CMS-1500 and Multiple Service Line Claims
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Alternative Claim Output
- AR Output Results
- Billing Run
- Claim Output
- Claim Receiver
- Claim/Invoice Batch
- Finance
- Finance >Processing >Create Claims/Invoices >Processing for a Period
- Finance Setup
- Finance Setup > Agency Setup > Claim Receivers > Information
- Submitter
Scenario 1: Claim Output - CMS-1500(02-12) One Claim/Page And A Multiple Service Line Claim
Specific Setup:
- Requires a "Billing Run" with at least 2 claims.
- Claims should have at least 2 services that were consolidated using "Service Line Consolidation".
Steps
- Navigate to "Finance Setup > Agency Setup > Claim Receivers > Information".
- Select "Receiver" for "Billing Run" from preconditions.
- Click on "Alternative Claim Output Format".
- Select "CMS-1500 (02-12) one claim/page".
- Set "Box 1 - Receiver Type for HCFA".
- Save.
- Navigate to "Finance > Processing > Create Claims/Invoices > Processing for a Period".
- Select desired "Submitter".
- Edit desired "Billing Run".
- Click on the "Claim" link.
- Click "Get Output" button.
- Select "Get Alternative Output - CMS-1500 (02-12) one claim/page".
- Click "Output Claim" link.
- Validate "Box 24" contains desired claim with each service line.
- Scroll to "2nd Page".
- Validate it contains 2nd claim with each service line.
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Topics
• Finance
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myEvolv NIAM Login
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Agency [EDIT]
- Agency > Staff & Security > Staff Information > Staff Profiles with Security
- Agency by Managing Office
- Setup > System > EvolvCS System Setup > System Settings/Preferences
- Staff Information
- Staff Listing - Agency Employees (By People ID)
- Staff Look Up Their Own Information
- Staff with Security
- Staff with Security (EDIT Form)
- Staff with Security [EDIT]
Scenario 1: NIAM Log In with Active Directory
Scenario 2: NIAM Log In without Active Directory
Scenario 3: NIAM Log In Without Active Directory With Two Agencies
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Topics
• NIAM • Third Party Solution
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Group Event With Participants SubForm
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Activities - Group Activities
- Agency Setup > Event Setup > Groups & Case > Events Setup
- Event Category
- Event Definition User - Group
- Groups
- Groups > Service Management > Service Management > Service Entry
- Groups/Classes
- Participant Role in the Event
- Related People (Profiles)
Scenario 1: Validate Has Participants On Group Event
Specific Setup:
- Requires a "Group" to be set up with at least one member.
- "Group Member" should have at least one collateral.
Steps
- Navigate to "Agency Setup > Event Setup > Groups & Case > Event Setup".
- Click on "Event Category".
- Select "Group Activities".
- Edit desired group event.
- Check "Has Participants".
- Save.
- Navigate to "Groups > Service Management > Service Management > Service Entry".
- Select desired group.
- Click "Enter New Service" button and select desired group event.
- Fill in required fields.
- Click "Get Attendees".
- Check desired "Group Members".
- Validate "Participants" tab is visible.
- Click on "Participants" tab.
- Fill in desired "Participants" SubForm.
- Save the event.
- Validate the "Group Event" saved.
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Topics
• Groups
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Staff Import API V2 With NIAM Fields Now Added
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Agency Setup > Other Setups > Import File Template > Import File Template
- Agency Setup >Other Setups >Import File Template >Import File Template
- Import File Setup Type
- Import File Setup Type > JSON API Import > JSON Payload
- Other
- Select Name -- Webpage Dialog
- Select Template -- Webpage Dialog
- Staff Information
Scenario 1: Validate Staff API Import Contains NIAM Fields Fields and Populates Successfully When Staff Import File Uploaded
Specific Setup:
Login Staff has "Is user restricted to API interaction?" checkbox checked in their staff profile form.
Steps
- Navigate to "Agency Setup > Other Setups > Import File Template > Import File Template" and Select Template "Staff Import API V2".
- Set Import File Type to "Staff Import API V2" type.
- Check "Is Automated", "CareFabric Uploading?", and "CareFabric API Access?" boxes.
- Select V2 for API Version.
- Uncheck "Use Form Import API?" checkbox.
- Set automation key (Ex: "STAFF_IMV2").
- Set Nightly Threshold to "99".
- Navigate to "Agency Setup > Other Setups > Import File Template > Fields Layout" and Select Template "Staff Import API V2".
- Verify two new NIAM fields exist.
- Check "USED" checkbox on all fields.
- Click "Generate JSON Layout".
- Copy the resulting JSON template.
- Navigate to "Setup > System Tools – Internal Use Only > Import File Setup Type > API Testing.
- Enter the User Name and Password for the system's API user to authenticate.
- Set API Action = IMPORT
- Set API VERSION = V2.
- Paste the JSON template (copied in step 4) into the "JSON Payload" textbox area.
- Fill out the values of the fields you wish to see in your new staff, including the two new NIAM fields (set Use NIAM Authentication = 1 and set NIAM Username).
- Click "Authenticate" and confirm successful.
- Press "JSON API Import" button and confirm successful import.
- Navigate to "Agency > Staff & Security > Staff Information > Staff Profiles with Security".
- Confirm that new staff exists and that his/her NIAM fields are filled with the provided values as expected.
- Navigate to "Setup > System Tools – Internal Use Only > Import File Setup Type > API Testing.
- Enter the User Name and Password for the system's API user to authenticate.
- Set API Action = IMPORT
- Set API VERSION = V2.
- Paste the JSON template (copied in step 4) into the "JSON Payload" textbox area.
- Fill out the values of the fields you wish to see in your 2nd new staff, including the two new NIAM fields (set Use NIAM Authentication = 0 and set NIAM Username).
- Click "Authenticate" and confirm successful.
- Press "JSON API Import" button and confirm successful import.
- Navigate to "Agency > Staff & Security > Staff Information > Staff Profiles with Security".
- Confirm that new staff exists and that his/her NIAM fields are filled with the provided values as expected.
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Topics
• Agency • Agency Setup • Setup
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Authorizations Report Service Parameter Look Up Table
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Microsoft Excel
- Processing... - Internet Explorer
- Report Output Data in CSV Format
- Report Parameters PickList
- Report: Billing Authorizations
- Reports > Clients > Services & Treatment > Authorizations
Scenario 1: Validate All Selections for Report: Clients Services & Treatment – Authorizations
Specific Setup:
- Requires access to "Reports > Clients > Services & Treatment > Authorizations".
- Requires Service Events to exist in the Agency.
Steps
- Navigate to "Reports > Clients > Services & Treatment > Authorizations".
- Enter a value for "Report Selection".
- Add a new "Parameter" of "Service".
- Click the Magnifying Glass in the "Value" column for the "Service" parameter to launch the "Look Up Table".
- Filter for the desired "Service" and confirm that results are returned.
- Select a "Service".
- Click "Preview".
- Confirm that the "Report" loads filtered by the selected "Service".
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Topics
• Reports
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Group Services Report
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- DELETE Form -- Webpage Dialog
- Groups > Service Management > Service Management > Service Entry
- Report: Group Services
- Reports > Groups > General > Services
Scenario 1: Validate Deleted Services are Removed from Group Services Reports
Specific Setup:
- Requires access to "Reports > Groups > General > Services".
- Requires access to "Groups > Service Management > Service Management > Service Entry".
- Requires the ability to Create and Delete Group Services.
Steps
- Navigate to "Groups > Service Management > Service Management > Service Entry".
- Select a Group.
- Add a service and include a member.
- Navigate to "Reports > Groups > General > Services".
- Set report parameters to contain the created service.
- Click the "Preview" button to load the Report Preview.
- Validate that the created Group Service appears in the preview.
- Close the Report.
- Navigate to "Groups > Service Management > Service Management > Service Entry".
- Delete the Service that was created earlier.
- Navigate to "Reports > Groups > General > Services".
- Validate that the Service no longer appears in the Report Preview.
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Topics
• Groups • Reports
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