Skip to main content

Avatar PM 2024 Update 7

  1. Last updated
  2. Save as PDF

Product Requirements and Recommendations

Avatar PM required
RADplus required

Recommended Update Level

Avatar PM 2024 Monthly Release 2024.00.00
RADplus 2024 Monthly Release 2024.00.00

Product Update Description

The following issues are resolved: 1) The 'Revoke?' field cannot be removed from the 'Disclosure Management' form (Authorization section) via the Site Specific Section Modeling once it is added to the form. 2) Re-billing an 837 Dental bill will not properly limit the services when 'Include Services Assigned For Re-Bill' field on 'Electronic Billing' form is set to "All Clients (Restrict to Date Range)" or "All Clients (only compile re-bill services)(Restrict to Date Range)".

Required Updates

None

Included Updates

None

Details
NEW0 CHANGED0 FIXED2
Fixed (2)
Site Specific Section Modeling - Disclosure Management
Resolves an issue to ensure that the fields can be added or removed from any section of the 'Disclosure Management' successfully via 'Site Specific Section Modeling' form. KB0075699 v0.01
Topics
• Disclosure • Site Specific Section Modeling
 
837 Dental - Validating Re-Bill Services - Restrict to date range
Resolves an issue to ensure that the '837 Dental' bill selects valid rebills from the queue if they are within the date of the program prompts when rebills by all clients (Restrict to date range) is selected. KB0075809 v0.01
Topics
• 837 Dental
 
Acceptance Tests
AV-93936 Summary | Details
Site Specific Section Modeling - Disclosure Management
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Site Specific Section Modeling (PM)
Scenario 1: Site Specific Section Modeling - Validating field add/remove - PATIENT40000 (Disclosure Management) - Request, Authorization, Disclosure section
Steps
  1. Open the 'Site Specific Section Modeling' form.
  2. Select the 'PATIENT40000 (Disclosure Management) Request' from the list.
  3. Select the 'Prompt Definition' section.
  4. Click [Add New Item].
  5. Select desired items from the 'Site Specific Field'.
  6. Verify the 'Prompt Definition' table contains the selected item.
  7. Click [Submit].
  8. Open the 'Site Specific Section Modeling' form.
  9. Select the 'PATIENT40000 (Disclosure Management) Request' from the list.
  10. Select the 'Prompt Definition' section.
  11. Select recently added item from the 'Prompt definition' table.
  12. Click [Edit Selected Item].
  13. Click [Delete Selected Item].
  14. Verify the 'Are you sure' prompt exists.
  15. Click [Yes].
  16. Verify the selected item is deleted from the 'Prompt Definition' table.
  17. Click [Discard].
  18. Open the 'Site Specific Section Modeling' form.
  19. Select the 'PATIENT40000 (Disclosure Management) Authorization' from the list.
  20. Select the 'Prompt Definition' section.
  21. Click [Add New Item].
  22. Select desired items from the 'Site Specific Field'.
  23. Verify the 'Prompt Definition' table contains the selected item.
  24. Click [Submit].
  25. Open the 'Site Specific Section Modeling' form.
  26. Select the 'PATIENT40000 (Disclosure Management) Authorization' from the list.
  27. Select the 'Prompt Definition' section.
  28. Select recently added item from the 'Prompt definition' table.
  29. Click [Edit Selected Item].
  30. Click [Delete Selected Item].
  31. Verify the 'Are you sure' prompt exists.
  32. Click [Yes].
  33. Verify the selected item is deleted from the 'Prompt Definition' table.
  34. Click [Discard].
  35. Open the 'Site Specific Section Modeling' form.
  36. Select the 'PATIENT40000 (Disclosure Management) Disclosure' from the list.
  37. Select the 'Prompt Definition' section.
  38. Click [Add New Item].
  39. Select desired items from the 'Site Specific Field'.
  40. Verify the 'Prompt Definition' table contains the selected item.
  41. Click [Submit].
  42. Open the 'Site Specific Section Modeling' form.
  43. Select the 'PATIENT40000 (Disclosure Management) Disclosure' from the list.
  44. Select the 'Prompt Definition' section.
  45. Select recently added item from the 'Prompt definition' table.
  46. Click [Edit Selected Item].
  47. Click [Delete Selected Item].
  48. Verify the 'Are you sure' prompt exists.
  49. Click [Yes].
  50. Verify the selected item is deleted from the 'Prompt Definition' table.
  51. Click [Discard].
  52. Open the 'Site Specific Section Modeling' form.
  53. Select the 'PATIENT40000 (Disclosure Management) Request' from the list.
  54. Select the 'Prompt Definition' section.
  55. Double click on the desired field in the 'Prompt Definition' table.
  56. Verify that all the information of the field populated correctly.
  57. Submit the form.
  58. Verify the form submitted successfully.
  59. Repeat steps from 53 through 58 for 'PATIENT40000 (Disclosure Management) Authorization' and 'PATIENT40000 (Disclosure Management) Disclosure' option.
Topics
• Disclosure • Site Specific Section Modeling
AV-95005 Summary | Details
837 Dental - Validating Re-Bill Services - Restrict to date range
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission (Outpatient)
  • Client Charge Input
  • Client Ledger
  • Create Interim Billing Batch File
  • Diagnosis
  • Electronic Billing
  • Electronic Re-Billing Service Assignment
  • Financial Eligibility
  • Guarantors/Payors
  • Registry Settings (PM)
  • Service Codes
  • Service Fee/Cross Reference Maintenance
Scenario 1: 837 Dental - Compile re-bill claims for all clients - Restrict to date range
Specific Setup:
  • Registry Setting:
  • Avatar PM Registry Setting 'Enable Dental Billing' must be enabled/set to value 'Y'.
  • Guarantors/Payors:
  • An existing guarantor is identified to be used. Note the guarantor's code/name.
  • Populated all the required fields to run the 837 Dental claim.
  • Guarantor/Program Billing defaults:
  • Select desired template that includes desired guarantor and program. Note the program/guarantor.
  • Populated all the required fields to run the 837 Dental claim in the '837 Dental' section.
  • Service codes:
  • An existing dental service code is identified to be used. Note the service code/description.
  • The 'Is This A Dental Service' is set to 'Yes'.
  • 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. Note client id, admission program, admission date.
  • Financial Eligibility:
  • The guarantor identified in the 'Guarantors/Payors' form is assigned to the client as a primary guarantor.
  • Set subscriber assignment of benefits to 'No' for the primary guarantor but 'Yes' to the secondary guarantor.
  • Client Charge Input:
  • A dental service is rendered to the client. Note service date, service code.
  • Client Ledger:
  • A service distributed correctly to the primary guarantor.
  • Close Charges:
  • Close the charges distributed to the client and guarantor.
  • Create Interim Billing Batch File:
  • Create an interim billing batch file that covers the services distributed to the primary guarantor of the client. Note the batch number.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select '837-Dental' from the 'Billing Form' dropdown list.
  3. Select desired guarantor from the 'Type Of Bill' dropdown list.
  4. Select desired value from the 'Individual Or All Guarantors' field.
  5. Select desired guarantor from the 'Guarantor' dropdown list.
  6. Select desired 'Billing Type'.
  7. Select the 'Sort File' from the 'Billing Options' field.
  8. Set the 'File Description' field to desired value.
  9. Select the 'Interim Billing' in the 'Select All Clients Or Interim Batch' field.
  10. Select the interim billing batch file created in the setup section.
  11. Populate all the required fields.
  12. Compile the bill for the primary guarantor.
  13. Verify the bill compiles successfully.
  14. Claim the bill for the primary guarantor.
  15. Verify the bill compiles successfully.
  16. Review the dump file. Note the claim Number.
  17. Close the file.
  18. Close the form.
  19. Open the 'Electronic Re-Billing Service Assignment' form.
  20. Flag the claim from above step for rebill.
  21. Note the following values in the form: 'Billing Form'; 'Claim Submission Reason Code; and 'Claim Original Reference Number'.
  22. Submit the form.
  23. Open the 'Electronic Billing' form.
  24. Select '837-Dental' from the 'Billing Form' dropdown list.
  25. Select desired guarantor from the 'Type Of Bill' dropdown list.
  26. Select desired value from the 'Individual Or All Guarantors' field.
  27. Select desired guarantor from the 'Guarantor' dropdown list.
  28. Select desired 'Billing Type'.
  29. Select the 'Sort File' from the 'Billing Options' field.
  30. Set the 'File Description' field to desired value.
  31. Select the 'Interim Billing' in the 'Select All Clients Or Interim Batch' field.
  32. Select the interim billing batch file created in the setup section.
  33. Select either 'All Clients (Restrict to Date Range)' or 'All Clients (only compile re-bill services)(Restrict to Date Range)' in the 'Include Services Assigned For Re-Bill' field.
  34. Select a date range that falls outside the service included in the claim from above steps.
  35. Compile the bill.
  36. Verify that the file does not compile successfully.
  37. Verify the 'No Information Found' message.
  38. Compile the bill with a date range that is inclusive of services in the claim.
  39. Verify the bill compiles successfully.
  40. Review the dump file.
  41. Verify the service is included in the bill.
  42. Close the file.
  43. Close the form.
Topics
• 837 Dental