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Avatar PM 2024 Monthly Release 2024.02.00 Acceptance Tests

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Update 20 Summary | Details
NCPDP
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Electronic Re-Billing Service Assignment
  • Launch RxConnect
  • RxConnect
Scenario 1: NCPDP - miscellaneous issues include claim rejection information and Medicare Part D re-billing related issues
Specific Setup:
  • The Avatar application must be associated with an RxConnect Instance and configured to communicate via HL7.
  • There must be active connections between Avatar and RxConnect for "ADT", "ORDERS", "FILL DETAILS", and "BILLING".
  • The "ADT" and "ORDERS" connections must have both values selected in the 'Sub System Code Facility ID(s) Supported' field and the 'Include Sub System Code Facility ID in Outbound Message' field in the 'HL7 Connection Manager' form, which is a Netsmart Staff Only form. Please contact your Netsmart Representative.
  • CE2000 must be installed and configured on the Database server.
  • The 'Avatar PM->Billing->Electronic Billing->NCPDP->->Enable NCPDP Billing' registry setting must be set to "Y".
  • The 'Avatar PM->Billing->Electronic Billing->Electronic Re-Billing Service Assignment->->Multiple Claim Original Reference Number/Claim Submission Reason Code' registry setting must be set to "Y".
  • The 'RADplus->Database Management->RxConnect->->->Enable RxConnect Facility ID' registry setting must be set to "Y".
  • Two inpatient programs must exist. (Program A) (Program B)
  • Two sub system codes must exist:
  • One associated with "Program A" with a 'Facility ID' of "41". (Sub System Code A)
  • One associated with "Program B" with a 'Facility ID' of "42". (Sub System Code B)
  • RxConnect must have at least two hospitals.
  • One with a 'HL7 ID' of "41" associated to "Sub System Code A". (Hospital A)
  • One with a 'HL7 ID' of "42" associated to "Sub System Code B". (Hospital B)
  • Please log out of the application and log back in after completing the above configuration.
  • Two clients must exist
  • One client must have an active episode associated with "Program A". (Client A)
  • One client must have an active episode associated with "Program B". (Client B)
  • “Client A” and "Client B" must have a ‘Date of Birth’, ‘Sex’ and address on file in the ‘Update Client Data’ form, as well as information filed in the ‘Allergies and Hypersensitivities’ form, ‘Diagnosis’ form, and in the ‘Height’ and ‘Weight’ fields in the ‘Vitals Entry’ form.
  • "Client A" and "Client B" must be associated with an NCPDP guarantor in the 'Financial Eligibility' form.
  • "Client A" and "Client B" must have active pharmacy-type orders each with a duration of "60 Days" that starts in the past that have been processed in RxConnect. (Order A) (Order B)
  • "Order A" and "Order B" must have two active NDC#'s each. (NDC A) (NDC B) for "Order A" and (NDC C) (NDC D) for "Order B".
  • "Order A" must be administered for the first seven days using "NDC A", the second seven days using "NDC B", the third set of seven days using "NDC A", and the last set of seven days using "NDC B".
  • "Order B" must be administered for the first seven days using "NDC C", the second seven days using "NDC D", the third set of seven days using "NDC C", and the last set of seven days using "NDC D".
  • Charges must be batched in RxConnect.
  • Charges must be compiled in the 'Compile Inbound HL7 Charge Batch File' form.
  • Charges must be posted in the 'Post Inbound HL7 Charge Batch File' form.
  • Charges must be rolled up and posted in the 'Compile/Edit/Post/Unpost Roll-Up Services Worklist' form and ensure that "Client A" and "Client B" contain two fills each for fourteen days.
  • Charges must be closed for "Client A" and "Client B".
  • An NCPDP bill must be created, claimed and a file must exist on the server, this is done in the 'Electronic Billing' form.
  • The bill must be processed through CE2000 and be rejected.
  • The user must be logged into the Root System Code.
Steps
  1. Access the 'Electronic Re-Billing Service Assignment' form.
  2. Click the 'NCPDP Response Worklist' menu item.
  3. Enter the first date of service and the last date of service in the 'From Date (of Service)' and 'Through Date (of Service)' fields.
  4. Select the "NCPDP Guarantor" in the 'Guarantor' field.
  5. Select "All" in the 'Individual or All Clients' field.
  6. Select "All Unresolved Items" in the 'Include the Following' field.
  7. Click [View Worklist].
  8. Validate the worklist is displayed and contains four rows, two for "Client A" and two for "Client B".
  9. Click [Close/Cancel]
  10. Log out of the application and log back into "Sub System Code A".
  11. Access the 'Electronic Re-Billing Service Assignment' form.
  12. Click the 'NCPDP Response Worklist' menu item.
  13. Enter the first date of service and the last date of service in the 'From Date (of Service)' and 'Through Date (of Service)' fields.
  14. Select the "NCPDP Guarantor" in the 'Guarantor' field.
  15. Select "All" in the 'Individual or All Clients' field.
  16. Select "All Unresolved Items" in the 'Include the Following' field.
  17. Click [View Worklist].
  18. Validate the worklist is displayed and contains two rows for "Client A".
  19. Validate the worklist does not contain any rows for "Client B".
  20. Click [Close/Cancel]
  21. In the 'Client' field search for "Client A's Last Name' and validate that "Client A" is displayed in the results.
  22. In the 'Client' field search for "Client B's Last Name' and validate that "Client B" is not displayed in the results.
  23. Log out of the application and log back into "Sub System Code B".
  24. Access the 'Electronic Re-Billing Service Assignment' form.
  25. Click the 'NCPDP Response Worklist' menu item.
  26. Enter the first date of service and the last date of service in the 'From Date (of Service)' and 'Through Date (of Service)' fields.
  27. Select the "NCPDP Guarantor" in the 'Guarantor' field.
  28. Select "All" in the 'Individual or All Clients' field.
  29. Select "All Unresolved Items" in the 'Include the Following' field.
  30. Click [View Worklist].
  31. Validate the worklist does not contain any rows for "Client A".
  32. Validate the worklist is displayed and contains two rows for "Client B".
  33. Click [Close/Cancel]
  34. In the 'Client' field search for "Client A's Last Name' and validate that "Client A" is not displayed in the results.
  35. In the 'Client' field search for "Client B's Last Name' and validate that "Client B" is displayed in the results.
  36. Log out of the application and log back into the Root System Code.
  37. Access the 'Electronic Re-Billing Service Assignment' form.
  38. Click the 'NCPDP Response Worklist' menu item.
  39. Enter the first date of service and the last date of service in the 'From Date (of Service)' and 'Through Date (of Service)' fields.
  40. Select the "NCPDP Guarantor" in the 'Guarantor' field.
  41. Select "All" in the 'Individual or All Clients' field.
  42. Select "All Unresolved Items" in the 'Include the Following' field.
  43. Click [View Worklist].
  44. Validate the worklist is displayed and contains four rows, two for "Client A" and two for "Client B".
  45. Check the 'Forward to Pharmacy' checkbox for the two rows for "Client A" and for one row for "Client B".
  46. Click [Save].
  47. Validate a "Successfully filed!" message is displayed and click [OK].
  48. Select "All Unresolved Items Flagged for Pharmacy (no response)" in the 'Include the Following' field.
  49. Click [View Worklist].
  50. Validate the worklist is displayed and contains three rows, two for "Client A" and one for "Client B".
  51. Close the form.
  52. Access the 'Launch RxConnect' form and click [Launch RxConnect].
  53. Click 'Configuration' and select "Active Hospital".
  54. Select "Hospital A" in the 'Select Hospital' field and click [Change Hospital].
  55. Click 'RxSummary'.
  56. Click the 'NCPDP Response' tab.
  57. Validate two rows are displayed for "Client A".
  58. Click the first row.
  59. Populate the first set of 'Response DUR Reason Codes' with values.
  60. Populate the first 'Submission Clarification Codes' field with any value and click [Submit].
  61. Click the second row.
  62. Populate the first 'Submission Clarification Codes' field with any value and click [Submit].
  63. Click 'Configuration' and select "Active Hospital".
  64. Select "Hospital B" in the 'Select Hospital' field and click [Change Hospital].
  65. Click 'RxSummary'.
  66. Click the 'NCPDP Response' tab.
  67. Validate one row is displayed for "Client B".
  68. Click the row.
  69. Populate the first set of 'Response DUR Reason Codes' with values and click [Submit].
  70. Click 'Log Out' and close the 'Launch RxConnect' form.
  71. Access the 'Electronic Re-Billing Service Assignment' form.
  72. Click the 'NCPDP Response Worklist' menu item.
  73. Enter the first date of service and the last date of service in the 'From Date (of Service)' and 'Through Date (of Service)' fields.
  74. Select the "NCPDP Guarantor" in the 'Guarantor' field.
  75. Select "All" in the 'Individual or All Clients' field.
  76. Select "All Unresolved Items Flagged for Pharmacy (with response)" in the 'Include the Following' field.
  77. Click [View Worklist].
  78. Validate the worklist is displayed and contains three rows, two for "Client A" and one for "Client B".
  79. Click [Close/Cancel]
  80. Select "All Resolved Items" in the 'Include the Following' field.
  81. Click [View Worklist].
  82. Validate the worklist is displayed and contains no data.
  83. Click [Close/Cancel].
  84. Click the 'NCPDP Re-Billing Service Assignment' menu item.
  85. Search for and select "Client A" in the 'Client ID' field.
  86. Select "Add Claim To Re-Bill" in the 'Add/Delete' field.
  87. Select the first claim number in the 'Claim Number' field.
  88. Validate a message is displayed stating "Information for re-billing has been provided by the pharmacy for this claim. Would you like to default in this information?" and click [Yes].
  89. Click [DUR Overrides].
  90. Validate the information entered in the 'Response DUR Reason Codes' fields is displayed and click [Close/Cancel].
  91. Select the second claim number in the 'Claim Number' field.
  92. Validate a message is displayed stating "Information for re-billing has been provided by the pharmacy for this claim. Would you like to default in this information?" and click [Yes].
  93. Click [DUR Overrides].
  94. Validate that no information is displayed and click [Close/Cancel].
  95. Search for and select "Client B" in the 'Client ID' field
  96. Validate "Add Claim To Re-Bill" is selected in the 'Add/Delete' field.
  97. Select the first claim number in the 'Claim Number' field.
  98. Validate a message is displayed stating "Information for re-billing has been provided by the pharmacy for this claim. Would you like to default in this information?" and click [Yes].
  99. Click [DUR Overrides].
  100. Validate the information entered in the 'Response DUR Reason Codes' fields is displayed and click [Close/Cancel].
  101. Select the second claim number in the 'Claim Number' field.
  102. Validate that no message is displayed. This is because no clarification or DUR information was entered for this claim.
  103. Close the form.
Topics
• NX • NCPDP
Update 36 Summary | Details
Discontinue or Hold Orders Upon Leave
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Orders This Episode
  • Leaves
  • eMAR
Scenario 1: OE NX - Put Orders On Hold During Leave
Specific Setup:
  • Avatar PM 2024 Update 36, Avatar OE 2024 Update 35, Avatar eMAR 2024 Update 16, Avatar CWS 2024 Update 48 and myAvatar NX Release 2024.07.00 is required in order to utilize full functionality.
  • The "(772) Discontinue or Hold Orders Upon Leave" extended attribute must be set to "Hold" in the Client '(757) Types Of Leave From' dictionary for "Leave"
  • Please log out of the application and log back in after completing the above configuration.
  • A client must have an active inpatient episode (Client A)
  • “Client A” must have a ‘Date of Birth’, ‘Sex’ and address on file in the ‘Update Client Data’ form, as well as information filed in the ‘Allergies and Hypersensitivities’ form, ‘Diagnosis’ form, and in the ‘Height’ and ‘Weight’ fields in the ‘Vitals Entry’ form.
Steps
  1. Select "Client A" and access the Order Entry Console.
  2. Search for and select any pharmacy-type order code.
  3. Populate the required fields and click [Add to Scratchpad].
  4. Search for and select any lab-type order code.
  5. Populate the required fields selecting a "PRN" frequency and click [Add to Scratchpad].
  6. Search for and select any dietary oral-type order code.
  7. Populate the required fields and click [Add to Scratchpad] and [Sign].
  8. Validate the 'Order grid' contains three orders.
  9. Access the 'Leaves' form.
  10. Populate the required fields selecting "Leave" from the 'Type of Leave From' field and click [Submit].
  11. Access the Order Entry Console.
  12. Validate the 'Order grid' contains the three orders with each having an action of "Active (On Hold automatically upon leave - Leave)".
  13. Access 'eMAR NX' for "Client A".
  14. Validate there is a banner across the pharmacy-type order hour columns displaying "Leave (Leave) Effective (leave date and leave time)".
  15. Click [Scan Client], populate the required fields, and click [Save].
  16. Perform 'Client Education' and 'Order Acknowledgement'.
  17. Click the ellipsis for the pharmacy-type order and select "Document Additional Dose".
  18. Validate the 'Select Administration Time' dialog is launched.
  19. Select any value in the 'Scheduled Undocumented Doses' section and click [Select].
  20. Validate the order is displayed in the 'Medication List' and click [Administer].
  21. Validate the 'Medication Administration' dialog is displayed.
  22. Populate the required fields.
  23. Click [Address Alerts] and validate there is an alert on the 'Administration Date/Time' tab that displays "This Administration Event is occurring while the order is on hold due to leave (Leave)."
  24. Override any alerts and click [Save Override(s)] and [Close].
  25. Click [Save].
  26. Validate a cell displays administration data for the time selected.
  27. Access 'Task List'.
  28. Search for and select "Client A" in the 'Search Clients' field.
  29. Validate the 'Dietary Oral-type' does not display.
  30. Click 'PRN Tasks'
  31. Validate the 'Lab' order is displayed, select the order, and click [Collect].
  32. Perform 'Order Acknowledgement' and 'Education'.
  33. Validate the 'Specimen Collection' dialog is displayed.
  34. Populate the required fields.
  35. Click [Alerts] and validate a warning displays "This Administration Event is occurring while the order is on hold due to leave (Leave)."
  36. Override any alerts and click [Save Override(s)] and [Close].
  37. Click [Sign].
  38. Access the Order Entry Console.
  39. Select the Dietary Oral-type order in the 'Order grid' and click [Resume], [Add to Scratchpad], and [Sign].
  40. Access 'Task List'.
  41. Click the 'Dietary-Oral Admin' for the next collection time.
  42. Click the checkbox for the order and click [Administer], [Acknowledge], and [Educate].
  43. Validate the 'Dietary-Oral Administration' dialog is displayed
  44. Populate the required fields.
  45. Click [Alerts], override any alerts and click [Save Override(s)] and [Close].
  46. Click [Sign].
Topics
• eMAR NX
Update 47 Summary | Details
File Import - DRG Code Table
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Diagnosis
  • Electronic Billing
Scenario 1: PM - File Import - DRG Code Table - Validating an 837 institutional bill
Specific Setup:
  • Registry Settings:
  • The 'Enable DRG Codes' must be enabled.
  • The 'Import File Delimiter' registry setting is set to value to "2".. This will change the delimiter type to tabs.
  • Site Specific Section Modeling:
  • Field 'DRG Code (ICD-10)' must be added to Avatar PM 'Diagnosis' form.
  • The following file import files are created to add and/or update the DRG Code Table. Note the location and of the files.
  • File import file to add 2-digit DRG code in the system.
  • File import file to delete the 2-digit DRG code from the system.
  • File import file to update the 2-digit DRG code to 3-digit DRG code by adding leading zero in the system.
  • Guarantor/Program Billing Defaults:
  • The 'Enable Using DRG Code In 2300-HI-Diagnosis Related Group (DRG) Information' must be set to 'Yes' in applicable template for 837 Institutional billing file generation.
  • Access to Crystal Reports or other SQL reporting tool.
  • Guarantors/Payors:
  • An existing guarantor is identified to be used. Note the guarantor's code/name.
  • Service codes:
  • An existing service code is identified to be used. Note the service code/description.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the service code identified in the 'Service Codes' form.
  • Admission:
  • An existing client is identified, or a new client is admitted in the desired program. Note client id, admission program, admission date.
  • Financial Eligibility:
  • The guarantor identified in the 'Guarantors/Payors' form is assigned to the client as the primary guarantor.
  • Diagnosis:
  • Diagnosis record exists with value for 'DRG Code (ICD-10)' included/filed.
  • Client Charge Input:
  • A service is rendered to the client. Note service date, service code.
  • Client Ledger:
  • The service distributed correctly to the assigned guarantor.
  • Close Charges:
  • Create Interim Billing Batch File:
  • An interim billing batch is created to include client, services and guarantor in the batch. Note the batch number.
Steps
  1. Open 'File Import' form.
  2. Select "DRG Code Table" from the 'File Type'.
  3. Select "Upload New File" in the 'Action' field.
  4. Click [Process Action].
  5. Select 'DRG Code Table' import file to import 2-digit DRG code.
  6. Click [Open].
  7. Select "Compile/Validate File" in the 'Action' field.
  8. Select loaded import file.
  9. Click [Process Action].
  10. Verify that 'Compile/Validate File' action completes, and message 'Compiled' is displayed.
  11. Click 'OK' button.
  12. Select "Print File" in 'Action' field to view successfully compiled import data.
  13. Select compiled import file.
  14. Click [Process Action].
  15. In 'DRG Code Table' File Import Report, verify that all valid import row(s) are included in the report with segment/value details.
  16. Select "Post File" in 'Action' field to post successfully compiled import data.
  17. Select compiled import file.
  18. Click [Process Action].
  19. Verify that 'Compile/Validate File' action completes, and message 'Posted' is displayed.
  20. Open Crystal Reports or other SQL reporting tool.
  21. Access the SQL table 'SYSTEM.file_import_drg_codes'.
  22. Verify that all 'DRG Code Table' File Import rows are included in the table with values from the import data file.
  23. Access the 'SYSTEM.table_drg_codes' table.
  24. Verify that all successfully posted 'DRG Code Table' File Import rows are reflected as new (or updated) DRG Code entries in table.
  25. Repeat the steps from 1 through 24 to update the 2 digit code with leading zero.
  26. Open the 'Diagnosis' form.
  27. Add/update the diagnosis record for the client for the date of service.
  28. Select the updated DRG code to the diagnosis record.
  29. Submit the form.
  30. Open the 'Electronic Billing' form.
  31. Select 837 Institutional in 'Billing Form' field.
  32. Select values for 837 bill generation in the 'Type of Bill', 'Individual or All Guarantors' and 'Billing Type' fields.
  33. Select "Sort File" in the 'Billing Options' field.
  34. Select/enter values for service inclusion in 'All Clients or Interim Billing Batch', 'Program(s)'
  35. Select value for 'Create Claims' field (and enter value for 'Date of Claim' if 'Yes').
  36. Enter/select values 'First Date of Service to Include' and 'Last Date of Service to Include' fields.
  37. Enter/select values for any other bill sorting criteria fields as required/desired.
  38. Click [Process].
  39. Verify the bill compiles successfully.
  40. Select 'Dump File' in the 'Billing Options' field.
  41. Select 837 file generated.
  42. Click [Process].
  43. For 837 Institutional format billing files generated - ensure that the 'DRG Code (ICD-10)' value associated to applicable Diagnosis record/entries for service(s) included in bill is present in 2300-HI-Diagnosis Related Group (DRG) Information claim loop. (Example: 'HI*ABK:O2402:::::::Y~HI*ABJ:O24013~HI*DR:079')
  44. Close the report.
  45. Close the form.
Scenario 2: PM - 'File Import' - Add / Edit / Delete 'DRG Code Table' Import
Specific Setup:
  • Registry Settings:
  • The 'Enable DRG Codes' must be enabled.
  • The 'Import File Delimiter' registry setting is set to "2". This will change the delimiter type to tabs.
  • The file import record layout for the Avatar 'DRG Code Table' is available for the user.
  • The file import files are created for the Avatar 'DRG Code Table to add, update and delete the DRG Code Table. Note the location of the files.
  • Access to Crystal Reports or other SQL reporting tool
Steps
  1. Open 'File Import' form.
  2. Select "DRG Code Table" from the 'File Type' field.
  3. Select "Upload New File" in the 'Action' field.
  4. Click [Process Action].
  5. Select 'DRG Code Table' import file to add the new DRG code to the table.
  6. Click [Open].
  7. Select "Compile/Validate File" in the 'Action' field.
  8. Select recently loaded import file.
  9. Click [Process Action].
  10. Verify that 'Compile/Validate File' action completes, and message 'Compiled' is displayed.
  11. Click [OK].
  12. Select "Print File" in the 'Action' field to view successfully compiled import data.
  13. Select successfully compiled import file.
  14. Click [Process Action].
  15. Verify all valid import row(s) are included in the report.
  16. Select "Post File" in the 'Action' field to post successfully compiled import data.
  17. Select successfully compiled import file.
  18. Click [Process Action].
  19. Validate the message 'Posted' is displayed.
  20. Query - select * from SYSTEM.file_import_drg_codes
  21. Validate the' add_edit_code' cell is equal to "A".
  22. Validate the 'add_edit_value' cell is equal to "Add".
  23. Validate the 'Code_set_code' cell is equal to "ICD10".
  24. Validate the 'drg_code' cell is equal to the DRG code added in the import file.
  25. Validate the drg_value cell is equal to description of the code added in the import file.
  26. Verify the 'pkey' cell exists.
  27. Query - select * from SYSTEM.table_drg_codes.
  28. Validate the 'drg_code' cell is equal to the DRG code added in the import file.
  29. Validate the drg_value cell is equal to description of the code added in the import file.
  30. Validate the ID cell is equal to the system generated unique id which will be used in the 'pkey' column of the import file. Note the ID.
  31. Close the report.
  32. Repeat steps 1 through 19 to import the file import file to edit an existing DRG code in the table.
  33. Query - select * from SYSTEM.file_import_drg_codes
  34. Validate the' add_edit_code' cell is equal to "E".
  35. Validate the 'add_edit_value' cell is equal to "Edit".
  36. Validate the 'Code_set_code' cell is equal to "ICD10".
  37. Validate the 'drg_code' cell is equal to the updated DRG code as listed in the import file.
  38. Validate the drg_value cell is equal to description of the code added in the import file.
  39. Verify the 'pkey' cell exists.
  40. Validate the ‘pkey’ column displays the correct value as listed in the import file.
  41. Query - select * from SYSTEM.table_drg_codes.
  42. Validate the 'drg_code' cell is equal to the updated DRG code as listed in the import file.
  43. Validate the drg_value cell is equal to description of the code added in the import file.
  44. Verify the 'pkey' cell exists.
  45. Validate the ‘pkey’ column displays the correct value as listed in the import file.
  46. Close the report.
  47. Repeat steps 1 through 19 to import the file import file to delete an existing DRG code from the table.
  48. Query - select * from SYSTEM.file_import_drg_codes
  49. Validate the' add_edit_code' cell is equal to "D".
  50. Validate the 'add_edit_value' cell is equal to "Delete".
  51. Validate the 'Code_set_code' cell is equal to "ICD10".
  52. Validate the 'drg_code' cell is equal to the DRG code added in the import file.
  53. Validate the drg_value cell is equal to description of the code added in the import file.
  54. Verify the 'pkey' cell exists.
  55. Validate the ‘pkey’ column displays the correct value as listed in the import file.
  56. Query - select * from SYSTEM.table_drg_codes.
  57. Validate the 'drg_code' cell does not contain the deleted DRG code which is listed to be deleted in the import file.
  58. Close the report.
Financial Determination - Field Verification
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Financial Determination
Scenario 1: 'Financial Determination' - filing financial determination for a client
Specific Setup:
  • Dictionary Update:
  • User must populate the following Client dictionary tables: 7104, 7108, 7110, 7113, 7118, 7127, and 7131.
  • Registry Setting:
  • The 'Include Enhanced Limits' setting must be enabled.
  • Guarantors/Payors:
  • An existing guarantor is identified to be used. Note the guarantor's code/name.
  • Admission:
  • An existing client is identified, or a new client is admitted. Note client id, admission program, admission date.
  • Financial Eligibility:
  • The guarantor identified in the 'Guarantors/Payors' form is assigned to the client as the primary guarantor.
  • User Definition:
  • User has access to the 'Financial Determination Configuration' and 'Financial Determination' forms.
  • Financial Determination Configuration:
  • Select "Create New" in the 'Configuration' field.
  • Enter the leap year day (i.e. 2/29/2024) in the 'Effective Date' field.
  • Do not enter any value in the 'Expiration Date' field.
  • Enter desired amount in the 'Lump Sum Value Is Net Assets Plus' field.
  • Enter desired amount in the 'FICA Tax Rate' field.
  • Enter desired amount in the 'Room And Board' field.
  • Enter desired amount in the 'Default Income Percentage For Ability To Pay' field.
  • Enter desired amount in the 'Each Additional Dependent' field.
Steps
  1. Select desired client and access the 'Financial Determination' form.
  2. Enter the leap year day (ex. 02/29/2024) in the 'Effective Date' field.
  3. Do not enter any value in the 'Expiration Date' field.
  4. Verify the 'Expiration Date' field is auto populated with the desired date (i.e. 02/28/2025).
  5. Clear the date from the 'Expiration Date' field.
  6. Change the 'Effective Date' field to non leap year day (i.e. 02/28/2022).
  7. Verify the 'Expiration Date' field is auto populated with the desired date (i.e. 02/27/2023).
  8. Clear the date from the 'Expiration Date' field.
  9. Change the 'Effective Date' field to non leap year day (i.e. 04/20/2024).
  10. Verify the 'Expiration Date' field is auto populated with the desired date (i.e. 04/19/2025).
  11. Select desired value in the 'Active?' field.
  12. Select desired value in the 'Residence Type' field.
  13. Select "Create New" in the 'Determination Information' field.
  14. Select desired value in the 'Determination Method' field.
  15. Select "Create New" in the 'Included Assets' field.
  16. Select desired value in the 'Asset Type' field.
  17. Enter desired value in the 'Asset Value' field.
  18. Select "Create New" in the 'Expense' field.
  19. Select desired value in the 'Expense Type' field.
  20. Select "Monthly" in the 'Expense Time' field.
  21. Enter desired value in the 'Expense Value' field.
  22. Validate the 'Total Assets' field contains desired amount.
  23. Validate the 'Net Value Of Excluded Assets' field contains desired value.
  24. Validate the 'Total Liabilities' field contains desired value.
  25. Validate the 'Protected Assets' field contains desired value.
  26. Validate the 'Net Assets' field contains desired value.
  27. Validate the 'Total Income' field contains desired value.
  28. Validate the 'Total Expenses' field contains desired value.
  29. Validate the 'Protected Income' field contains desired value.
  30. Validate the 'Net Income' field contains desired value.
  31. Click [Submit].
  32. Validate all the fields filled out in the previous steps remain filled out.
  33. Close the form.
Topics
• Diagnosis • 837 Institutional • File Import • Financial Determination
Update 56 Summary | Details
'Detail of Visits By Client and Program' report
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Detail of Visits By Client and Program
Scenario 1: Detail of Visits By Client and Program - validate report
Steps
  1. Access the 'Detail of Visits By Client and Program' form.
  2. Enter the desired date in the 'Include Services From' field.
  3. Enter the desired date in the 'Include Services Through' field.
  4. Select the desired value(s) in the 'Select The Program To Be Included' field.
  5. Click [Process].
  6. Validate the 'Detail of Visits By Client and Program' report is displayed and contains the expected data based on the dates/program(s) selected.
  7. Close the report and the form.
Scenario 2: Detail of Visits By Client and Program - validate report
Steps
  1. Access the 'Detail of Visits By Client and Program' form.
  2. Enter the desired date in the 'Include Services From' field.
  3. Enter the desired date in the 'Include Services Through' field.
  4. Select the desired value(s) in the 'Select The Program To Be Included' field.
  5. Click [Process].
  6. Validate the 'Detail of Visits By Client and Program' report is displayed and contains the expected data based on the dates/program(s) selected.
  7. Close the report and the form.
Topics
• Detail of Visits By Client and Program
Update 58 Summary | Details
Guardiant - metric processing
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Guardiant
  • Guardiant Application - Analytics
Scenario 1: Guardiant Metric Processing/Data - Validations (Avatar PM)
Specific Setup:
  • Have a system configured for "Guardiant" reporting
  • Logged in user has access to the "Guardiant" form in Avatar and the "Guardiant" application
Steps
  1. Open form "Guardiant"
  2. Click [Test Daily Collection]
  3. Validate message "Test Succeeded" is displayed
  4. Click [Yes] to the warning message
  5. Validate message "Test Succeeded" is displayed
  6. Click [Test Metrics Collection]
  7. Validate message "Test Succeeded" is displayed
  8. Click [Yes] to the warning message
  9. Validate message "Test Succeeded" is displayed
  10. Log into "Guardiant"
  11. At the "Client Search", select the desired client account number
  12. Click "Analytics" from the menu on the right side panel
  13. Click the "Finance" tab at the top of the page
  14. Navigate to the "PM Total Payments" metric graph
  15. Hover over the current date and a previous date on the graph
  16. Validate the values displayed, are as expected
  17. Navigate to the "PM Total Charges" metric graph
  18. Hover over the current date and a previous date on the graph
  19. Validate the values displayed, are as expected
  20. Navigate to the "# of 835 Files Posted" metric graph
  21. Hover over the current date and a previous date on the graph
  22. Validate the values displayed, are as expected
  23. Navigate to the "# of 837 Files Posted" metric graph
  24. Hover over the current date and a previous date on the graph
  25. Validate the values displayed, are as expected
  26. Navigate to the "Number of Claim Follow-Ups Created" metric graph
  27. Hover over the current date and a previous date on the graph
  28. Validate the values displayed, are as expected
  29. Navigate to the "Number of Claim Follow-Up Notes Created" metric graph
  30. Hover over the current date and a previous date on the graph
  31. Validate the values displayed, are as expected
  32. Navigate to the "Number of Records in AR Auto Batch" metric graph
  33. Hover over the current date and a previous date on the graph
  34. Validate the values displayed, are as expected
  35. Click the "Clinical" tab at the top of the page
  36. Navigate to the "Clinical Metrics" metric graph
  37. Hover over the current date and a previous date on the graph
  38. Validate the values displayed, are as expected
  39. Navigate to the "Services by Week" metric graph
  40. Hover over the current date and a previous date on the graph
  41. Validate the values displayed, are as expected
Topics
• Forms
Update 61 Summary | Details
Practitioner Enrollment Form - Database Validation
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Practitioner Enrollment
  • Practitioner Termination
  • Performing Provider Registration
Scenario 1: Practitioner Enrollment Form - Validate SYSTEM.staff_enrollment_history for PERFID and PPIUNIQUEID
Specific Setup:
  • Registry Settings:
  • 'Enable Practitioners link to Performing Providers' ='Y'.
  • Practitioner Enrollment:
  • A new Practitioner is enrolled, or an existing Practitioner is chosen - Note Registration Date, Practitioner ID.
Steps
  1. Open "Practitioner Enrollment" form.
  2. Enter desired 'Staff' in 'Select Staff'.
  3. Click [New Staff].
  4. Click [Yes].
  5. Enter the desired 'Staff Name' in 'Name'.
  6. Enter any value in 'Date of Birth'.
  7. Enter any value in 'Registration Date'.
  8. Enter any value in 'Office Address - Zip Code'.
  9. Enter any value in 'Office Telephone (1) '.
  10. Click [Categories/Taxonomy].
  11. Select desired value from 'Category/Taxonomy'.
  12. Enter desired value in 'Effective Date'.
  13. Select desired value in 'Practitioner Category'.
  14. Select desired value in 'Discipline'.
  15. Select desired value in 'Practitioner Categories For Coverage'.
  16. Click [Add Practitioner Categories].
  17. Validate dialog: 'Saved. Please note: The changes will take effect when you submit the form'.
  18. Click [OK].
  19. Click [Practitioner Enrollment].
  20. Click [Submit].
  21. Open "Performing Provider Registration" form.
  22. Enter the 'Staff Name' enrolled above in 'Select Performing Provider'.
  23. Click the 'Staff Name'.
  24. Verify 'Performing Provider's Name' is the name of 'Staff' enrolled above.
  25. Verify 'Registration Start Date' is same 'Registration Date' of the 'Staff'.
  26. Verify 'Primary License Type for Claim' is same as the 'Practitioner Category' of the 'Staff'.
  27. Click [Submit].
  28. Validate form return dialog.
  29. Click [No].
  30. Open any SQL Database.
  31. Query the Following : 'Select * from SYSTEM.staff_enrollment_history table';.
  32. Verify 'Staff' details are populated.
  33. Verify 'PERFID' column is populated with desired value.
  34. Verify 'PPIUniqueID' column is populated with desired value.
  35. Close the Query.
  36. Open "Practitioner Termination" form.
  37. Enter the 'Staff ID'.
  38. Enter any valid date in 'Termination Date'.
  39. Select any valid reason from 'Reason For Termination'.
  40. Click [Submit].
  41. Open "Performing Provider Registration" form.
  42. Enter the 'Staff Name' enrolled above in 'Select Performing Provider'.
  43. Click the 'Staff Name'.
  44. Verify 'Performing Provider's Name' is the name of 'Staff' enrolled above.
  45. Verify 'Registration Start Date' is same 'Registration Date' of the 'Staff'.
  46. Verify 'Registration End Date' is same 'Termination Date' of the 'Staff'.
  47. Click [Submit].
  48. Validate form return dialog.
  49. Click [No].
File Import - Posting/Adjustment Posting'
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Posting/Adjustment Codes Definition
  • Create Interim Billing Batch File
  • Electronic Billing
  • Client Ledger
  • Payment Acknowledgement
Scenario 1: File Import - Validate Payment/Adjustment import files
Specific Setup:
  • Registry Settings:
  • Avatar PM->Billing->Remittance Processing->->->Enable Payment Acknowledgement = Y.
  • Avatar PM->Billing->Remittance Processing->->->Prevent Posting Payments Unless Payment has been Acknowledged = 3, at a minimum.
  • Avatar PM->System Maintenance->File Import->->->Import File Delimiter – note the value to be used when creating the file to import.
  • Posting/Adjustment Codes Definition has been used to note a payment code.
  • A new payment code is created or an existing payment code is edited and set to inactive. "Payment Code 1"
  • An active new payment code is created or an existing payment code is chosen, "Payment Code 2".
  • Admission:
  • An existing client is identified or new client is admitted. Note Client ID.
  • Financial Eligibility:
  • Client created above is assigned a guarantor. Note Guarantor ID.
  • Client Charge Input:
  • Services are rendered to the client. Service date and service code assigned is noted.
  • File Import :
  • Create an import "File A" to add inactive payment code (Payment Code 1).
  • Create an import "File B" to add active payment code (Payment Code 2).
  • Create an import "File C" to add inactive Adjustment code (Adjustment Code 1).
  • Create an import "File D" to add active Adjustment code (Adjustment Code 2).
Steps
  1. Open the "File Import" form.
  2. Select the 'Payment/Adjustment Posting' in the 'File Type' field.
  3. Click [Upload New File] in 'Action'.
  4. Click [Process Action].
  5. Select 'File A'.
  6. Click [Compile/Validate File] in 'Action'.
  7. Select 'File A' in the 'Files(s)' field.
  8. Click [Process Action].
  9. Validate a message displays: 'File A contains one or more errors. These errors can be reviewed using 'Print Errors' action'.
  10. Click [OK].
  11. Click [Print Errors] in 'Action'.
  12. Select 'File A' in the 'Files(s)' field.
  13. Click [Process Action].
  14. Validate the contents of the file, and the 'Posting code is inactive' error message.
  15. Click [Close Report].
  16. Click [Delete File] in 'Action'.
  17. Select 'File A' in the 'Files(s)' field.
  18. Click [Process Action].
  19. Click [Yes] in 'Delete File' dialog.
  20. Validate the dialog: 'Deleted'.
  21. Click [OK].
  22. Click [Upload New File] in the 'Action'.
  23. Click [Process Action].
  24. Select 'File B'.in the 'Files(s)' field.
  25. Click [Compile/Validate File] in the 'Action'.
  26. Select 'File B' in the 'Files(s)' field.
  27. Click [Process Action].
  28. Validate the message : 'Compiled'.
  29. Click [OK].
  30. Click [Print File] in 'Action'.
  31. Select 'File B' in the 'Files(s)' field.
  32. Click [Process Action].
  33. Validate the contents of the report.
  34. Click [Close Report].
  35. Select 'Post File' in the 'Action'.
  36. Click [Process Action].
  37. Select 'File B' in the 'Files(s)' field.
  38. Validate a message displays: Posted.
  39. Click [OK].
  40. Click [Discard].
  41. Open "Client Ledger" form.
  42. Enter the 'Client ID'.
  43. Click [Episode] in 'Claim/Episode/All Episodes'.
  44. Select the desired 'Episode #' form 'Episode'.
  45. Click [Simple] in 'Ledger Type'.
  46. Click [Process].
  47. Validate the imported activity in the report data.
  48. Click [X].
  49. Click [No] in the 'Form Return' dialog.
  50. Repeat 1-51,using "File C".
  51. Repeat 1-51,using "File D".
Topics
• Practitioner • File Import
Update 62 Summary | Details
'Services by Program and Age Group' report
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Services By Program and Age Group
Scenario 1: Services By Program and Age Group - Validate report
Specific Setup:
  • Multiple clients defined with different ages.
  • Multiple services on file for clients.
Steps
  1. Access the 'Services by Program and Age Group' form.
  2. Enter the desired date in the 'Include Services From' field.
  3. Enter the desired date in the 'Include Services Through' field.
  4. Select the desired program(s) in the 'Select Programs To Be Included' field.
  5. Click [Process].
  6. Validate the 'Services By Program & Age Group' report is displayed.
  7. Validate the report contains the services for the defined date range as expected.
  8. Close the report and the form.
Topics
• Report Viewer
Update 69 Summary | Details
Advanced Billing Rule Definition
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Financial Eligibility
  • Advanced Billing Rule Definition
  • Client Charge Input
  • Client Ledger
Scenario 1: Advanced Billing Rule Definition
Specific Setup:
  • Admission:
  • An existing client is identified, or a new client is admitted. Note client id, admission program, admission date.
  • Financial Eligibility:
  • Two guarantors, identified in the 'Guarantors/Payors' form. are assigned to the client as a primary guarantor and secondary guarantor.
  • Service Codes:
  • Service Code 1 = selected in 'Service Code' in 'Advanced Billing Rule Definition' form.
  • Service Code 2 = selected in 'Selected Service(s) Must Be Rendered By A Practitioner With One Of The Following Practitioner Categories For Coverage' in 'Advanced Billing Rule Definition' form.
Steps
  1. Open "Advanced Billing Rule Definition" form.
  2. Click [Add] in 'Add Or Edit Advanced Billing Rule'.
  3. Click [Yes] in 'Active'.
  4. Enter any description in 'Advanced Billing Rule Description'.
  5. Select 'Service Code 1' in 'Service Code'.
  6. Select the primary guarantor in 'Guarantor'.
  7. Enter any value in 'Effective Date'.
  8. Click desired value in 'Associated To Gender'.
  9. Click [Compliance] in 'Rule Defines Conditions For *'.
  10. Select 'Service Code 2' in 'Select Service(s) That Must Also Be Rendered For Distribution'.
  11. Select desired value in 'Selected Service(s) Must Be Rendered By A Practitioner With One Of The Following Practitioner Categories For Coverage'.
  12. Set 'Selected Service(s) Must Be Rendered Within How Many Days Prior To The Service For Incident To Services' to '0'.
  13. Click [File Advanced Billing Rule].
  14. Verify the message: 'Advanced billing rule filed'.
  15. Click [OK].
  16. Click [Discard].
  17. Click [Yes].
  18. Open "Client Charge Input" form.
  19. Enter 'Client ID'.
  20. Enter desired date in 'Date of Service'.
  21. Enter 'Service Code 1' in 'Service Code'.
  22. Enter the desired 'Practitioner'.
  23. Click [Submit].
  24. Validate Form Return.
  25. Click [Yes].
  26. Repeat Steps 18-25 for 'Service Code 2' with same 'Date of Service'.
  27. Open "Close Charges" form.
  28. Click [Liability Update] in 'Liability Update Or Close Charges'.
  29. Enter the date of services given in 'Client Charge Input' in 'Thru Date'.
  30. Click [Individual] in 'Individual, All, Or Interim Batch Cycle'.
  31. Enter the 'Client ID'.
  32. Select the desired 'Episode' in 'Episode Number'.
  33. Click [Submit].
  34. Open the "Client Ledger" form.
  35. Enter the 'Client ID'.
  36. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  37. Click [Simple] in 'Ledger Type'.
  38. Click [Yes] in 'Include Zero Charges'.
  39. Click [Process].
  40. Validate the report data to verify that the charges distributed to primary guarantor.
  41. Click [X].
  42. Click [No].
  43. Repeat Steps 1-17.
  44. Repeat Steps 18-39 with Date of Service for 'Service Code 1' before the Date of Service for 'Service Code 2'.
  45. Validate the report data to verify that the charges distributed to the secondary guarantor.
  46. Click [X].
  47. Click [No].
Topics
• Advanced Billing Rule Definition
Update 71 Summary | Details
Bed Management - 'Leave Status Change'
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Bed Management
  • Leaves
  • Leave Status Change
Scenario 1: Bed Management - Validate 'Leaves' and 'Leave Status Change' functionality
Specific Setup:
  • A client is enrolled in an existing inpatient episode (Client A).
Steps
  1. Access the 'Bed Management' form.
  2. Click the [Print Current Bed Status Report].
  3. Validate the 'Current Bed Status Report' is displayed and contains "Client A" in their assigned unit/room/bed.
  4. Close the report.
  5. Click [Bed Management].
  6. Navigate to the unit/room/bed for "Client A" and validate they are displayed as expected.
  7. Close the form.
  8. Select "Client A" and access the 'Leaves' form.
  9. Enter the current date in the 'Leave Date' field.
  10. Enter the current time in the 'Leave Time' field.
  11. Select any non-billable value in the 'Type Of Leave From' field.
  12. Select the desired value in the 'Reason For Leave' field.
  13. Populate any other desired fields.
  14. Submit the form.
  15. Access the 'Bed Management' form.
  16. Click the [Print Current Bed Status Report].
  17. Validate the 'Current Bed Status Report' is displayed and no longer contains "Client A" in their assigned unit/room/bed since they were placed on a non-billable leave.
  18. Close the report.
  19. Click [Bed Management].
  20. Navigate to the unit/room/bed for "Client A" and validate they are no longer displayed from the 'Leave Date' forward since they were placed on a non-billable leave.
  21. Close the form.
  22. Select "Client A" and access the 'Leave Status Change' form.
  23. Enter the current date in the 'Effective Date Of Leave Status Change' field.
  24. Enter the current time in the 'Effective Time Of Leave Status Change' field.
  25. Select the desired value in the 'Reason For Closure Of Leave' field.
  26. Select any non-billable value in the 'Type Of Leave From' field.
  27. Select the desired value in the 'Reason For Leave' field.
  28. Populate any other desired fields.
  29. Submit the form.
  30. Access the 'Bed Management' form.
  31. Click the [Print Current Bed Status Report].
  32. Validate the 'Current Bed Status Report' is displayed and does not contain "Client A" in their assigned unit/room/bed since they were placed on a non-billable leave.
  33. Close the report.
  34. Click [Bed Management].
  35. Navigate to the unit/room/bed for "Client A" and validate they are not displayed from the 'Leave Date' forward since they were placed on a non-billable leave.
  36. Close the form.
Bed Management - 'Client Merge' functionality
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Bed Management
Scenario 1: Bed Management - Validate 'Client Merge' functionality
Specific Setup:
  • The 'Allow Merging Into Existing Episode' registry setting is set to "Y".
  • An inpatient program is defined in 'Program Maintenance' (Program A).
  • Units, rooms, and beds are defined (Bed A & Bed B will be used for testing).
  • A client is enrolled in "Program A" in "Bed A" with an 'Admission Date' of "01/02/2024" (Client A).
  • A second client is enrolled in "Program A" in "Bed B" with an 'Admission Date' of "01/01/2024" (Client B).
Steps
  1. Access the 'Bed Management' form.
  2. Click [Bed Management].
  3. Navigate to the unit & room for "Bed A" and "Bed B".
  4. Validate "Client A" is in "Bed A" as expected.
  5. Validate "Client B" is in "Bed B" as expected.
  6. Close the form.
  7. Access the 'Client Merge' Form.
  8. Enter the "Client A" in the 'Source Client' field.
  9. Enter the "Client B" in 'Target Client' field.
  10. Select "No" in the 'Merge All Client Data Through Single Filing' field.
  11. Select the existing episode for "Client A" in the 'Source Client Episode' field.
  12. Select "No" in the 'Create New Episode On Merge' field.
  13. Click [File].
  14. Validate a message is displayed stating: Do you wish to continue with the indicated action?
  15. Click [Yes].
  16. Validate a message is displayed stating: The following episode has been updated for the target client indicated to include data from the source episode.
  17. Click [OK].
  18. Validate a message is displayed stating: All bed assignments associated with the source episodes have been removed.
  19. Click [OK] and close the form.
  20. Access the 'Bed Management' form.
  21. Click [Bed Management].
  22. Navigate to the unit & room for "Bed A" and "Bed B".
  23. Validate "Client B" is in "Bed B" as expected.
  24. Validate "Client A" is no longer displayed and "Bed A" is available.
  25. Click [Close] and [Print Current Bed Status Report].
  26. Validate the 'Current Bed Status Report' is displayed.
  27. Validate "Client B" is in "Bed B" as expected.
  28. Validate "Client A" is no longer displayed and "Bed A" is available.
  29. Close the report.
  30. Click [Bed Management].
  31. Navigate to the unit & room for "Bed A" and "Bed B".
  32. Select "Client B" in "Bed B".
  33. Click [Switch].
  34. Select "Bed A" in the 'Bed 2' field and populate the details accordingly.
  35. Click [Switch].
  36. Validate "Client B" now displays in "Bed A" as expected.
  37. Click [Close] and [Print Current Status Report].
  38. Validate the 'Current Bed Status Report' is displayed.
  39. Validate "Client B" is in "Bed A" as expected.
  40. Close the report and the form.
Topics
• Bed Management • Leaves • Client Merge
Update 75 Summary | Details
Client Demographics - Personal pronouns
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Update Client Data
  • Discharge
  • Pre Admit
Scenario 1: 'Admission' form - Field Validation
Specific Setup:
  • A client is enrolled in an existing episode (Client A).
  • The registry setting "Client Demographics - Additional Fields to Include" should include a "10" in the value string. Such as "3&10".
Steps
  1. Select "Client A" and access the 'Admission' form.
  2. Select an existing episode and click [Edit].
  3. Select the "Demographics" section.
  4. Validate the 'Consent On File For Use of Integrated eSignature' field is present with values of "Yes" and "No".
  5. Select "No" in the 'Consent On File For Use of Integrated eSignature' field.
  6. Select "Something else, please specify" in 'Select Personal Pronouns'.
  7. The "Personal Pronouns" text field become enabled.
  8. Enter text into the "Personal Pronouns" field.
  9. Click [Submit].
  10. Select "Client A" and access the 'Admission' form.
  11. Select an existing episode and click [Edit].
  12. Select the "Demographics" section.
  13. Validate "No" is selected in the 'Consent On File For Use of Integrated eSignature' field.
  14. Validate "Personal Pronouns" reflects the value entered or chosen.
  15. Close the form.
  16. Access Crystal Reports or other SQL reporting tool.
  17. Create a report using the 'SYSTEM.patient_current_demographics' SQL table.
  18. Navigate to the row for "Client A".
  19. Validate the 'esig_consent_on_file_code' field is present and contains "N".
  20. Validate the 'esig_consent_on_file_value' field is present and contains "No".
  21. Close the report.
  22. Create a report using the 'SYSTEM.patient_demographic_history' SQL table.
  23. Navigate to the row for "Client A".
  24. Validate the 'esig_consent_on_file_code' field is present and contains "N".
  25. Validate the 'esig_consent_on_file_value' field is present and contains "No".
  26. Close the report.
Scenario 2: 'Update Client Data' form - Verification of 'Client Demographics' form fields
Specific Setup:
  • A client is enrolled in an existing episode (Client A).
  • The 'Client Demographics - Additional Fields' registry setting must be set to "10&7".
Steps
  1. Select "Client A" and access the 'Update Client Data' form.
  2. Validate the 'Other Race(s)' field is present on the form.
  3. Select any two desired values from the 'Other Race(s)' field.
  4. Click the "Clear All" link.
  5. Validate the previously selected values no longer display as selected in the 'Other Race(s)' field.
  6. Select "Something else, please specify" in 'Select Personal Pronouns'.
  7. The "Personal Pronouns" text field become enabled.
  8. Enter text into the "Personal Pronouns" field.
  9. Click [Submit].
  10. Select "Client A" and access the 'Update Client Data' form.
  11. Validate the 'Other Race(s)' field displays as expected.
  12. Validate "Personal Pronouns" reflects the value entered or chosen.
  13. Close the form.
  14. Access Crystal Reports or other SQL reporting tool.
  15. Create a report using the 'SYSTEM.patient_current_demographics' SQL table.
  16. Navigate to the row for "Client A".
  17. Validate the 'other_race_value_long' field is present and displays blank.
  18. Validate the 'other_race_value_short' field is present and displays blank.
  19. Close the report.
  20. Create a report using the 'SYSTEM.patient_demographic_history' SQL table.
  21. Navigate to the row for "Client A".
  22. Validate the 'other_race_value_long' field is present and displays blank.
  23. Validate the 'other_race_value_short' field is present and displays blank.
  24. Close the report.
Scenario 3: 'Discharge' form - Field Validation
Specific Setup:
  • A client is enrolled in an existing episode (Client A).
  • The registry setting "Client Demographics - Additional Fields to Include" should include a "10" in the value string. Such as "3&10".
Steps
  1. Select "Client A" and access the 'Discharge' form.
  2. Select an existing episode and click [Edit].
  3. Enter the desired date in the 'Date Of Discharge' field.
  4. Enter the desired time in the 'Discharge Time' field.
  5. Select the desired value in the 'Type Of Discharge' field.
  6. Select the desired practitioner in the 'Discharge Practitioner' field.
  7. Select the "Demographics" section.
  8. Enter "testgmailcom" in the 'Client's Email Address' field.
  9. Validate a message is displayed stating: Please enter a valid email address.
  10. Click [OK].
  11. Enter "testgmail.com" in the 'Client's Email Address' field.
  12. Validate a message is displayed stating: Please enter a valid email address.
  13. Click [OK].
  14. Enter "testgmail@com" in the 'Client's Email Address' field.
  15. Validate a message is displayed stating: Please enter a valid email address.
  16. Click [OK].
  17. Enter "test@gmail.com" in the 'Client's Email Address' field.
  18. Please note: a valid email address should contain '@' that separates the name and address. The name should be the first piece and the address should be the second piece. The address must have a '.' which separates the domain name.
  19. Select "Something else, please specify" in 'Select Personal Pronouns'.
  20. The "Personal Pronouns" text field become enabled.
  21. Enter text into the "Personal Pronouns" field.
  22. Click [Submit].
  23. Select "Client A" and access the 'Discharge' form.
  24. Select the discharged episode and click [Edit].
  25. Validate all previously filed data is displayed.
  26. Select the "Demographics" section.
  27. Validate the 'Client's Email Address' field contains "test@gmail.com".
  28. Validate "Personal Pronouns" reflects the value entered or chosen.
  29. Close the form.
Scenario 4: 'Pre Admit' form - Field Validation
Specific Setup:
  • A client is enrolled in an existing Pre Admit episode (Client A).
  • The registry setting "Client Demographics - Additional Fields to Include" should include a "10" in the value string. Such as "3&10".
Steps
  1. Select "Client A" and access the 'Pre Admit' form.
  2. Select an existing episode and click [Edit].
  3. Select the "Demographics" section.
  4. Enter "testgmailcom" in the 'Client's Email Address' field.
  5. Validate a message is displayed stating: Please enter a valid email address.
  6. Click [OK].
  7. Enter "testgmail.com" in the 'Client's Email Address' field.
  8. Validate a message is displayed stating: Please enter a valid email address.
  9. Click [OK].
  10. Enter "testgmail@com" in the 'Client's Email Address' field.
  11. Validate a message is displayed stating: Please enter a valid email address.
  12. Click [OK].
  13. Enter "test@gmail.com" in the 'Client's Email Address' field.
  14. Please note: a valid email address should contain '@' that separates the name and address. The name should be the first piece and the address should be the second piece. The address must have a '.' which separates the domain name.
  15. Select "Something else, please specify" in 'Select Personal Pronouns'.
  16. The "Personal Pronouns" text field become enabled.
  17. Enter text into the "Personal Pronouns" field.
  18. Click [Submit].
  19. Select "Client A" and access the 'Pre Admit' form.
  20. Select an existing episode and click [Edit].
  21. Select the "Demographics" section.
  22. Validate the 'Client's Email Address' field contains "test@gmail.com".
  23. Validate "Personal Pronouns" reflects the value entered or chosen.
  24. Close the form.
Topics
• Admission • Update Client Data • Discharge • Pre Admit
Update 78 Summary | Details
'Services by Program and Group Code' report
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Services by Program and Group Code
Scenario 1: Services by Program and Group Code - Validate report
Specific Setup:
  • Group services must exist.
Steps
  1. Access the 'Services by Program and Group Code' form.
  2. Enter the desired date in the 'Include Services Starting' field.
  3. Enter the desired date in the 'Include Services Through' field.
  4. Click [Process].
  5. Validate the 'Services by Program & Group Code' report is displayed.
  6. Validate the report contains the group services for the defined date range as expected.
  7. Close the report and the form.
Topics
• Report Viewer
Update 79 Summary | Details
'Services by Provider and Group Code' report
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Services by Provider and Group Code
Scenario 1: Services by Provider and Group Code - Validate report
Specific Setup:
  • Group services must exist.
Steps
  1. Access the 'Services by Provider and Group Code' form.
  2. Enter the desired date in the 'Include Services Starting' field.
  3. Enter the desired date in the 'Include Services Through' field.
  4. Click [Process].
  5. Validate the 'Services By Provider & Group Code' report is displayed.
  6. Validate the report contains the group services for the defined date range as expected.
  7. Close the report and the form.
Topics
• Report Viewer
Update 82 Summary | Details
'Client Charge Input' form
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Client Charge Input
  • Client Ledger
Scenario 1: Client Charge Input - Validate the 'Override Liability Distribution' registry setting
Steps
  1. Access the 'Registry Settings' form.
  2. Enter "Override Liability Distribution" in the 'Limit Registry Settings to the Following Search Criteria' field.
  3. Click [View Registry Settings].
  4. Enter "Y" in the 'Registry Setting Value' field.
  5. Click [Submit], [OK], and [Yes].
  6. Repeat steps 1a-1d, then close the form.
  7. Access the 'Client Charge Input' form.
  8. Validate the 'Guarantor Override' section is added to the form and is not duplicated.
  9. Close the form.
  10. Access the 'Registry Settings' form.
  11. Enter "Override Liability Distribution" in the 'Limit Registry Settings to the Following Search Criteria' field.
  12. Click [View Registry Settings].
  13. Enter "N" in the 'Registry Setting Value' field.
  14. Click [Submit], [OK], and [No].
  15. Access the 'Client Charge Input' form.
  16. Validate the 'Guarantor Override' section is removed from the form, as expected.
  17. Close the form.
Topics
• Registry Settings • Client Charge Input
Update 83 Summary | Details
Avatar PM - Smart Search functionality
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Progress Notes (Group and Individual)
Scenario 1: Validate the 'Enable Smart Search Functionality' registry setting
Specific Setup:
  • The 'Enable Smart Search Functionality' registry setting is set to "Y".
  • The 'Alternate Client Lookup Types to Display' registry setting must be set to include "95&102&176" at a minimum:
  • 95 - Client's Home Phone
  • 102 - Client's Cell Phone
  • 176 - Preferred Name
  • A client is enrolled in an existing episode (Client A).
Steps
  1. Select "Client A" and access the 'Update Client Data' form.
  2. Enter the desired value in the 'Preferred Name' field.
  3. Enter the desired value in the 'Client's Home Phone' field.
  4. Enter the desired value in the 'Client's Cell Phone' field.
  5. Click [Submit].
  6. Navigate to the 'Search Clients' field in the 'My Clients' widget.
  7. Enter the 'Preferred Name' for "Client A".
  8. Validate the 'Results' contains "Client A" as expected.
  9. Enter the 'Home Phone' for "Client A".
  10. Validate the 'Results' contains "Client A" as expected.
  11. Enter the 'Cell Phone' for "Client A".
  12. Validate the 'Results' contains "Client A" as expected.
  13. Access the 'Progress Notes (Group and Individual)' form.
  14. In the 'Select Client' field, enter the 'Preferred Name' for "Client A".
  15. Validate the 'Results' contains "Client A" as expected.
  16. In the 'Select Client' field, enter the 'Home Phone' for "Client A".
  17. Validate the 'Results' contains "Client A" as expected.
  18. In the 'Select Client' field, enter the 'Cell Phone' for "Client A".
  19. Validate the 'Results' contains "Client A" as expected.
  20. Close the form.
  21. Access the 'Update Client Data' form.
  22. Validate a 'Select Client' dialog is displayed.
  23. In the 'Select Client' field, enter the 'Preferred Name' for "Client A".
  24. Validate the 'Results' contains "Client A" as expected.
  25. In the 'Select Client' field, enter the 'Home Phone' for "Client A".
  26. Validate the 'Results' contains "Client A" as expected.
  27. In the 'Select Client' field, enter the 'Cell Phone' for "Client A".
  28. Validate the 'Results' contains "Client A" as expected.
  29. Click [Cancel].
Topics
• Registry Settings • Client Search
Update 84 Summary | Details
File Import
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Guarantors/Payors
Scenario 1: File Import: Guarantors Payors Add/Edit
Specific Setup:
  • File Import:
  • The 'Guarantors/Payors' file type is added to the File Import.
  • Create an import file to add a new 'Guarantors/Payors', "File A".
  • Create an import file to edit above 'Guarantors/Payors', "File B".
Steps
  1. Open the "File Import" form.
  2. Select the "Guarantors/Payors" in 'File Type'.
  3. Select "Upload New File" in 'Action'.
  4. Click [Process Action].
  5. Select "File A".
  6. Select "Compile/Validate File" in 'Action'.
  7. Select "File A" in 'Files(s)'.
  8. Click [Process Action].
  9. Validate the message displays: Compiled
  10. Click [OK].
  11. Select "Print File" in 'Action'.
  12. Select "File A" in 'Files(s)'.
  13. Click [Process Action].
  14. Validate the report displays the contents of the file.
  15. Click [Close Report].
  16. Select "Post File" in 'Action'.
  17. Click [Process Action].
  18. Select "File A".
  19. Validate the message displays: Posted.
  20. Click [OK].
  21. Close the form.
  22. Open the "Guarantors/Payors" form.
  23. Click [Edit].
  24. Select the guarantor in "File A".
  25. Validate the form contains the data based on the uploaded file.
  26. Close the form.
  27. Follow steps 1 - 26 for "File B" which edits the guarantor through file import.
File Import
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Guarantors/Payors
Scenario 1: File Import: Guarantors Payors 835
Specific Setup:
  • File Import:
  • The 'Guarantors/Payors 835' file type is added to "File Import"
  • Create an import file to add invalid 835 details to a Guarantor. "File A".
  • Create an import file to add valid 835 details to a valid Guarantor: "File B".
Steps
  1. Open the "File Import" form.
  2. Select the 'Guarantors/Payors 835' in 'File Type'.
  3. Click [Upload New File] in 'Action'.
  4. Click [Process Action].
  5. Select "File A".
  6. Click [Compile/Validate File] in 'Action'.
  7. Select "File A" in 'Files(s)'.
  8. Click [Process Action].
  9. Validate the message display: File A contains one or more errors. These errors can be reviewed using 'Print Errors' action.
  10. Click [OK].
  11. Click [Print Errors] in 'Action'.
  12. Select "File A" in 'Files(s)'.
  13. Click [Process Action].
  14. Validate the report displays appropriate error messages.
  15. Click [Close Report].
  16. Click [Delete File] in 'Action'.
  17. Select "File A" in 'Files(s)'.
  18. Click [Process Action].
  19. Validate message displays: Deleted.
  20. Click [Yes].
  21. Click [OK].
  22. Click [Upload New File] in 'Action'.
  23. Click [Process Action].
  24. Select "File B".
  25. Click [Compile/Validate File] in 'Action'.
  26. Select "File B" in the 'Files(s)'.
  27. Click [Process Action].
  28. Validate the message displays: Compiled.
  29. Click [OK]
  30. Click [Print File] in 'Action'.
  31. Select "File B" in 'Files(s)'.
  32. Click [Process Action].
  33. Validate the report displays the contents of the file.
  34. Click [Close Report].
  35. Click [Post File] in 'Action'.
  36. Select "File B".
  37. Click [Process Action].
  38. Validate the message displays: Posted.
  39. Click [OK].
  40. Click [Discard].
  41. Click [OK].
  42. Open the "Guarantors/Payors" form.
  43. Click [Edit].
  44. Select the guarantor in "File B".
  45. Click [835] item.
  46. Validate the form contains the data based on the uploaded file.
  47. Click [Discard].
Topics
• Guarantor/Payors • File Import
Update 85 Summary | Details
Dictionary Update - Race OMB Standards
Scenario 1: PM - Dictionary Update - Client - Race OMB Standards, # 981
Specific Setup:
  • Dictionary Update:
  • PM - Client - # 981 - Race OMB Standards:
  • The following values have been added to the dictionary:
  • 2131-1 = Other Race
  • ASKU = Asked but Unknown
  • UNK = Unknown
  • The following value has been made inactive.
  • 2108-9 = White European


Steps
  1. Open "Dictionary Update".
  2. Select 'Client' in 'File'.
  3. Select 'Individual Data Element' in 'Individual or All Data Elements'.
  4. Enter/Select the following dictionary: (981) Race OMB Standards **LOCKED**.
  5. Click [Print Dictionary].
  6. Validate that the dictionary contains:
  7. 1002-5 = American Indian or Alaska Native
  8. 2028-9 = Asian
  9. 2054-5 = Black or African American
  10. 2076-8 = Native Hawaiian or Other Pacific Islander
  11. 2106-3 = White
  12. 2108-9 = White European-INACTIVE
  13. 2131-1 = Other Race
  14. ASKU = Asked but Unknown
  15. UNK = Unknown
  16. Close the report.
  17. Close the form.
Topics
• Dictionary
Update 86 Summary | Details
CCBHC Billing - CCBHC 837 Professional Billing
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Electronic Billing
Scenario 1: CCBHC Billing - 837 Professional - Primary and Add-on Enumerated CCBHC services rendered to the client
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • An add-on service code is created with the following:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • A primary service code is created to have desired number of add-on service with the following:
  • Service Code Category = Primary Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • Select Multiple Add-On codes = An Add-On code created above is checked
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a primary guarantor and a CCBHC guarantor is assigned to the client as a secondary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The primary service, with an add-on service, is rendered to the client.
  • Client Ledger:
  • The liability for the primary and add-on service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the charges.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the services.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Individual Cash Posting:
  • The primary service is fully paid such that primary guarantor pays the full amount of primary service.
  • An add-on service is partially paid, and the remaining liability is transferred to the secondary CCBHC guarantor.
  • Close Charges:
  • The PPS charges are closed.
  • All CCBHC setup is complete. CCBHC Billing functionality is used by the agency. If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name for each guarantor.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • An add-on service code is created with the following:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • A primary service code is created to have desired number of add-on services with the following:
  • Service Code Category = Primary Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • Select Multiple Add-On codes = An Add-On code created above is checked
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a primary guarantor and a CCBHC guarantor is assigned to the client as a secondary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The primary service is rendered to the client and make sure that the add-on service is also selected for filing.
  • Client Ledger:
  • The liability for the primary and add-on service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the charges.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the services.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Individual Cash Posting:
  • The primary service is fully paid such that primary guarantor pays the full amount of primary service.
  • An add-on service is partially paid, and the remaining liability is transferred to the secondary CCBHC guarantor.
  • Close Charges:
  • The PPS charges are closed.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select desired guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. All other fields are populated as required/needed.
  9. Click [Process].
  10. Verify 'Compile Complete' message.
  11. Select "Run Report" in the 'Billing Options' field.
  12. Select "Print" in 'Print Or Delete Report'.
  13. Select the recently compiled file from the 'File' dropdown.
  14. Click [Print 837 Report].
  15. Verify that the primary, Add-on and PPS services are included in the '837 Professional Submission' link.
  16. Click [X].
  17. Click [X].
Scenario 2: CCBHC Billing - 837 Professional - Enumerated CCBHC service – Partially paid and transferred remaining liability to CCBHC guarantor from the Non CCBHC guarantor
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name for each guarantor.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • A CCBHC Enumerated service code is created with the following:
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a primary guarantor and a CCBHC guarantor is assigned to the client as a secondary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The CCBHC Enumerated service is rendered to the client, and the add-on service has been saved.
  • Client Ledger:
  • The liability for the CCBHC Enumerated service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the charges.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the services.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Individual Cash Posting:
  • The service distributed to the primary guarantor is partially paid, and the remaining liability is transferred to the secondary CCBHC guarantor.
  • Close Charges:
  • The CCBHC PPS charges are closed.
  • Create Interim Billing Batch File:
  • An interim billing batch is created to include the service transferred to the CCBHC guarantor.
  • Electronic Billing:
  • The 837 Professional bill is claimed for the CCBHC guarantor.
  • The services distributed to CCBHC guarantors are included in the bill.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select CCBHC guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. All other fields are populated as required/needed.
  9. Click [Process].
  10. Verify 'Compile Complete' message.
  11. Select "Run Report" in the 'Billing Options' field.
  12. Select "Print" in 'Print Or Delete Report'.
  13. Select the recently compiled file from the 'File' dropdown.
  14. Click [Print 837 Report].
  15. Verify the enumerated and CCBHC PPS service are included in the '837 Professional Submission' link.
  16. Click [X].
  17. Compile the bill again for the CCBHC guarantor for the same parameters.
  18. Select "Sort File" option from the 'Billing Options'
  19. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  20. All other fields are populated as required/needed.
  21. Click [Process].
  22. Verify 'No Information' found.
  23. Verify that system does not compile the bill again as the services are claimed.
  24. Click [X].
Scenario 3: CCBHC Billing - 837 Professional - Enumerated CCBHC service –Liability fully transferred to non CCBHC guarantor from the CCBHC guarantor
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name for each guarantor.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • A CCBHC Enumerated service code is created with the following:
  • Type of Fee = desired value.
  • CCBHC Enumerated Service = Yes.
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary, and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a secondary guarantor, and a CCBHC guarantor is assigned to the client as a primary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The CCBHC Enumerated service is rendered to the client.
  • Client Ledger:
  • The liability for the CCBHC Enumerated service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the enumerated CCBHC charges.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the service.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Close Charges:
  • Close the PPS charges.
  • Create Interim Billing Batch File:
  • An interim billing batch is created to include the services distributed to the CCBHC guarantor.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • Individual Cash Posting:
  • The service distributed to the primary guarantor is fully transferred to the secondary Non CCBHC guarantor.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select CCBHC guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. Set 'Create Claims' field to "No".
  9. All other fields are populated as required/needed.
  10. Click [Process].
  11. Verify 'No Information' found.
  12. Verify that system does not compile the bill again as the services are claimed.
  13. Click [X].
Scenario 4: CCBHC Billing - 837 Professional - Enumerated CCBHC service distributed to the primary contract CCBHC guarantor and CCBHC PPS service distributed to the another contract CCBHC secondary guarantor
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • Two contract CCBHC guarantors are identified to be used as a primary and secondary guarantor. Note the guarantor's code/name for each guarantor.
  • Configure the primary guarantor for contractual adjustments during liability distribution.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = None.
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1.
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • A CCBHC Enumerated service code is created with the following:
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • Two contract guarantors are assigned to the client as a primary and secondary guarantor.
  • Customize the benefit plan for the primary guarantor such that it only covers the enumerated service and not the PPS service.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The CCBHC Enumerated service is rendered to the client.
  • Client Ledger:
  • The liability for the CCBHC Enumerated service is distributed to the primary guarantor.
  • Close Charges:
  • Close the enumerated CCBHC charges.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the service.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor.
  • Close Charges:
  • Close the PPS charges.
  • Electronic Billing:
  • The service distributed to the primary guarantor is claimed. Note the claim number.
  • The service distributed to the secondary guarantor is claimed. Note the claim number.
  • Client Ledger:
  • Two services on the separate claims.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select secondary CCBHC guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. Set 'Create Claims' field to "No".
  9. All other fields are populated as required/needed.
  10. Click [Process].
  11. Verify the 'No Information Found' message found.
  12. Click [X].
  13. Click [X].
CCBHC Billing - Subsequent Bills
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Electronic Billing
Scenario 1: CCBHC Billing - 837 Professional - Primary and Add-on Enumerated CCBHC services rendered to the client
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • An add-on service code is created with the following:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • A primary service code is created to have desired number of add-on service with the following:
  • Service Code Category = Primary Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • Select Multiple Add-On codes = An Add-On code created above is checked
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a primary guarantor and a CCBHC guarantor is assigned to the client as a secondary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The primary service, with an add-on service, is rendered to the client.
  • Client Ledger:
  • The liability for the primary and add-on service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the charges.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the services.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Individual Cash Posting:
  • The primary service is fully paid such that primary guarantor pays the full amount of primary service.
  • An add-on service is partially paid, and the remaining liability is transferred to the secondary CCBHC guarantor.
  • Close Charges:
  • The PPS charges are closed.
  • All CCBHC setup is complete. CCBHC Billing functionality is used by the agency. If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name for each guarantor.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • An add-on service code is created with the following:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • A primary service code is created to have desired number of add-on services with the following:
  • Service Code Category = Primary Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • Select Multiple Add-On codes = An Add-On code created above is checked
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a primary guarantor and a CCBHC guarantor is assigned to the client as a secondary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The primary service is rendered to the client and make sure that the add-on service is also selected for filing.
  • Client Ledger:
  • The liability for the primary and add-on service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the charges.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the services.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Individual Cash Posting:
  • The primary service is fully paid such that primary guarantor pays the full amount of primary service.
  • An add-on service is partially paid, and the remaining liability is transferred to the secondary CCBHC guarantor.
  • Close Charges:
  • The PPS charges are closed.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select desired guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. All other fields are populated as required/needed.
  9. Click [Process].
  10. Verify 'Compile Complete' message.
  11. Select "Run Report" in the 'Billing Options' field.
  12. Select "Print" in 'Print Or Delete Report'.
  13. Select the recently compiled file from the 'File' dropdown.
  14. Click [Print 837 Report].
  15. Verify that the primary, Add-on and PPS services are included in the '837 Professional Submission' link.
  16. Click [X].
  17. Click [X].
Scenario 2: CCBHC Billing - 837 Professional - Enumerated CCBHC service – Partially paid and transferred remaining liability to CCBHC guarantor from the Non CCBHC guarantor
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name for each guarantor.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • A CCBHC Enumerated service code is created with the following:
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a primary guarantor and a CCBHC guarantor is assigned to the client as a secondary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The CCBHC Enumerated service is rendered to the client, and the add-on service has been saved.
  • Client Ledger:
  • The liability for the CCBHC Enumerated service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the charges.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the services.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Individual Cash Posting:
  • The service distributed to the primary guarantor is partially paid, and the remaining liability is transferred to the secondary CCBHC guarantor.
  • Close Charges:
  • The CCBHC PPS charges are closed.
  • Create Interim Billing Batch File:
  • An interim billing batch is created to include the service transferred to the CCBHC guarantor.
  • Electronic Billing:
  • The 837 Professional bill is claimed for the CCBHC guarantor.
  • The services distributed to CCBHC guarantors are included in the bill.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select CCBHC guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. All other fields are populated as required/needed.
  9. Click [Process].
  10. Verify 'Compile Complete' message.
  11. Select "Run Report" in the 'Billing Options' field.
  12. Select "Print" in 'Print Or Delete Report'.
  13. Select the recently compiled file from the 'File' dropdown.
  14. Click [Print 837 Report].
  15. Verify the enumerated and CCBHC PPS service are included in the '837 Professional Submission' link.
  16. Click [X].
  17. Compile the bill again for the CCBHC guarantor for the same parameters.
  18. Select "Sort File" option from the 'Billing Options'
  19. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  20. All other fields are populated as required/needed.
  21. Click [Process].
  22. Verify 'No Information' found.
  23. Verify that system does not compile the bill again as the services are claimed.
  24. Click [X].
Scenario 3: CCBHC Billing - 837 Professional - Enumerated CCBHC service –Liability fully transferred to non CCBHC guarantor from the CCBHC guarantor
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name for each guarantor.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • A CCBHC Enumerated service code is created with the following:
  • Type of Fee = desired value.
  • CCBHC Enumerated Service = Yes.
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary, and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a secondary guarantor, and a CCBHC guarantor is assigned to the client as a primary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The CCBHC Enumerated service is rendered to the client.
  • Client Ledger:
  • The liability for the CCBHC Enumerated service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the enumerated CCBHC charges.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the service.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Close Charges:
  • Close the PPS charges.
  • Create Interim Billing Batch File:
  • An interim billing batch is created to include the services distributed to the CCBHC guarantor.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • Individual Cash Posting:
  • The service distributed to the primary guarantor is fully transferred to the secondary Non CCBHC guarantor.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select CCBHC guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. Set 'Create Claims' field to "No".
  9. All other fields are populated as required/needed.
  10. Click [Process].
  11. Verify 'No Information' found.
  12. Verify that system does not compile the bill again as the services are claimed.
  13. Click [X].
Scenario 4: CCBHC Billing - 837 Professional - Enumerated CCBHC service distributed to the primary contract CCBHC guarantor and CCBHC PPS service distributed to the another contract CCBHC secondary guarantor
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • Two contract CCBHC guarantors are identified to be used as a primary and secondary guarantor. Note the guarantor's code/name for each guarantor.
  • Configure the primary guarantor for contractual adjustments during liability distribution.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = None.
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1.
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • A CCBHC Enumerated service code is created with the following:
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • Two contract guarantors are assigned to the client as a primary and secondary guarantor.
  • Customize the benefit plan for the primary guarantor such that it only covers the enumerated service and not the PPS service.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The CCBHC Enumerated service is rendered to the client.
  • Client Ledger:
  • The liability for the CCBHC Enumerated service is distributed to the primary guarantor.
  • Close Charges:
  • Close the enumerated CCBHC charges.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the service.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor.
  • Close Charges:
  • Close the PPS charges.
  • Electronic Billing:
  • The service distributed to the primary guarantor is claimed. Note the claim number.
  • The service distributed to the secondary guarantor is claimed. Note the claim number.
  • Client Ledger:
  • Two services on the separate claims.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select secondary CCBHC guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. Set 'Create Claims' field to "No".
  9. All other fields are populated as required/needed.
  10. Click [Process].
  11. Verify the 'No Information Found' message found.
  12. Click [X].
  13. Click [X].
CCBHC Billing - Secondary CCBHC billing from a non-CCBHC primary guarantor
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Electronic Billing
Scenario 1: CCBHC Billing - 837 Professional - Primary and Add-on Enumerated CCBHC services rendered to the client
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • An add-on service code is created with the following:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • A primary service code is created to have desired number of add-on service with the following:
  • Service Code Category = Primary Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • Select Multiple Add-On codes = An Add-On code created above is checked
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a primary guarantor and a CCBHC guarantor is assigned to the client as a secondary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The primary service, with an add-on service, is rendered to the client.
  • Client Ledger:
  • The liability for the primary and add-on service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the charges.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the services.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Individual Cash Posting:
  • The primary service is fully paid such that primary guarantor pays the full amount of primary service.
  • An add-on service is partially paid, and the remaining liability is transferred to the secondary CCBHC guarantor.
  • Close Charges:
  • The PPS charges are closed.
  • All CCBHC setup is complete. CCBHC Billing functionality is used by the agency. If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name for each guarantor.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • An add-on service code is created with the following:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • A primary service code is created to have desired number of add-on services with the following:
  • Service Code Category = Primary Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • Select Multiple Add-On codes = An Add-On code created above is checked
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a primary guarantor and a CCBHC guarantor is assigned to the client as a secondary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The primary service is rendered to the client and make sure that the add-on service is also selected for filing.
  • Client Ledger:
  • The liability for the primary and add-on service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the charges.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the services.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Individual Cash Posting:
  • The primary service is fully paid such that primary guarantor pays the full amount of primary service.
  • An add-on service is partially paid, and the remaining liability is transferred to the secondary CCBHC guarantor.
  • Close Charges:
  • The PPS charges are closed.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select desired guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. All other fields are populated as required/needed.
  9. Click [Process].
  10. Verify 'Compile Complete' message.
  11. Select "Run Report" in the 'Billing Options' field.
  12. Select "Print" in 'Print Or Delete Report'.
  13. Select the recently compiled file from the 'File' dropdown.
  14. Click [Print 837 Report].
  15. Verify that the primary, Add-on and PPS services are included in the '837 Professional Submission' link.
  16. Click [X].
  17. Click [X].
Scenario 2: CCBHC Billing - 837 Professional - Enumerated CCBHC service – Partially paid and transferred remaining liability to CCBHC guarantor from the Non CCBHC guarantor
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name for each guarantor.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • A CCBHC Enumerated service code is created with the following:
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a primary guarantor and a CCBHC guarantor is assigned to the client as a secondary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The CCBHC Enumerated service is rendered to the client, and the add-on service has been saved.
  • Client Ledger:
  • The liability for the CCBHC Enumerated service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the charges.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the services.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Individual Cash Posting:
  • The service distributed to the primary guarantor is partially paid, and the remaining liability is transferred to the secondary CCBHC guarantor.
  • Close Charges:
  • The CCBHC PPS charges are closed.
  • Create Interim Billing Batch File:
  • An interim billing batch is created to include the service transferred to the CCBHC guarantor.
  • Electronic Billing:
  • The 837 Professional bill is claimed for the CCBHC guarantor.
  • The services distributed to CCBHC guarantors are included in the bill.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select CCBHC guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. All other fields are populated as required/needed.
  9. Click [Process].
  10. Verify 'Compile Complete' message.
  11. Select "Run Report" in the 'Billing Options' field.
  12. Select "Print" in 'Print Or Delete Report'.
  13. Select the recently compiled file from the 'File' dropdown.
  14. Click [Print 837 Report].
  15. Verify the enumerated and CCBHC PPS service are included in the '837 Professional Submission' link.
  16. Click [X].
  17. Compile the bill again for the CCBHC guarantor for the same parameters.
  18. Select "Sort File" option from the 'Billing Options'
  19. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  20. All other fields are populated as required/needed.
  21. Click [Process].
  22. Verify 'No Information' found.
  23. Verify that system does not compile the bill again as the services are claimed.
  24. Click [X].
Scenario 3: CCBHC Billing - 837 Professional - Enumerated CCBHC service –Liability fully transferred to non CCBHC guarantor from the CCBHC guarantor
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name for each guarantor.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • A CCBHC Enumerated service code is created with the following:
  • Type of Fee = desired value.
  • CCBHC Enumerated Service = Yes.
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary, and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a secondary guarantor, and a CCBHC guarantor is assigned to the client as a primary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The CCBHC Enumerated service is rendered to the client.
  • Client Ledger:
  • The liability for the CCBHC Enumerated service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the enumerated CCBHC charges.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the service.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Close Charges:
  • Close the PPS charges.
  • Create Interim Billing Batch File:
  • An interim billing batch is created to include the services distributed to the CCBHC guarantor.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • Individual Cash Posting:
  • The service distributed to the primary guarantor is fully transferred to the secondary Non CCBHC guarantor.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select CCBHC guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. Set 'Create Claims' field to "No".
  9. All other fields are populated as required/needed.
  10. Click [Process].
  11. Verify 'No Information' found.
  12. Verify that system does not compile the bill again as the services are claimed.
  13. Click [X].
Scenario 4: CCBHC Billing - 837 Professional - Enumerated CCBHC service distributed to the primary contract CCBHC guarantor and CCBHC PPS service distributed to the another contract CCBHC secondary guarantor
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • Two contract CCBHC guarantors are identified to be used as a primary and secondary guarantor. Note the guarantor's code/name for each guarantor.
  • Configure the primary guarantor for contractual adjustments during liability distribution.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = None.
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1.
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • A CCBHC Enumerated service code is created with the following:
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • Two contract guarantors are assigned to the client as a primary and secondary guarantor.
  • Customize the benefit plan for the primary guarantor such that it only covers the enumerated service and not the PPS service.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The CCBHC Enumerated service is rendered to the client.
  • Client Ledger:
  • The liability for the CCBHC Enumerated service is distributed to the primary guarantor.
  • Close Charges:
  • Close the enumerated CCBHC charges.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the service.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor.
  • Close Charges:
  • Close the PPS charges.
  • Electronic Billing:
  • The service distributed to the primary guarantor is claimed. Note the claim number.
  • The service distributed to the secondary guarantor is claimed. Note the claim number.
  • Client Ledger:
  • Two services on the separate claims.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select secondary CCBHC guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. Set 'Create Claims' field to "No".
  9. All other fields are populated as required/needed.
  10. Click [Process].
  11. Verify the 'No Information Found' message found.
  12. Click [X].
  13. Click [X].
CCBHC Billing - Enhanced Secondary Claims Handling
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Electronic Billing
Scenario 1: CCBHC Billing - 837 Professional - Primary and Add-on Enumerated CCBHC services rendered to the client
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • An add-on service code is created with the following:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • A primary service code is created to have desired number of add-on service with the following:
  • Service Code Category = Primary Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • Select Multiple Add-On codes = An Add-On code created above is checked
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a primary guarantor and a CCBHC guarantor is assigned to the client as a secondary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The primary service, with an add-on service, is rendered to the client.
  • Client Ledger:
  • The liability for the primary and add-on service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the charges.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the services.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Individual Cash Posting:
  • The primary service is fully paid such that primary guarantor pays the full amount of primary service.
  • An add-on service is partially paid, and the remaining liability is transferred to the secondary CCBHC guarantor.
  • Close Charges:
  • The PPS charges are closed.
  • All CCBHC setup is complete. CCBHC Billing functionality is used by the agency. If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name for each guarantor.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • An add-on service code is created with the following:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • A primary service code is created to have desired number of add-on services with the following:
  • Service Code Category = Primary Code
  • Service Code Type = desired value
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • Select Multiple Add-On codes = An Add-On code created above is checked
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a primary guarantor and a CCBHC guarantor is assigned to the client as a secondary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The primary service is rendered to the client and make sure that the add-on service is also selected for filing.
  • Client Ledger:
  • The liability for the primary and add-on service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the charges.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the services.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Individual Cash Posting:
  • The primary service is fully paid such that primary guarantor pays the full amount of primary service.
  • An add-on service is partially paid, and the remaining liability is transferred to the secondary CCBHC guarantor.
  • Close Charges:
  • The PPS charges are closed.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select desired guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. All other fields are populated as required/needed.
  9. Click [Process].
  10. Verify 'Compile Complete' message.
  11. Select "Run Report" in the 'Billing Options' field.
  12. Select "Print" in 'Print Or Delete Report'.
  13. Select the recently compiled file from the 'File' dropdown.
  14. Click [Print 837 Report].
  15. Verify that the primary, Add-on and PPS services are included in the '837 Professional Submission' link.
  16. Click [X].
  17. Click [X].
Scenario 2: CCBHC Billing - 837 Professional - Enumerated CCBHC service – Partially paid and transferred remaining liability to CCBHC guarantor from the Non CCBHC guarantor
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name for each guarantor.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • A CCBHC Enumerated service code is created with the following:
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a primary guarantor and a CCBHC guarantor is assigned to the client as a secondary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The CCBHC Enumerated service is rendered to the client, and the add-on service has been saved.
  • Client Ledger:
  • The liability for the CCBHC Enumerated service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the charges.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the services.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Individual Cash Posting:
  • The service distributed to the primary guarantor is partially paid, and the remaining liability is transferred to the secondary CCBHC guarantor.
  • Close Charges:
  • The CCBHC PPS charges are closed.
  • Create Interim Billing Batch File:
  • An interim billing batch is created to include the service transferred to the CCBHC guarantor.
  • Electronic Billing:
  • The 837 Professional bill is claimed for the CCBHC guarantor.
  • The services distributed to CCBHC guarantors are included in the bill.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select CCBHC guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. All other fields are populated as required/needed.
  9. Click [Process].
  10. Verify 'Compile Complete' message.
  11. Select "Run Report" in the 'Billing Options' field.
  12. Select "Print" in 'Print Or Delete Report'.
  13. Select the recently compiled file from the 'File' dropdown.
  14. Click [Print 837 Report].
  15. Verify the enumerated and CCBHC PPS service are included in the '837 Professional Submission' link.
  16. Click [X].
  17. Compile the bill again for the CCBHC guarantor for the same parameters.
  18. Select "Sort File" option from the 'Billing Options'
  19. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  20. All other fields are populated as required/needed.
  21. Click [Process].
  22. Verify 'No Information' found.
  23. Verify that system does not compile the bill again as the services are claimed.
  24. Click [X].
Scenario 3: CCBHC Billing - 837 Professional - Enumerated CCBHC service –Liability fully transferred to non CCBHC guarantor from the CCBHC guarantor
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • A commercial guarantor and a CCBHC guarantor are identified. Note the guarantor's code/name for each guarantor.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = Same Claim: Hold PPS Charges for Remittances from Private Insurance and Group with Component Services on the Same Claim
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • A CCBHC Enumerated service code is created with the following:
  • Type of Fee = desired value.
  • CCBHC Enumerated Service = Yes.
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary, and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified, or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • A commercial guarantor is assigned to the client as a secondary guarantor, and a CCBHC guarantor is assigned to the client as a primary guarantor identified in the 'Guarantors/Payors' form.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The CCBHC Enumerated service is rendered to the client.
  • Client Ledger:
  • The liability for the CCBHC Enumerated service is distributed to the primary guarantor only.
  • Close Charges:
  • Close the enumerated CCBHC charges.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the service.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor only.
  • Close Charges:
  • Close the PPS charges.
  • Create Interim Billing Batch File:
  • An interim billing batch is created to include the services distributed to the CCBHC guarantor.
  • Electronic Billing:
  • The services distributed to the primary guarantor are claimed. Note the claim number.
  • Individual Cash Posting:
  • The service distributed to the primary guarantor is fully transferred to the secondary Non CCBHC guarantor.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select CCBHC guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. Set 'Create Claims' field to "No".
  9. All other fields are populated as required/needed.
  10. Click [Process].
  11. Verify 'No Information' found.
  12. Verify that system does not compile the bill again as the services are claimed.
  13. Click [X].
Scenario 4: CCBHC Billing - 837 Professional - Enumerated CCBHC service distributed to the primary contract CCBHC guarantor and CCBHC PPS service distributed to the another contract CCBHC secondary guarantor
Specific Setup:
  • CCBHC Billing functionality is used by the agency. All CCBHC setup is complete.
  • If the functionality is desired, but not installed, please contact your Netsmart Client Alignment Representative.
  • Guarantors/Payors:
  • Two contract CCBHC guarantors are identified to be used as a primary and secondary guarantor. Note the guarantor's code/name for each guarantor.
  • Configure the primary guarantor for contractual adjustments during liability distribution.
  • Guarantor/Program Billing defaults:
  • A 'Guarantor/Program Billing Defaults' template has been created for the guarantor and has a value of 'Yes' in 'CCBHC Template'.
  • The guarantors identified above, and the admission program of the client are assigned to this template.
  • 837 Professional:
  • CCBHC Claim Grouping = None.
  • Maximum Service Information Per Claim Information (Maximum LX Per CLM) =1.
  • All other fields are populated as required/needed.
  • Note the template name, name of the guarantor and name of the admission program.
  • An active 'CCBHC PPS Service Definition' exists.
  • Dictionary Update:
  • A value of "Yes" is added in 'CCBHC Location' in the extended dictionary for 'Client, 10006, Location', for a minimum of one location.
  • Service codes:
  • A CCBHC Enumerated service code is created with the following:
  • Type of Fee = desired value
  • CCBHC Enumerated Service = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the primary and add-on service codes created/identified in the 'Service Codes' form.
  • Admission:
  • An existing outpatient client is identified or a new client is admitted in the program identified in the 'Guarantor/Program billing defaults' form.
  • Note client id, admission program, admission date.
  • Financial Eligibility:
  • Two contract guarantors are assigned to the client as a primary and secondary guarantor.
  • Customize the benefit plan for the primary guarantor such that it only covers the enumerated service and not the PPS service.
  • Diagnosis:
  • An active diagnosis record is created for the client.
  • Client Charge Input:
  • The CCBHC Enumerated service is rendered to the client.
  • Client Ledger:
  • The liability for the CCBHC Enumerated service is distributed to the primary guarantor.
  • Close Charges:
  • Close the enumerated CCBHC charges.
  • CCBHC PPS Compile:
  • The CCBHC PPS Compile process has been processed for the service.
  • Client Ledger:
  • The CCBHC PPS service created via compile distributes to the secondary CCBHC guarantor.
  • Close Charges:
  • Close the PPS charges.
  • Electronic Billing:
  • The service distributed to the primary guarantor is claimed. Note the claim number.
  • The service distributed to the secondary guarantor is claimed. Note the claim number.
  • Client Ledger:
  • Two services on the separate claims.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select an "837 Professional" from the 'Billing Form'.
  3. Select "Individual" from the 'Individual Or All Guarantors' field.
  4. Select secondary CCBHC guarantor from the 'Guarantor' drop down.
  5. Select "Outpatient" from the 'Billing Type' field.
  6. Select "Sort File" option from the 'Billing Options'
  7. Select "Yes" in 'Include CCBHC Services' to include the CCBHC service.
  8. Set 'Create Claims' field to "No".
  9. All other fields are populated as required/needed.
  10. Click [Process].
  11. Verify the 'No Information Found' message found.
  12. Click [X].
  13. Click [X].
Topics
• 837 Professional • CCBHC
Update 88 Summary | Details
Dynamic fields/forms
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Service Fee/Cross Reference Maintenance
Scenario 1: Service Fee/Cross Reference Maintenance - Multiple Definitions on Same Date - Dynamic Messaging
Steps

Internal testing only
Topics
• Disclosure
Update 89 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: Remittance Processing Widget - Refresh functionality and Registry Setting = ' 'Enable Guarantor Sort By Name' help message validation
Specific Setup:
  • Home View:
  • The 'Remittance Processing' widget is added in the home view.
  • 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
  • Financial Eligibility:
  • The guarantors identified above are assigned to the client.
  • Client Charge Input:
  • 5-6 services are rendered to the client. Note the service start/end dates 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
  1. Locate the 'Remittance Processing' widget on the home view.
  2. Click [Create Batch] in the 'Action for Batch' field.
  3. Enter a description in the 'Description' field. Note the batch description.
  4. Navigate to the 'Remittance Details' section.
  5. Click [Add Row].
  6. Enter 'Client A' created in the setup in the 'Client' cell.
  7. Double-click the 'GuarID#' cell.
  8. Select 'Guarantor 1' from setup.
  9. Verify the 'Start Date' and 'End Date' fields contain the start and end date of the services rendered to the Client.
  10. For any service row, enter the desired amount in the 'Pmt Amt' field.
  11. Select the desired code in the 'Pmt Code' field.
  12. For any service row, enter the desired amount in the 'Adj Amt' field.
  13. Select the desired code in the 'Adj Code' field.
  14. For any service row, enter, the desired amount in the 'xfr Amt' field.
  15. Select the desired code in the 'xfr Code' field.
  16. Select the desired guarantor in the 'xfer to Guar' field.
  17. Click [Save and Exit].
  18. Validate the message 'Remittance batch saved'.
  19. Click [OK].
  20. Go to the 'Batch' section.
  21. Click [Edit] in the 'Action for Batch' field.
  22. Select the desired batch created above in 'Remittance Batch Number'.
  23. Validate 'Payment Posted' populates with the amount entered in the batch.
  24. Validate 'Adjustment Posted' populates with the amount entered in the batch.
  25. Validate 'Transfer Posted 'populates with the amount entered in the batch.
  26. Click [Refresh].
  27. Validate the widget has no records to display.
  28. Open the "Registry Settings" form.
  29. Set the 'Limit Registry Settings to the Following Search Criteria' to 'Enable Guarantor Sort By Name'.
  30. Click [Yes] in 'Include Hidden Registry Settings'.
  31. Validate the 'Registry Setting Details' section includes 'Remittance Processing'.
  32. Validate the 'Registry Setting Value' is set to 'Y'.
  33. Click [Submit].
  34. Validate Form Return Dialog.
  35. Click [No].
  36. Locate the 'Remittance Processing' widget on the home view.
  37. Click [Create Batch] in the 'Action for Batch' field.
  38. Enter a description in the 'Description' field. Note the batch description.
  39. Validate 'Default Guarantor' displays Guarantor by name.
  40. Click [Refresh].
  41. Repeat steps 27-32 ,with 'Registry Setting Value' is set to 'N'.
  42. Click [Submit].
  43. Validate Form Return Dialog.
  44. Click [No].
  45. Locate the 'Remittance Processing' widget on the home view.
  46. Click [Create Batch] in the 'Action for Batch' field.
  47. Enter a description in the 'Description' field. Note the batch description.
  48. Validate 'Default Guarantor' displays Guarantor by number.
  49. Click [Refresh].
Topics
• Registry Settings • Widgets
Update 90 Summary | Details
Client Merge
Scenario 1: Cal-PM -Client Merge (InPatient and Outpatient)
Specific Setup:
  • At least two clients must be admitted to active episodes.
Steps
  1. Open "Client Merge" form.
  2. Validate the warning contains: The Client Merge process uses significant system resources. It is recommended to run after hours or during your lowest usage time to prevent any performance impacts.
  3. Click [OK].
  4. Enter the 'Source Client'.
  5. Enter the 'Target Client'.
  6. Select desired option in 'Merge All Client Data Through Single Filing'.
  7. Select desired episode from 'Source Client Episode'.
  8. Select desired option in 'Create New Episode On Merge'.
  9. Click [File].
  10. Validate the following message displays: 'Do you wish to continue with the indicated action?'
  11. Click [Yes].
  12. Validate the following message displays: 'The following new episode has been created for the target client indicated. Episode x'.
  13. Click [OK].
  14. Click [Discard].
  15. Open "Admission" form.
  16. Enter the "Target Client".
  17. Verify the merged episode data is present.
  18. Click [Cancel].
Topics
• Client Merge
2023 Update 92 Summary | Details
NCPDP - new tables and NCPDP Claim Submission Response Report
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • NCPDP System Defaults
  • Electronic Billing
  • NCPDP Claim Submission Response Report
Scenario 1: NCPDP Claim Submission Response Report
Specific Setup:
  • The Avatar application must be associated with an RxConnect Instance and configured to communicate via HL7.
  • There must be active connections between Avatar and RxConnect for "ADT", "ORDERS", "FILL DETAILS", and "BILLING".
  • The "ADT" and "ORDERS" connections must have both values selected in the 'Sub System Code Facility ID(s) Supported' field and the 'Include Sub System Code Facility ID in Outbound Message' field in the 'HL7 Connection Manager' form, which is a Netsmart Staff Only form. Please contact your Netsmart Representative.
  • CE2000 must be installed and configured on the Database server.
  • The 'Avatar PM->Billing->Electronic Billing->NCPDP->->Enable NCPDP Billing' registry setting must be set to "Y".
  • The 'Create New Fill For Every Change In NDC' field must be set to "Yes" in the 'NCPDP System Defaults' form.
  • The user logged into the application must have access to the 'SYSTEM.ncpdp_system_defaults' table.
  • Please log out of the application and log back in after completing the above configuration.
  • A client must have an active inpatient episode. (Client A)
  • “Client A” and "Client B" must have a ‘Date of Birth’, ‘Sex’ and address on file in the ‘Update Client Data’ form, as well as information filed in the ‘Allergies and Hypersensitivities’ form, ‘Diagnosis’ form, and in the ‘Height’ and ‘Weight’ fields in the ‘Vitals Entry’ form.
  • "Client A" and "Client B" must be associated with an NCPDP guarantor in the 'Financial Eligibility' form.
  • "Client A" must have three active pharmacy-type orders each with a duration of "60 Days" that starts in the past and have been processed in RxConnect. (Order A) (Order B) (Order C)
  • "Order A" must have a 'Frequency' of "Every Day"
  • "Order B" must have a 'Frequency' of "Twice A Day" administration times at "09:00 AM" and "09:00 PM".
  • "Order C" must have a 'Frequency of "3 Times A Day" with administration times at "09:00 AM", "03:00 PM", and "09:00 PM".
  • "Order A" and "Order C" must have one active NDC #.(NDC A) (NDC B)
  • "Order B" must have two active NDC #'s. (NDC C) (NDC D)
  • "Order A" must be administered for the first 14 days of a month using "NDC A".
  • "Order B" must be administered for the first 14 days of a month, where the "09:00 AM" administration on each day is using "NDC C" and administered for the "09:00 PM" administration for the same days with "NDC D".
  • "Order C" must be administered seven times starting at the first of a month using "NDC B".
  • Charges must be batched in RxConnect.
  • Charges must be compiled and posted in the 'Compile Inbound HL7 Charge Batch File' and 'Post Inbound HL7 Charge Batch File' forms.
  • Charges must be rolled up and posted in the 'Compile/Edit/Post/Unpost Roll-Up Services Worklist' form.
  • Charges must be closed for "Client A".
Steps
  1. Access the 'NCPDP System Defaults' form.
  2. Select "No" in the 'Create New Fill For Every Change In NDC' field and click [Submit].
  3. Validate a "Filed" message is displayed and click [OK].
  4. Close the form.
  5. Access the 'Electronic Billing' form.
  6. Select "NCPDP" in the 'Billing Form' field.
  7. Select "Medicare Part D" in the 'Type Of Bill' field.
  8. Select "Individual" in the 'Individual Or All Guarantors' field.
  9. Select the NCPDP guarantor associated with "Client A" in the 'Guarantor' field.
  10. Select "Inpatient" in the 'Billing Type' field
  11. Select "Sort File" in the 'Billing Options' field
  12. Set the 'File Description' field to any value.
  13. Select "All Clients" in the 'All Clients Or Interim Billing Batch' field.
  14. Select the program associated with "Client A" in the 'Program(s)' field.
  15. Select "Yes" in the 'Create Claims' field.
  16. Set the 'Date Of Claim' field to the first date of service for all orders.
  17. Set the 'First Date Of Service To Include' field to the first date of service for all orders.
  18. Set the 'Last Date of Service To Include' field to the last date of service for all orders.
  19. Click [Process].
  20. Validate a "Compile Complete" message is displayed and click [OK].
  21. Select "Create File On Server" in the 'Billing Options' field.
  22. Select the file description name in the 'File' field
  23. Click [Process].
  24. Validate a "File(s) created." message is displayed and click [OK].
  25. Close the form.
  26. The file is processed through CE2000.
  27. Access the 'NCPDP Claim Submission Response Report' form.
  28. Select the appropriate file description in the 'Claim Submission File' form and click [Run Report].
  29. Validate the 'NCPDP Claim Submission Response Report' is displayed and contains values in the 'Processing Notes' section of the report and all relevant data.
  30. Click [Close Report].
  31. Create a report using the 'SYSTEM.ncpdp_system_defaults' table and validate that the information filed in the 'NCPDP System Defaults' form are displayed.
Topics
• NCPDP System Defaults • NCPDP
Update 93 Summary | Details
Real Time Inquiry (270) Request
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Financial Eligibility
  • Guarantors/Payors
  • Eligibility Response (271) Report
Scenario 1: PM - Enable RevConnect = YA - Real Time Inquiry (270) Request
Specific Setup:
  • Netsmart Client Alignment Associate has been contacted to enable 'RevConnect'.
  • Netsmart Avatar support has completed the following:
  • Enabled the 'Enable RevConnect' registry setting has been updated to contain 'YA'.
  • Completed & submitted the 'RevConnect Configuration' form.
  • 'System Generated Email Settings' has been used to add the tester’s email to enable notification verification.
  • Registry Setting:
  • The 'Enable 270/271 Transaction Sets' registry setting is set to 'Y'.
  • Eligibility Inquiry (270/271) Real-Time Setup:
  • The 'Access Point Type' contains a 'RevConnect' option only when the 'Enable RevConnect' registry setting has a value of 'YA'.
  • The 'RevConnect Account Key' field is added to the form when the 'Enable RevConnect' registry setting has a value of 'YA'.
  • Guarantors/Payors:
  • An existing guarantor is identified and has a value of:
  • 'Yes' in 'Support 270/271 Transaction Sets' of the '270 / 271 / 834' sections.
  • A value in 'Real Time 270/271 Access Point'.
  • Add desired data to other fields, noting the values.
  • Admission:
  • A client is admitted to a program, or an existing client is identified. Note client id/name, admission date/program.
  • Financial Eligibility: The above guarantor is assigned to client.
  • Based on the setup in the '270 / 271 / 834' section of 'Guarantors/Payors', the client either has one, or any combination of the following: services, appointments, or an eligibility request in financial eligibility.
  • Eligibility Inquiry (270/271) Real-Time Setup:
  • The 'Access Point Type' contains a 'RevConnect' option only when the 'Enable RevConnect' registry setting has a value of 'YA'.
  • The 'RevConnect Account Key' field is added to the form when the 'Enable RevConnect' registry setting has a value of 'YA'.
Steps
  1. Open 'Real Time Inquiry (270) Request'.
  2. Create a request for the client.
  3. Close the form.
  4. Open 'Eligibility Inquiry And Response (270/271) Report'.
  5. Enter the 'Client' ID' and other desired data.
  6. Click 'Display Report'.
  7. Validate the report data.
  8. Close the report.
  9. Close the form.
  10. Open 'Real Time Inquiry (270) Request'.
  11. Enter the 'Client ID', 'Guarantor' and other desired data.
  12. Click [Process Report].
  13. Click [OK].
  14. Review the report data.
  15. Validate that the 'Response' field contains the correct data.
  16. If desired, click [Post Inquiry].
  17. Close the form.
  18. Open 'CareFabric Monitor'.
  19. Enter the desired 'From Date', 'Through Date' and 'Client ID'.
  20. Click [View Activity Log].
  21. Review the data to ensure the events/actions were created.
  22. Close the report.
  23. Close the form.
Topics
• Real Time Inquiry (270) Request • RevConnect
Update 97 Summary | Details
Scheduling Calendar
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Service Codes
  • Financial Eligibility
  • Payment Acknowledgement
  • Client Ledger
Scenario 1: Scheduling Calendar - Check In/Check Out
Specific Setup:
  • Service Codes:
  • A pre-payment service code is added such that 'Group Code' =Non-Billable and 'Covered Charge Category'= Non Billable. (Service Code A).
  • Posting Adjustment Codes Definition:
  • Add new or edit existing Payment Posting Code and ensure it has a payment reversal posting code associated with it. (Posting Code 1).
  • Registry Settings:
  • Set 'Enable Payment Acknowledgement' to "Y".
  • Select "4" in 'Prevent Posting Payments Unless Payment has been Acknowledged'.
  • Select "1" in 'Add Previous Balance To Expected Self Pay Amount'.
  • Select "Y" in ' 'Include Guarantors with Self Pay System Financial Class'.
  • Set 'Pre Payment Service Code' to "Service Code A".
  • Set 'Pre Payment Default Posting Code "Posting Code 1".
  • Dictionary Update:
  • Add new dictionary update in 'Payor' file type, data element (1000) Financial Class, set 'Self Pay' value for Extended Dictionary Data Element 'System Financial Class'.
  • Guarantors/Payors:
  • Add new guarantor and set Financial Class = 'System Financial Class'.
  • A Self Pay guarantor with Financial Class =s Self Pay. Note the Guarantor id/name.
  • Admission:
  • Client:
  • An inpatient or outpatient client or an existing client is identified. Note the client ID/name, and admission date/program.
  • Self pay guarantor identified above is assigned to the Client.
Steps
  1. Open the "Scheduling Calendar" form.
  2. Select desired date and time for appointment.
  3. Right click on any desired time.
  4. Click [Add Appointment].
  5. Enter the 'Client ID'.
  6. Enter the desired service code in 'Service Code'.
  7. Click [Submit].
  8. Right click on the appointment created above.
  9. Click [Check In].
  10. Verify the 'Expected Self Pay Amount'.
  11. Enter desired amount in 'Amount Received at Check in'.
  12. Click [Submit].
  13. Verify the report displays correct data.
  14. Click [Close Report].
  15. Click [Dismiss].
  16. Open any SQL reporting tool.
  17. Query the following table: SYSTEM.unacknowledged_payments
  18. Verify JOIN_TO_APPT_ID column is populated with value.
  19. Close the Query.
  20. Open "Payment Acknowledgement" form.
  21. Click [Post Front Office and myHP Payments].
  22. Click [T] in 'Payment Collection Date'.
  23. Select desired value from 'Treatment Service'.
  24. Select desired value from 'Type'.
  25. Click [Review].
  26. Select the desired service from the grid.
  27. Click [Save].
  28. Enter desired number in 'Batch Number'.
  29. Click [T] in 'Deposit Date'.
  30. Select desired value from 'Category'.
  31. Enter any desired number in 'BankRef #'.
  32. Click [Post].
  33. Validate the message filed successfully.
  34. Click [OK].
  35. Click [Discard].
  36. Open "Client Ledger" form.
  37. Enter the 'Client ID'.
  38. Click [All Episodes] in 'Claim/Episodes/All Episodes'.
  39. Click [Simple] in 'Ledger Type'.
  40. Click [Process].
  41. Validate the ledger report displays correct data.
  42. Click [X].
  43. Open "Scheduling Calendar" form.
  44. Right click on the appointment created above.
  45. Click [Check Out].
  46. Verify 'Self Pay Owed' amount and 'Received at Checked In'.
  47. Verify 'Expected Self Pay Amount'.
  48. Click [Submit].
  49. Verify the report.
  50. Click [Close Report].
  51. Click [Dismiss].
  52. Repeat steps to verify ledger report displays correct data.
Topics
• Scheduling Calendar
Update 101 Summary | Details
The 'Day Program Attendance' widget
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Day Program Attendance Widget
  • View Definition
  • Client Ledger
Scenario 1: Day Program Attendance widget - Validate 'Complete Close' functionality with multiple practitioners
Specific Setup:
  • Please note: this is for Avatar NX only.
  • The 'Day Program Attendance' widget must be added to a view in 'View Definition'.
  • The logged in user must have the 'Day Program Attendance' widget accessible from their myDay view.
  • A program is defined in 'Program Maintenance' with the following (Program A):
  • "Yes" selected in the 'Is This A Day Program?' field.
  • A service code selected in the 'Day Program Missed Visit Service Code' field.
  • One or more active service codes selected in the 'Day Program Services' section (Service Code A).
  • A schedule configured for Monday through Friday in the 'Day Program Schedule' section.
  • Two practitioners are defined (Practitioner A & Practitioner B).
  • A client is admitted into "Program A" (Client A).
Steps
  1. Navigate to the 'Day Program Attendance' widget.
  2. Select "Program A" in the 'Program' field.
  3. Select the desired practitioner in the 'Practitioner' field.
  4. Please note: this will be the default 'Practitioner' for all rows unless a different practitioner is selected in each individual row.
  5. Validate "Client A" is displayed in the 'Day Program Attendance' widget.
  6. Validate the 'Start Time' and 'Close Time' fields contain the times configured in 'Program Maintenance'.
  7. Validate the row for "Client A" does not contain a value in the 'In', 'Out', and 'Service' fields.
  8. Click [Complete Close].
  9. Validate a message is displayed stating: All clients must have a time recorded before close can be completed.
  10. Enter the desired time in 'In' field.
  11. Enter the desired time in the 'Out' field.
  12. Validate the 'Length' field contains the total time between the 'In' and 'Out' times.
  13. Select "Service Code A" in the 'Service' field.
  14. Validate the 'Practitioner' field is displayed and contains a list of practitioners in alphabetical order by last name.
  15. Select "Practitioner A" in the 'Practitioner' field.
  16. Validate the 'Total' field contains the total time between the 'In' and 'Out' times.
  17. Click on the [Return] icon.
  18. Validate a second row is added for "Client A" with:
  19. 'PATID' containing the PATID for "Client A". Please note: 'Name' field will not be populated for 'Return' rows.
  20. 'In' time with the current time.
  21. 'Length' field will contain * indicating this is a running count until an 'Out' time is calculated.
  22. 'Practitioner' with the 'Practitioner' selected in the main row (if one is selected). In this case, it will be "Practitioner A".
  23. Enter the desired time in the 'Out' field.
  24. Validate the 'Length' field contains the total time between the 'In' and 'Out' times for the second row.
  25. Select "Service Code A" in the 'Service' field.
  26. Select "Practitioner B" in the 'Practitioner' field.
  27. Validate the 'Total' field contains the sum of the total times from row 1 and row 2.
  28. Click [Complete Close].
  29. Validate a 'Day Program Posting Authentication' dialog is displayed.
  30. Enter the logged in username in the 'User ID' field.
  31. Enter the password for the logged in user in the 'Password' field.
  32. Click [OK].
  33. Validate "Client A" is no longer displayed in the 'Day Program Attendance' widget.
  34. Validate the gray/disabled text field at the top of the widget contains: Close completed for today.
  35. Access the 'Client Ledger' form.
  36. Select "Client A" in the 'Client ID' field.
  37. Select "All Episodes" in the 'Claim/Episode/All Episodes' field.
  38. Select "Simple" in the 'Ledger Type' field.
  39. Select "Yes" in the 'Include Zero Charges' field.
  40. Click [Process].
  41. Validate the 'Client Ledger Report' contains two rows for "Service Code A".
  42. Two services will be displayed: One for the service with "Practitioner A" and one for the service with "Practitioner B".
  43. Click [Close] and close the form.
  44. Access Crystal Reports or other SQL Reporting Tool.
  45. Create a report using the 'SYSTEM.billing_tx_history' SQL table.
  46. Validate two rows are displayed for the posted service for "Client A".
  47. One row will contain the following:
  48. 'duration' = the 'Length' from the first row for "Client A" in the 'Day Program Attendance' widget
  49. 'SERVICE_CODE' = "Service Code A"
  50. 'PROVIDER_ID' = "Practitioner A"
  51. Another row will contain the following:
  52. 'duration' = the 'Length' from the second row for "Client A" in the 'Day Program Attendance' widget
  53. 'SERVICE_CODE' = "Service Code A"
  54. 'PROVIDER_ID' = "Practitioner B"
  55. Close the report.
Topics
• Day Program Attendance
Update 103 Summary | Details
Console Widget Viewer - Admission Data
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Update Client Data
  • Diagnosis
  • Console Widget Viewer
  • Pre Admit
Scenario 1: 'All Documents' widget - Validate multiple 'Admission' records for the same client
Specific Setup:
  • Please note: this is for Avatar NX only.
  • A Documentation View must be set up on a user's view containing the 'All Documents' widget and the 'Console Widget Viewer' ('All Documents' view).
  • The 'All Documents' widget must contain a 'Multi-Form Tab' with the 'Admission' form assigned. This will be referred to as the "Admission" tab.
Steps
  1. Access the 'Admission' form.
  2. Admit a new client into Episode 1. Note: this will be referred to as "Client A".
  3. Populate all required and desired fields.
  4. Select the desired value in the 'Type of Admission' field.
  5. Enter the desired value in the 'Admission Comments' field.
  6. Submit the form.
  7. Select "Client A" and access the 'Admission' form.
  8. Click [Add] to admit the client into Episode 2.
  9. Populate all required and desired fields.
  10. Select the desired value in the 'Type of Admission' field.
  11. Enter the desired value in the 'Admission Comments' field.
  12. Submit the form.
  13. Select "Client A" and navigate to the 'All Documents' view.
  14. In the 'All Documents' widget, select the "Admission" tab.
  15. Select the 'Admission' record for Episode 1.
  16. Click to view the record and validate it displays as expected in the 'Console Widget Viewer'.
  17. Validate the proper admission data for Episode 1 is displayed.
  18. Click [Close All].
  19. Select the 'Admission' record for Episode 2.
  20. Click to view the record and validate it displays as expected in the 'Console Widget Viewer'.
  21. Validate the proper admission data for Episode 2 is displayed.
  22. Click [Close All].
Topics
• Admission
Update 107 Summary | Details
SQL table
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Form and Table Documentation (PM)
Internal Test Only
Modifiers by Practitioner Category
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • MODIFIERS BY PRACTITIONER CATEGORY
  • Diagnosis
  • Financial Eligibility
  • Client Charge Input
  • Create Interim Billing Batch File
  • Electronic Billing
Scenario 1: Modifiers by Practitioner Category - workflow
Specific Setup:
  • Form Designer: If previously used to modify the 'Modifiers By Practitioner Category' form, it may be necessary to revert to 'Netsmart Produced Changes'.
  • Registry Settings:
  • Set the 'Enable Duplicate Service Modifiers' registry setting to "Y".
  • Program Maintenance:
  • Identify a minimum of two outpatient programs: Program 1 & Program 2.
  • Guarantors/Payor:
  • Identify a minimum of two guarantors in different Financial Classes: Guarantor 1 & Guarantor 2.
  • Practitioner Enrollment:
  • Identify a minimum of two practitioners in different Practitioner Categories. Practitioner Category 1 & Practitioner Category 2.
  • CPT Code:
  • Identify a minimum of two CPT Codes. CPT Code 1 & CPT Code 2.
  • Service Codes:
  • Service Code 1: An existing service code is identified that contains CPT Code 1, or a new Service Code is created. The service code has a fee record.
  • Service Code 2: An existing service code is identified that contains CPT Code 2, or a new Service Code is created. The service code has a fee record.
  • Clients:
  • Client 1:
  • Is admitted to Program 1.
  • Diagnosis records are created for the client.
  • The financial eligibility record contains Guarantor 1 as the primary guarantor.
  • Client Charge Input is used to create a minimum of one service for each service code.
  • Client Ledger validates that the charges distributed to Guarantor 1.
  • Close Charges has been used to close the charges.
  • If desired, create an interim billing batch.
  • Client 2:
  • Is admitted to Program 2
  • Diagnosis records are created for the client.
  • The financial eligibility record contains Guarantor 2 as the primary guarantor.
  • Client Charge Input is used to create a minimum of one service for each service code.
  • Client Ledger validates that the charges distributed to Guarantor 2.
  • Close Charges has been used to close the charges.
  • If desired, create an interim billing batch.
Steps
  1. Open the "Modifiers by Practitioner Categories" form.
  2. Validate that the form has the following fields:
  3. Guarantor ID - required
  4. Financial Class Selection
  5. Program - required
  6. Treatment Setting Selection
  7. CPT Code - required
  8. Practitioner Category - required
  9. Start Date
  10. End Date
  11. Modifier - required
  12. Duplicate Service Modifiers
  13. Delete Modifiers button
  14. Print Modifiers button
  15. Export Modifiers button
  16. If desired, click [Print Modifiers] to receive a report of records already filed in the system.
  17. Select the classes for 'Guarantor 1' and 'Guarantor 2' in 'Financial Class Selection'.
  18. Verify that only guarantors in those classes display in 'Guarantor ID'.Select 'Guarantor 1' and 'Guarantor 2' in 'Guarantor ID'.
  19. Select 'Outpatient' in 'Treatment Setting Selection'.
  20. Verify that only 'Outpatient' programs display in 'Program'.
  21. Select 'Program 1 in 'Program'.
  22. Select 'CPT Code 1' in 'CPT Code'.
  23. Select 'Practitioner Category 1' in 'Practitioner Category'.
  24. Validate that the 'Modifier' field is marked as required.
  25. Enter an invalid format values in 'Duplicate Service Modifiers' similar to "Invalid_Test".
  26. Verify that an error displays "Invalid Format" with an 'OK' button.
  27. Click [OK].
  28. Enter up to two values for 'Duplicate Service Modifiers' similar to "D1,D2".
  29. Verify that the 'Modifier' field is no longer required.
  30. Enter up to four values in 'Modifiers' similar to "M1,M2".
  31. Enter the 'Start Date' and 'End Date' values.
  32. Select [Submit].
  33. Select the same parameters just submitted:
  34. Click [Print Modifiers.] and validate that report contains the requested record.
  35. Click [Export Modifiers] and validate that the export file contains the requested record.
  36. Close the form.
  37. Create a query of the SQL table:' SYSTEM.mods_by_category' and validate that the Modifiers filed above are added in the table as individual rows.
  38. Note that there may be pre-existing data in the table.
  39. If desired, select a row of data that can be deleted in the form. Note the details.
  40. Close the query.
  41. Open the "Modifiers By Practitioner Category" form.
  42. If desired, enter the details noted in the table and click [Delete Modifiers].
  43. Verify that a message displays: 'You Are About To Delete Modifiers. Are You Sure You Want To Continue?' and that the message has 'OK' and 'Cancel' buttons. Continue as desired.
  44. Select 'Guarantor 2' in 'Guarantor ID'.
  45. Select 'Outpatient' in 'Treatment Setting Selection'.
  46. Select 'Program 2' in 'Program'.
  47. Select 'CPT Code 2' in 'CPT Code'.
  48. Select 'Practitioner Category 2' in 'Practitioner Category'.
  49. Enter desired values for 'Modifiers' similar to "M3,M4".
  50. Enter desired values for 'Duplicate Service Modifiers' similar to "D3,D4".
  51. Enter the 'Start Date' and 'End Date' values.
  52. Select [Submit].
  53. If desired, print the report for the parameters just submitted and validate the data,
  54. If desired, create a query of the SQL table:' SYSTEM.mods_by_category' and validate that the record filed above is added to the table.
  55. Close the query.
  56. Open the "Electronic Billing" form.
  57. Create the 837 Professional bills for each client.
  58. Review the dump file.
  59. Validate that the modifiers are correct in the service level 'SV1' segment.
  60. Close the report.
  61. Close the form.
File Import - Modifiers by Practitioner Category
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • MODIFIERS BY PRACTITIONER CATEGORY
Scenario 1: File Import - Modifiers by Practitioner Category
Specific Setup:
  • Registry Settings: 'Enable Duplicate Service Modifiers' is set to "Y".
  • The following files exist for File Import - Modifiers by Practitioner Category:
  • File A: Will add a record with desired values. Note the values.
  • File B: Will edit the record created when File A is posted. Note the values.
  • The 'Avatar_PM_File_Import_Record_Layouts' will be included in the update zip file.
Steps
  1. Open "File Import".
  2. Select the 'Modifiers By Practitioner Category' file type.
  3. Select the 'Upload New File' action radio button.
  4. Click [Process].
  5. Select 'File A'.
  6. Compile, print and post the file.
  7. Close the form.
  8. Open "Modifiers By Practitioner Category".
  9. Based on the contents of 'File A' select the desired 'Guarantor ID ', 'Program', 'CPT Code ', 'Practitioner Category', and 'Modifier'.
  10. Click [Print Modifiers].
  11. Validate the report contents.
  12. Close the report.
  13. Close the form.
  14. Repeat steps 1 - 13 for 'File 'B.
Topics
• Modifiers by Practitioner • File Import
Update 109 Summary | Details
'Client Merge' process
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Update Client Data
Scenario 1: Client Merge - Validate the 'Allow Merging Into Existing Episode' registry setting
Specific Setup:
  • Two clients are admitted into existing episodes in the same outpatient programs (Client A, Client B).
Steps
  1. Access the 'Registry Settings' form.
  2. Enter "Allow Merging Into Existing Episode" in the 'Limit Registry Settings to the Following Search Criteria' field.
  3. Click [View Registry Settings].
  4. Validate the 'Registry Setting' field contains: Avatar PM->System Maintenance->Client Merge->->->Allow Merging Into Existing Episode.
  5. Enter "Y" in the 'Registry Setting Value' field.
  6. Submit the form.
  7. Access the 'Client Merge' form.
  8. Select "Client A" in the 'Source Client' field.
  9. Select "Episode # 1" from the 'Source Client Episode' field.
  10. Select "Client B" in the 'Target Client' field.
  11. Validate the 'Create New Episode on Merge' field is displayed.
  12. Select "No" in the 'Create New Episode On Merge' field.
  13. Click [File].
  14. Validate a 'Do you wish to continue with the indicated action?' message is displayed.
  15. Click [Yes].
  16. Validate a message stating 'The following episode has been updated for the target client indicated to include data from the source. Episode 1.
  17. Click [OK] and close the form.
  18. Access Crystal Reports or other SQL Reporting Tool.
  19. Create a report using the 'SYSTEM.client_merge_log' SQL table.
  20. Validate the merged client data is displayed as expected.
  21. Close the report.
Scenario 2: Client Merge - Validate the 'Allow Merging Of All Client Data Through Single Filing' registry setting
Specific Setup:
  • Three clients are admitted into existing episodes in different outpatient programs (Client A, Client B, Client C).
Steps
  1. Access the 'Registry Settings' form.
  2. Enter "Allow Merging Of All Client Data" in the 'Limit Registry Settings to the Following Search Criteria' field.
  3. Click [View Registry Settings].
  4. Validate the 'Registry Setting' field contains: Avatar PM->System Maintenance->Client Merge->->->Allow Merging Of All Client Data Through Single Filing.
  5. Enter "Y" in the 'Registry Setting Value' field.
  6. Submit the form.
  7. Access the 'Client Merge' form.
  8. Select "Client A" in the 'Source Client' field.
  9. Validate the 'Merge All Client Data Through Single Filing' field is displayed.
  10. Select "Yes" in the 'Merge All Client Data Through Single Filing' field.
  11. Select "Client B" in the 'Target Client' field.
  12. Click [File].
  13. Validate a "Client Merge" message is displayed stating: Do you wish to continue with the indicated action.
  14. Click [Yes].
  15. Validate a "Client Merge" message is displayed stating: All information has been merged into the target client and the source client has been deleted from the system.
  16. Click [OK].
  17. Close the form.
  18. Access Crystal Reports or other SQL Reporting Tool.
  19. Create a report using the 'SYSTEM.client_merge_log' SQL table.
  20. Validate the merged client data is displayed as expected.
  21. Close the report.
Topics
n/a
 

Avatar_PM_2024_Monthly_Release_2024.02.00_Details.csv