State Forms - West Virginia
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- APS Authorization Requests Outbound File
Scenario 1: APS Authorization Requests Outbound File
Specific Setup:
- The 'Netsmart MPI' (Master Patient Index) module is installed.
- Registry Setting: Avatar PM->Client Information->Client Demographics->->->Allow Spaces in Client Name = Y.
- Registry Setting: Avatar State Forms->West Virginia State Forms->Managed Care Authorizations->->->Enable APS Authorization Functionality = “Y”
- Registry Setting: Avatar PM->Client Information->Client Demographics->->->Client Demographics - Additional Fields = 3.
- Service Code that will be used for services has a Service/Fee Cross Reference Maintenance record that contains a value in 'CPT-4 / HCPCS Code'.
- PM Site Specific Section Modeling has been used to add the 'SS Guarantors/Payors Free Text (20) 1' to the 'Guarantor/Payors' form.
- Program Maintenance: Select an outpatient program that has data in all required fields, data in the address fields, and is assigned the above service code, at a minimum.
- Site Specific Section Modeling has been used to add 'SS Guarantors/Payors Free Text (20) 1' to the Guarantors/Payors form.
- Guarantors/Payors exists that has 'Yes' in 'Is This A Managed Care Contract' and all required fields populated in 'Authorization Information' section, using units, and desired value in 'SS Guarantors/Payors Free Text (20) 1'.
- Client A is admitted to the above program.
- Client has a space in the first name and the middle name, such as first name is: JO ANN, and middle name is: MARIE ELIZABETH.
- The client also has the following records: Financial Eligibility, Diagnosis, Managed Care Authorizations containing all required fields and desired fields for APS Authorization Requests, and a Care Connection record.
- Guarantor/Program Billing Defaults contains a value in 'Billing Provider Primary Identification # (2010AA-NM1-09)'. The template is assigned to the guarantor and program assigned to the client.
- Facility Defaults has a file path in 'Output Path On Server For Electronic Billing'.
- User Definition has been used to give the user access to: Avatar PM > State Forms > APS Authorization Requests Outbound File.
Steps
- Open 'APS Authorization Requests Outbound File'.
- Select 'Compile' in 'File Generation Option'.
- Select desired value in 'Type of File'.
- Enter desired 'File Description'.
- Enter desired 'Start Date'
- Enter desired 'End Date'.
- Click [Process].
- Review each report link, validating the data, including the space in the first and middle names.
- Close all reports.
- Close all forms.
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Topics
• State Forms
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