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Avatar PM 2024 Update 61

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Product Requirements and Recommendations

Avatar PM required
RADplus required

Recommended Update Level

Avatar PM 2024 Monthly Release 2024.01.02
RADplus 2024 Monthly Release 2024.01.02

Product Update Description

The 'PERFID' and 'PPIUniqueID' fields are added to the SYSTEM.staff_enrollment_history table to map the MSO performing provider ID and performing provider registration filed in the 'Practitioner Enrollment' form. Also the issue is resolved where the 'Payment/Adjustment Posting' file import is allowing inactive posting/adjustment codes to be used.

Required Updates

Avatar PM 2024 Update 31

Included Updates

8, 9, 16, 17, 23, 28, 29, 31, 34, 35, 42, 44, 46, 47, 57, 60

Details
NEW0 CHANGED0 FIXED2
Fixed (2)
Practitioner Enrollment Form - Database Validation
The SYSTEM.staff_enrollment_history table has been updated to add the fields ‘'PERFID' and 'PPIUniqueID'. This will allow mapping of the Performing Provider ID and Performing Provider Registration information submitted in the 'Practitioner Enrollment' form.
Topics
• Practitioner
 
File Import - Posting/Adjustment Posting'
An issue is resolved where 'File Import' allows inactive posting codes to be used and posted without error in 'Posting/Adjustment Posting'. KB0076598 v0.01
The ‘File Import’, ‘'Posting/Adjustment Posting' file will produce an error when an inactive posting code is included in the file. This will prevent the inactive posting code from being filed.
Topics
• File Import
 
Acceptance Tests
AV-97425 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:
  • Performing Provider Registration
  • Practitioner Enrollment
  • Practitioner Termination
  • Registry Settings (PM)
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].
Topics
• Practitioner
AV-97801 Summary | Details
File Import - Posting/Adjustment Posting'
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Client Ledger
  • Create Interim Billing Batch File
  • Electronic Billing
  • File Import
  • Payment Acknowledgement
  • Posting/Adjustment Codes Definition
  • Registry Settings (PM)
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
• File Import
Table Changes
Table Column Change
SYSTEM.staffenrollmenthistory PERFID Added
SYSTEM.staffenrollmenthistory PPIUniqueID Added