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ProviderConnect 2022.11.1 Acceptance Tests

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PCON-3420 Summary | Details
ProviderConnect Users Report
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • ProviderConnect Users Report - Data Export File
  • ProviderConnect Users Report - Report Results
  • ProviderConnect Users Report - Search Criteria
Scenario 1: 'ProviderConnect Users Report' - Verification of Report Data Generation and 'Export Data' function
Specific Setup:
  • 'View Reports Menu' and 'View ProviderConnect Users Report' permissions must be assigned to user/access group
Steps
  1. Navigate to 'Reports' menu.
  2. Open 'ProviderConnect Users Report'.
  3. Enter/select desired values for 'Agency' and 'Active Users Only' criteria.
  4. Note - 'Agency' field will be restricted/read-only where logged in as Provider-level user
  5. Click 'Generate Report' button.
  6. Ensure that report results are opened for display, including the following columns/information:
  7. 'Agency
  8. 'Username'
  9. 'Last Name'
  10. 'First Name'
  11. 'Email Address'
  12. 'Last Logged In'
  13. 'Active'
  14. 'Account Locked'
  15. Ensure 'ProviderConnect Users Report' results can be sorted by each information field (by using arrow sorting icons in column header).
  16. Ensure that 'Search' field is present in 'ProviderConnect Users Report' results display, and automatically filters report data displayed according to entered search term.
  17. Ensure that 'Export Data' button is present in 'ProviderConnect Users Report' results display.
  18. Click 'Export Data' button. This will download/open '.csv' (comma-separated value) data export file containing report results, named 'ProviderConnectUsers_report_(ReportGenerationDateTime)'. (Example: 'ProviderConnectUsers_report_20197151518')
  19. Open data export file using local application (Microsoft Excel, Windows Notepad, Google Docs, etc).
  20. In data export file, ensure report name is included in first row. ('ProviderConnect Users Report')
  21. In data export file, ensure report criteria is included. ('Agency Selected')
  22. In data export file, ensure report column headers are included. ("Agency","Username","Last Name","First Name","Email Address","Last Logged In","Active","Account Locked")
  23. In data export file, ensure that all report result rows are included in file with data elements for each column header defined. (Example: "Horizon House","horizon","User One","Horizon House","horizon@horizonhouse.com","2019-07-15 11:42:00","Yes","No")
  24. Ensure that if no report results/data are returned for criteria entered, user is presented with dialog message noting 'No data to export' on clicking 'Export Data' button.
Topics
• Reports
PCON-3505 Summary | Details
ProviderConnect 'Billing' Claim/Service Submission
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Billing - Bill Generation section
  • Billing - Treatment Billing
  • Claim Processing (CMS 1500)
  • Treatment Entry
  • Treatment Entry - Add Claim
Scenario 1: ProviderConnect 'Billing' - Verification of service submission to Avatar MSO
Specific Setup:
  • ProviderConnect System Configuration Item 'Tx_HideClaims' may be disabled or enabled
  • One or more clients with valid Service Authorization(s) eligible for ProviderConnect Treatment/Service entry
  • 'View Treatment', 'Add Treatment' and 'View Billing' permissions must be assigned to user/access group
Steps
  1. In ProviderConnect Main Menu, open 'Lookup Client' form.
  2. Enter lookup criteria for client and click 'Search by Criteria' button.
  3. In 'Client Lookup' results, open client record for claim/service entry.
  4. Navigate to 'Treatment' pre-display tab.
  5. Click 'Add Professional Claim' button (or 'Add Institutional Claim' button).
  6. Note - Only 'Add Professional Service' / 'Add Institutional Service' buttons/actions will be present where ProviderConnect System Configuration Item 'Tx_HideClaims' is enabled; proceed to Acceptance Testing step 8.
  7. Enter/select values for 'Funding Source' and 'Principal Diagnosis' claim-level fields, and any other fields as desired/required.
  8. Note - Claim Entry (and Acceptance Testing step) not applicable where ProviderConnect System Configuration Item 'Tx_HideClaims' is enabled; proceed to Acceptance Testing step 8.
  9. Click 'Add Claim' button to save claim entry and proceed to service entry under new claim.
  10. Click 'Add Professional Treatment' button (or 'Add Institutional Treatment' button).
  11. Enter values for 'Service Date', 'Authorization', 'CPT Code', 'Clinician' and 'Performing Provider License Type'/'Program' (if applicable).
  12. Click 'Set Treatment Date' button.
  13. Enter/select treatment detail field values as required/desired.
  14. Click 'Add Treatment(s)' button to save treatment service entry.
  15. If 'Coordination of Benefits' information entry is desired - Following claim/service entry, open newly entered claim within 'Treatment' pre-display tab.
  16. Note - Claim/Service 'Coordination Of Benefits' Entry (and Acceptance Testing step) not applicable where ProviderConnect System Configuration Item 'Tx_HideClaims' is enabled; proceed to Acceptance Testing step 18.
  17. Navigate to 'Services' section of claim display, and click 'Add COB' button to add service level 'Coordination of Benefits' information.
  18. Select value for 'Third Party Payer' field (from Avatar PM/Cal-PM Guarantors defined/allowed).
  19. Enter/select values for service level 'Coordination of Benefits' information fields, and click 'Add Service COB' button to file/save entry.
  20. Repeat service level 'Coordination of Benefits' add/save process as desired for any additional Third Party Payer entries.
  21. Navigate to ProviderConnect Main Menu.
  22. In ProviderConnect Main Menu, open 'Billing' menu.
  23. Select fiscal year under which service entered above exists, and click 'Generate New Bill' button.
  24. Click 'Bill Details' button.
  25. Click 'Submit Bill' button; this will transmit the service entered to Avatar MSO.
  26. In Avatar MSO, ensure that new claims processing batch is created (or existing open batch updated) on receipt of services from ProviderConnect.
  27. In Avatar MSO, open 'Claim Processing (CMS 1500)' or 'Claim Processing (UB-04)' form for the claims processing batch created by ProviderConnect.
  28. Select claim entered via ProviderConnect, and click 'Edit' button.
  29. Navigate to 'Service Detail' section of form.
  30. Verify that service(s) entered in ProviderConnect is/are present in Avatar MSO.
  31. Select service entered via ProviderConnect, and click 'Edit Selected Item' button.
  32. Click 'Enter Third Party Adjudication Data' button to view service level 'Coordination of Benefits' information if filed via ProviderConnect.
  33. In Avatar MSO 'Third Party Adjudication Data' display for service, ensure that Guarantor(s) selected/filed in ProviderConnect service level 'Coordination of Benefits' information are reflected/present (if entered via ProviderConnect).
Topics
• Billing • Service Entry