that says "Compiled.". Click [OK]. Select 'Post File' from the 'Action' field. Select the file compiled in Step 10 from the 'File(s)' field. Click [Process Action]. Verify the success message shown that says "Posted.". Click [OK]. Select 'Print File' from the 'Action' field. Select the file posted in Step 15 from the 'File(s)' field. Click [Process Action]. Validate that the report text contains all the values that are filed for "Template 1", which also includes the new field "Sort Claims by Date of Service" and its value. Close the report. Click [Discard]. Click [Yes]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" from the 'Select Template' field. Select '837 Professional' section. Verify that the 'Sort Claims by Date of Service' field has no values selected. Click [Discard]. Click [Yes]. Open 'File Import'. Select 'Guarantor/Program Billing Defaults Template' in 'File Type'. Select 'Upload New File' from the 'Action' field. Click [Process Action]. Select File B" from the setup. Verify that the file loaded successfully. Select 'Compile/Validate File' from the 'Action' field. Select the uploaded file from the 'File(s)' field. Click [Process Action]. Verify the success message shown that says "Compiled.". Click [OK]. Select 'Post File' from the 'Action' field. Select the file compiled in Step 40 from the 'File(s)' field. Click [Process Action]. Verify the success message shown that says "Posted.". Click [OK]. Select 'Print File' from the 'Action' field. Select the file posted in Step 45 from the 'File(s)' field. Click [Process Action]. Validate that the report text contains all the values that are filed for "Template 1", which also includes the new field "Sort Claims by Date of Service" and its value. Close the report. Click [Discard]. Click [Yes]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" from the 'Select Template' field. Select '837 Professional' section. Verify that the 'Sort Claims by Date of Service' field has the value 'No' selected. Click [Discard]. Click [Yes]. Open 'File Import'. Select 'Guarantor/Program Billing Defaults Template' in 'File Type'. Select 'Upload New File' from the 'Action' field. Click [Process Action]. Select "File C" from the setup. Verify that the file loaded successfully. Select 'Compile/Validate File' from the 'Action' field. Select the uploaded file from the 'File(s)' field. Click [Process Action]. Verify the success message shown that says "Compiled.". Click [OK]. Select 'Post File' from the 'Action' field. Select the file compiled in Step 70 from the 'File(s)' field. Click [Process Action]. Verify the success message shown that says "Posted.". Click [OK]. Select 'Print File' from the 'Action' field. Select the file posted in Step 75 from the 'File(s)' field. Click [Process Action]. Validate that the report text contains all the values that are filed for "Template 1", which also includes the new field "Sort Claims by Date of Service" and its value. Close the report. Click [Discard]. Click [Yes]. Open 'Guarantor/Program Billing Defaults'. Select 'Edit Template'. Select "Template 1" from the 'Select Template' field. Select '837 Professional' section. Verify that the 'Sort Claims by Date of Service' field has the value 'Yes' selected. Click [Discard]. Click [Yes].	Topics • Roll-Up Services Definition • Electronic Billing • Compile/Edit/Post/Unpost Roll-up Services Worklist • Guarantor / Program Billing Defaults • 837 Professional • File Import • Registry Settings • Quick Billing

Avatar_PM_2024_Monthly_Release_2024.01.02_Details.csv