myAvatar LA Forms and Functionality
Once the myAvatar LA Provider Integration system setup is complete, you will only need to modify your workflow to search and select the LA County ID in the Admission, Admission (Outpatient), Financial Eligibility, and Cross Episode Financial Eligibility (PM Only) forms. Otherwise this integration should appear seamless.
Forms Impacted:
Program Maintenance And Single Program Maintenance (PM Only)
The field LA County Program is added to the form, which is only visible if the module is installed and the registry setting Enable LA Provider Integration is set to “1”.
An LA County program must be selected in this field for each program where web services are to be submitted to LA for client episodes.
Each program must contain the Legal Entity recognized by LA County. The selection value within the field is pre-populated upon the module installation. The value is only to display the assigned Legal Entity contracted with the county for admission to IBHIS. All existing programs must be updated to include this LA County Program.
Guarantors/Payors
The field LA County Guarantor is added to the form, which is only visible if the module is installed and the registry setting Enable LA Provider Integration is enabled.
The LA County guarantor must be selected in order to determine if web services are initially generated upon closing charges on the provider system.
Each guarantor billable to IBHIS (LA County) must contain the guarantor assigned to the facility/provider by LA County. The selection value within the field is pre-populated upon the module installation with the guarantors accepted by the BizTalk web services. Those guarantors that have been mapped to the LA County Guarantor must be updated to include an LA County Guarantor.
Admission/Admission (Outpatient)
The following fields are added to the forms, if the module is installed and the registry setting Enable LA Provider Integration is enabled. These fields enable the client to be associated with the LA County ID assigned in IBHIS.
Once a client is selected, or a new admission entered, the fields will be populated and disabled from updating. Any changes needed for the LA County ID must be completed in the Change LA County ID form.
- Search LA Client - Enabled when the selected program has an LA County Program assigned through the Program Maintenance form. This field will utilize information entered on the Admission and Admission (Outpatient) forms to call the SearchClient web service.
This will return a list for you to select the correct LA County client from, and allow information saved at LA County to be defaulted into the Demographics section through the GetClientDetails web service for the selected LA County ID. - Medi-Cal Policy Number - Enabled when the selected program has an LA County Program assigned through the Program Maintenance form. This field is used by the Search LA Client command button as part of the search parameters submitted on the SearchClient web service. The Medi-Cal Policy Number returned upon matching a client is the Client Index Number (CIN) found in the IBHIS (LA County) system.
- LA Client ID - This field is display only.
Upon filing the Admission or Admission (Outpatient) form, an event is triggered to the web service queue to generate an UpdateClientDetails web service for the selected client. The web service will only be generated for clients who have a LA County ID and an active episode at LA.
Update Client Data
Upon filing the Update Client Data form, an event is triggered to the web service queue to generate an UpdateClientDetails web service for the selected client. The web service will only be generated for clients who have a LA County ID and an active episode at LA.
Financial Eligibility/Cross Episode Financial Eligibility
The fields Search LA Client and LA Client ID are added to the form, if the module is installed and the registry setting “Enable LA Provider Integration” is enabled. These fields enable the client to be associated with the LA County ID assigned in IBHIS.
- Search LA Client is only enabled when the selected Guarantor on the Guarantor Selection section has an LA County Guarantor assigned through the Guarantors/Payors form. This field will utilize information entered previously on the Admission, Admission (Outpatient), and Update Client Data forms to call the SearchClient web service. The search will return a list of clients for you to select the correct LA County client from.
- LA County ID is display only.
Upon filing Financial Eligibility, all guarantors selected will be checked that have “Eligibility Verified” = “Yes”, and if any of those guarantors also have a “LA County Guarantor” selected that is mapped to an LA County Benefit Plan that is “LA County” or “Medi-Cal”, then the client will start the web service process for that client.
Note: Changes to Financial Eligibility information in the most recent, active episode will activate the web service process for that client. Example: Client A has Episode 1 and 2 that are both open episodes. Episode 2 is the most recent episode; changes to financial information (i.e. Date of Birth) should be made in this episode.
As of wsdl v201601, the {CreateClientFinEligibility} is no longer available.
Change MR#
If the selected client has an LA County ID, then the Change MR # submission process will also change the client MR# number to the new MR # in the following SQL tables:
- LAPROV.id_mapping
- LAPROV.history_umdap
- LAPROV.csi_admission
- LAPROV.audit_services
- LAPROV.queue
- LAPROV.error_queue
- LAPROV.error
Client Delete
If the selected client has an LA County ID, then the Change Delete submission process will also remove the client MR# in the following SQL tables:
- LAPROV.id_mapping
- LAPROV.csi_admission
- LAPROV.queue
- LAPROV.error_queue
- LAPROV.error
Client Merge (PM Only)
Changes to logic TBD.
The logic for the Client Merge will be as follows:
Program Transfer
When transferring a client from a non-LA County Program to a LA County Program through the Program Transfer form, the system will validate the client to determine if the client should be submitting to LA County and add records to the queue as needed.
Discharge
Upon filing the Discharge form, an entry is added to the web service queue to generate the DischargeClient web service for client when the client is deceased. Once a client is admitted into an outpatient program in LA, the episode remains open until the client is discharged and the client is deceased.
Diagnosis
Upon filing the Diagnosis form, an entry is added to the web service queue to generate the CreateClientDiagnosis for new diagnosis records or UpdateClientDiagnosis for diagnosis records are being edited.
Upon the web service return there are additional fields that are passed back that is stored in myAvatar with the diagnosis record. This information is passed into the web services for UpdateClientDiagnosisweb services.
- SQL table “SYSTEM.client_diagnosis_record” stores “DiagnosisUniqueID” for each diagnosis record in field “la_diagnosis_unique_id”.
- SQL table “SYSTEM. client_diagnosis_entry” stores “DiagnosisCodeEntryRowID” for each diagnosis node in field “la_row_id”.
For PM systems, there are additional fields that are added to the Diagnosis form to capture the following information for the diagnosis web services:
- General Medical Condition Summary Code (CSI)
- Substance Abuse / Dependence (CSI)
- Substance Abuse / Dependence Diagnosis (CSI)
- Trauma (CSI)
These fields are hidden upon installation, and will only be visible if when the Enable LA Provider Integration registry setting is enabled.
CSI Admission (Avatar Cal-PM only)
In Cal-PM, there is an existing CSI Admission form which will always be used for systems running myAvatar Cal-PM. myAvatar PM systems with LA Provider Integration will have the new form LA CSI Admission introduced through the module which will only be visible when the Enable LA Provider Integration registry setting is enabled.
Upon filing, an entry is added to the web service queue to generate either the CreateClientCSI or UpdateClientDetails web service for the data filed from this form.
An entry is also added to the web service queue to generate either the CreateClientCSI or UpdateClientDetails web service for the last filed data for this form upon the Financial Eligibility workflow.
In order to determine, which web service to generate, (CreateClientCSI or UpdateClientDetails) the GetClientCSI web service is called. If no CSI information is returned from LA, the CreateClientCSI is generated. If CSI information is returned, then the UpdateClientDetails is generated.
There are no changes to the SQL table, and Cal-PM systems will continue using the product SQL table SYSTEM.admission_ca_csi_data.
SQL Table:
SQL Table Name=SYSTEM.admission_ca_csi_data
Client Conditions: Pregnancy (Cal-PM Only)
In Cal-PM, there is an existing Client Condition - Pregnancy form which will always be used for systems running myAvatar Cal-PM.
PM will have new form LA Client Conditions Pregnancy introduced through the module and will only be visible in PM when the Enable LA Provider Integration registry setting is enabled.
The CreateClientPregnancy web service returns a ‘ClientPregnancyUniqueID’ within the acknowledgement. This field is saved with the pregnancy record in field ‘la_pregnancy_unique_id’ in SQL table ‘SYSTEM.client_condition_preg’.
Any subsequent filings for that record will be submitted to LA through the UpdateClientPregnancy web service.
New Forms
LA CSI Admission (PM Only)
The LA CSI Admission form is added by the module, and this form will only be accessible to myAvatar PM Applications when the Enable LA Provider Integration registry setting is enabled. This form is a copy of the CSI Admission form found in myAvatar Cal-PM.
This form will always be hidden for systems running Cal-PM.
Upon filing, adds an entry to the web service queue to generate either the CreateClientCSI or UpdateClientDetails web service for the data filed from this form.
An entry is also added to the web service queue to generate either the CreateClientCSI or UpdateClientDetails web service for the last filed data for this form upon the Financial Eligibility workflow.
In order to determine, which web service to generate, (CreateClientCSI or UpdateClientDetails) the GetClientDetails web service is called. If no CSI information is returned from LA, the CreateClientCSI web service is generated. If CSI information is returned, then the UpdateClientDetails web service is generated.
Avatar Cal-PM users will continue to use the CSI Admission that is installed with the myAvatar Cal-PM product.
Dictionary Setup:
The County School dictionary comes pre-populated with the codes/values from the “DMH IBHIS Dictionary Values V.3.9.8” excel spreadsheet from the IBHIS website.
http://lacdmh.lacounty.gov/hipaa/doc...ues_v3_9_8.xls
You can inactive codes that are not used by your facility to simplify data entry.
SQL Table:
SQL Table Name=LAPROV.csi_admission
LA UMDAP
The LA UMDAP form is used to store the client's annual Uniform Method of Determining Ability to Pay information obtained by the reporting Legal Entity. This form is a copy of the ‘Systemwide Annual Liability’ RADplus modeled form in IBHIS and will be available for both PM and Cal-PM.
The LA UMDAP form will be introduced through the module and is only accessible when the Enable LA Provider Integration registry setting is enabled.
Data entered for the specific client in the UMDAP section of the Family Registration form is not copied to this form, so the data must be entered separately.
Upon entering the LA UMDAP form the GetClientUMDAPDetails web service is generated and is used as follows:
- If the client selected does not have any UMDAP information filed, but LA UMDAP information is returned by the GetClientUMDAPDetails web service, you will be prompted to review the information and be given the option to file the LA UMDAP information to myAvatar .
- Upon editing an LA UMDAP record in myAvatar , if the LA UMDAP record has a ClientAdditionalUMDAPUniqueID that matches an UMDAP record returned by the GetClientUMDAPDetails web service, the records will be compared. If there are any differences, you will be prompted to review both myAvatar and LA UMDAP records. You will also be given the option to default the LA UMDAP information into the form. When the information is defaulted, it will not be saved to myAvatar until you submit the form.
SQL Table:
SQL Table Name=LAPROV.history_umdap
LA Client Conditions: Pregnancy (PM Only)
In Cal-PM, there is an existing product Client Conditions - Pregnancy form, which will continue being used by Cal-PM users.
A new form LA Client Conditions: Pregnancy is introduced for PM by the LA Provider Integration module, and is only visible in PM when the Enable LA Provider Integration registry setting is enabled.
This form will only be available in systems running myAvatar PM, and will be hidden for systems running Cal-PM.
The CreateClientPregnancy web service returns a ‘ClientPregnancyUniqueID’ within the acknowledgement. This field is saved with the pregnancy record in field ‘la_pregnancy_unique_id’ in SQL table ‘SYSTEM.client_condition_preg’.
Any subsequent filings for that record will be submitted to LA through the UpdateClientPregnancy web service.
SQL Table:
SQL Table Name= LAPROV.client_condition_preg
LA View Client Information
The LA View Client Information form allows you to view information from LA IBHIS for the selected myAvatar client or LA County client. You will be allowed to select a current myAvatar ID or search LA for an existing LA County ID.
The information returned from these web services is available for viewing only through this form and will not be saved in myAvatar .
You are able to select the following information to view:
- LA Active Episode: GetClientActiveEpisode
- LA Client Details: GetClientDetails (The web service returns Client, Client Living Arrangement, Smoking Assessment)
- LA CSI Information: GetClientCSI
- LA DCFS History: GetDCFSClientSvcHist
- LA Episode Information: GetClientEpisodeHist
- LA Legacy Service History: GetClientLegacySvcHist
- LA Pregnancy History: GetClientPregnancyDetails
- LA Public Guardian: GetPublicGuardianSvcHist
- LA Service History: GetClientSvcHist
- LA UMDAP: GetClientUMDAPDetails
- LA Diagnosis History: GetClientDiagnosisHistory
- LA Financial Eligibility: GetFinEligibility
- LA Guarantor Plan Details: GetClientGuarantorPlanDetails
Change LA County ID
The Change LA County ID form gives you the ability to change the assigned LA County ID that is found in any form that displays the LA County ID, such as the Admission and Financial Eligibility forms. This is useful when a client is incorrectly assigned to another client, or when LA County QA/HIM notifies the Legal Entity of a duplicate client merge.
Upon submission, if the myAvatar client meets the criteria for submitting web services, then applicable web services are pushed to the web service queue.
Changing the LA County ID may impact claiming.
Upload LA County ID #
A one-time upload of LA County ID is available to you with the assistance of Netsmart. You will need to provide a comma-delimited file in the following format.
Please contact your Netsmart representative for more information.
File Format
LA Resend Queue
If a web service request from the queue cannot be processed for any reason (web services are down, web service is missing required fields, etc.) the web service request will be removed from the queue and added to the error queue. Through this form, entries from the error queue are available for selection.
Once entries are selected, you can either choose to resend the web service request or delete the items from the Resend queue. For convenience, the Error Queue Report command button will allow you to pull up and view the error queue information in a report.
LA Provider Reports
The LA Provider Reports form allows you to run reports from a single point of entry. The form consists of a report selection, start and end date range, and process report command button.
The start date will default to yesterday’s date, and the end date will default to today’s date. You can change this as needed to produce the report in the necessary date range.
The reports available are listed below:
Error Report
This report allows you to view web services errors in between the specified date range selected.
View Queue
This report allows you to view web service transactions currently in the queue in between the date range selected.
Audit
This report allows you to view web service audit history in between the date range selected.
LA County ID
This report allows you to view clients currently in your system with their associated LA County ID.
Error Queue
This report allows you to view web service transactions currently in the error queue in between the date range selected.