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Avatar SF 2024 Update 11

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Recommended Update Level

Avatar PM 2024 Monthly Release 2024.01.01
Avatar SF 2024 Monthly Release 2024.01.01
RADplus 2024 Monthly Release 2024.01.01

Product Update Description

The 'Michigan County Bill' is modified to include discharge date, total charges by revenue code, third party payment amounts, self pay liability, and check/EFT numbers. Also, the 'Exclude from Michigan County Bill as Third Party' extended dictionary is added to the 'Financial Class' dictionary to provide the ability to limit which third party payment amounts are included in the 'Michigan County Bill'.

Required Updates

None

Included Updates

3, 4, 7

Details
NEW1 CHANGED0 FIXED0
New (1)
Michigan County Bill - Crystal Report and SQL table changes
The ‘Michigan County Bill’ report has been updated to include discharge date, total charges by revenue code, third party payment amounts, self pay liability, and check/EFT numbers.
Value Added: The 'Michigan County Bill' is enhanced to gain more detailed information for financial tracking and reporting process.
Topics
• Michigan County Bill
 
Acceptance Tests
AV-96791 Summary | Details
Michigan County Bill - Crystal Report and SQL table changes
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Crystal Report Viewer
  • Discharge
  • Michigan County Bill
  • Michigan County Bill - Compile File
Scenario 1: Michigan County Bill - Validating a bill for the discharged inpatient client
Specific Setup:
  • Guarantors/Payors:
  • Three existing guarantors are identified to be used. One of them is with a financial class of 'Self-Pay'. Note the guarantor 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 using the revenue code. Note the revenue codes for the service code(s) identified.
  • Admission:
  • An existing client is identified or a new client is admitted. Note client id, admission program, admission date.
  • Financial Eligibility:
  • The guarantors identified in the 'Guarantors/Payors' form is assigned to the client as a primary, Secondary and Self-Pay as a tertiary guarantor.
  • A financial eligibility record for the client is created such that the liability distributed across all 3 guarantors.
  • Recurring Client Charge Input:
  • 5-7 services are rendered to the client. Note service dates, service codes.
  • Client Ledger:
  • The services are distributed correctly to the assigned guarantors.
  • Dictionary Update:
  • File - Payor
  • Data Element - Financial Class
  • Dictionary Code - Desired code for the financial class of the third party guarantor
  • Dictionary Value - Financial class of the third party guarantor
  • Extended Dictionary Data Element - Exclude from Michigan County Bill as Third Party
  • Extended Dictionary Value - No
  • Individual Cash Posting:
  • Partial payments posted against the primary guarantor of the client using 'Check'. Note the amount, posting date and check number.
  • Partial payments posted against the third party guarantor of the client using 'Check'. Note the amount, posting date and check number.
  • Close Charges:
  • The charges are closed.
  • Discharge:
  • Client is discharged after last date of service.
Steps
  1. Open the 'Michigan County Bill' form.
  2. Select "Compile" from the 'Compile, Print, or Delete' field.
  3. Set the 'Print Charges Thru' field to a desired date.
  4. Select "No" in the 'Create Claims' field.
  5. Select "No" in the 'Print For Interim Batch' field.
  6. Select desired guarantors from the 'Guarantor(s)' field.
  7. Select "Individual" from the 'Print For An Individual Or All Clients' field.
  8. Select desired client from 'Client ID' field.
  9. Click [Process County Bill].
  10. Validate the bill compiles successfully.
  11. Validate the crystal report launched successfully and includes following details:
  12. Validate 'DISCHARGE DATE' field exist under 'CUR ADMIT DATE' field.
  13. Validate 'DISCHARGE DATE' field displays the date of discharge when the client is discharged from the episode.
  14. Validate 'DISCHARGE DATE' field does not display any value when the client is active in the episode.
  15. Validate the total charges in the 'PATIENT MONTHLY TOTAL' section between days and liability.
  16. Validate the total charges for each patient for each month grouped by revenue code.
  17. Validate the guarantor name and payment amount for all third party guarantors other than billing guarantor.
  18. Validate the total billed to self-pay guarantor.
  19. Close the report.
  20. Close the form.
  21. Open the 'Crystal Report' or any other SQL data viewer.
  22. Run the SQL query to retrieve data from the 'STATEFORM.mich_county_bill_census' table.
  23. Validate the 'discharge_date' field is added in the 'STATEFORM.mich_county_bill_census' table.
  24. Run the SQL query to retrieve data from the 'STATEFORM.mich_county_bill_stmt' table.
  25. Validate the 'total_charges' field is added to the table and contains correct charges.
  26. Validate the 'total_billed_self_pay' is added to the table and contains correct charges distributed to the self pay gaarantor.
  27. Validate the 'third_party_guar_id' field is added to the table and displays correct guarantor code for the third party guarantor.
  28. Run the SQL query to retrieve data from the 'STATEFORM.mich_county_bill_detail' table.
  29. Validate the 'total_charges' field is added to the table and contains correct charges.
  30. Validate the 'total_billed_self_pay' is added to the table and contains correct charges distributed to the self pay gaarantor.
  31. Validate the 'third_party_guar_id' field is added to the table and displays correct guarantor code for the third party guarantor.
  32. Validate the rows with new 'type' of "THIRDPARTY" and add new field called 'third_party_guar_id'.
  33. Validate the 'revenue_code' field is added to the table and displays revenue code of the service code.
  34. Validate the 'check_eft_num' field exist in the table and displays the correct value of the check/EFT numbers.
  35. Close the report.
Scenario 2: Michigan County Bill - Active Outpatient client
Specific Setup:
  • Guarantors/Payors:
  • Three existing guarantors are identified to be used. One of them is with a financial class of 'Self-Pay'. Note the guarantor 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 using the revenue code. Note the revenue codes for the service codes identified.
  • Admission (Outpatient):
  • An existing client is identified or a new client is admitted. Note client id, admission program, admission date.
  • Financial Eligibility:
  • The guarantors identified in the 'Guarantors/Payors' form is assigned to the client as a primary, Secondary and Self-Pay as a tertiary guarantor.
  • A financial eligibility record for the client is created such that the liability distributed across all 3 guarantors.
  • Diagnosis:
  • The diagnosis record is created for the client. Not the diagnosis date. Client should have active diagnosis record at the date of service.
  • Recurring Client Charge Input:
  • 5-7 services are rendered to the client. Note service dates, service codes.
  • Client Ledger:
  • The services are distributed correctly to the assigned guarantors.
  • Dictionary Update:
  • File - Payor
  • Data Element - Financial Class
  • Dictionary Code - Desired code for the financial class of the third party guarantor
  • Dictionary Value - Financial class of the third party guarantor
  • Extended Dictionary Data Element - Exclude from Michigan County Bill as Third Party
  • Extended Dictionary Value - No
  • Individual Cash Posting:
  • Partial payments posted against the primary guarantor of the client using 'Check'. Note the amount, posting date and check number.
  • Partial payments posted against the third party guarantor of the client using 'Check'. Note the amount, posting date and check number.
  • Close Charges:
  • The charges are closed.
Steps
  1. Open the 'Michigan County Bill' form.
  2. Select "Compile" from the 'Compile, Print, or Delete' field.
  3. Set the 'Print Charges Thru' field to a desired date.
  4. Select "No" in the 'Create Claims' field.
  5. Select "No" in the 'Print For Interim Batch' field.
  6. Select desired guarantors from the 'Guarantor(s)' field.
  7. Select "Individual" from the 'Print For An Individual Or All Clients' field.
  8. Select desired client from 'Client ID' field.
  9. Click [Process County Bill].
  10. Validate the bill compiles successfully.
  11. Validate the crystal report launched successfully and includes following details:
  12. Validate 'DISCHARGE DATE' field exist under 'CUR ADMIT DATE' field.
  13. Validate 'DISCHARGE DATE' field does not display any value as the client is active in the episode.
  14. Validate the total charges in the 'PATIENT MONTHLY TOTAL' section between days and liability.
  15. Validate the total charges for each patient for each month grouped by revenue code.
  16. Validate the guarantor name and payment amount for all third party guarantors other than billing guarantor.
  17. Validate the total liability distributed to the self-pay guarantor.
  18. Close the report.
  19. Close the form.
  20. Open the 'Crystal Report' or any other SQL data viewer.
  21. Run the SQL query to retrieve data from the 'STATEFORM.mich_county_bill_census' table.
  22. Validate the 'discharge_date' field is added in the 'STATEFORM.mich_county_bill_census' table.
  23. Run the SQL query to retrieve data from the 'STATEFORM.mich_county_bill_stmt' table.
  24. Validate the 'total_charges' field is added to the table and contains correct charges.
  25. Validate the 'total_billed_self_pay' is added to the table and contains correct charges distributed to the self pay gaarantor.
  26. Validate the 'third_party_guar_id' field is added to the table and displays correct guarantor code for the third party guarantor.
  27. Run the SQL query to retrieve data from the 'STATEFORM.mich_county_bill_detail' table.
  28. Validate the 'total_charges' field is added to the table and contains correct charges.
  29. Validate the 'total_billed_self_pay' is added to the table and contains correct charges distributed to the self pay gaarantor.
  30. Validate the 'third_party_guar_id' field is added to the table and displays correct guarantor code for the third party guarantor.
  31. Validate the rows with new 'type' of "THIRDPARTY" and add new field called 'third_party_guar_id'.
  32. Validate the 'revenue_code' field is added to the table and displays revenue code of the service code.
  33. Validate the 'check_eft_num' field exist in the table and displays the correct value of the check/EFT numbers.
  34. Close the report.
Topics
• Michigan County Bill
Table Changes
Table Column Change
STATEFORM.mich_county_bill_census discharge_date new
STATEFORM.mich_county_bill_detail total_charge new
STATEFORM.mich_county_bill_detail revenue_code new
STATEFORM.mich_county_bill_detail total_billed_self_pay new
STATEFORM.mich_county_bill_detail check_eft_num new
STATEFORM.mich_county_bill_detail third_party_guar_id new
STATEFORM.mich_county_bill_stmt total_charge new
STATEFORM.mich_county_bill_stmt total_billed_self_pay new
STATEFORM.mich_county_bill_stmt third_party_guar_id new