Adjustment Claims
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- ActionsView
- All Clients With Security Listing by PeopleID
- AR Management
- Cash Receipts for Remittance
- Claims Maintenance NX Form Set
Scenario 1: Validate Actions On An Adjustment Claim
Specific Setup:
Requires a client with a claim that has been "Adjusted".
Steps
- Navigate to "Finance > Remittance Processing > Remittance Application > AR Management".
- Select desired "Remittance".
- Set search parameters to search for desired claim.
- Validate the "Status" of the adjustment claim is listed as "No Remit".
- Add a "Denial" to the claim.
- Click "Add Action".
- Select "Action" dropdown box.
- Validate the actions "Write Off, Resubmit, Resubmit To Other, Adjustment and Void" are listed.
- Select "Resubmit"
- Validate "Submit To" contains same payer.
- Save.
- Wait for billing to run.
- Click on desired "Adjustment Claim" link.
- Click on "Submissions" tab.
- Validate the second submission is listed.
- Validate "Claim Frequency" is "Replacement of Prior Claim".
- Delete the action.
- Click "Add Action" and select "Write Off".
- Save.
- Validate the claim balance is zero.
- Delete the action.
- Click "Add Action" and select "Adjustment".
- Save.
- Validate a new "Adjustment Claim" is created.
Scenario 2: Validate Resubmit To Other Action On An Adjustment Claim
Specific Setup:
- Requires a client with a claim that has been "Adjusted".
- Client should have a "Secondary Benefit Assignment" that can also bill the service.
Steps
- Navigate to "Finance > Remittance Processing > Remittance Application > AR Management".
- Select desired "Remittance".
- Set search parameters to search for desired claim.
- On the "Adjustment Claim" add a "Partial Payment".
- Click "Add Action".
- Select "Action" dropdown box.
- Select "Resubmit To Other".
- Validate "Submit To" contains desired "Secondary Payer".
- Save.
- Wait for billing to run.
- Click on desired "Adjustment Claim" link.
- Click on "Submissions" tab.
- Validate the second submission is listed.
- Validate "Claim Frequency" is "Admit thru Discharge Claim".
- Validate "Claim Submission" has desired "Payer" and "Balance".
|
Topics
• Finance
|
Added Support for DOC Additional Rate
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- All People with Benefit Assignments with LOS
- Billing Batch Management 2.0 Form Set
- Billing Batches Management
- Billing Run Request Limit People Subform
- BillingProcessHistory
- Client Search
- Critical Information
- FinanceClaims
- Immediate Billing Run Request [ADD]
- Program Enrollment Modifier [EDIT]
- Submitter Information
Scenario 1: Validate Claim Includes DOC Additional Rate
Specific Setup:
- Requires a client that can bill "Facility Placement".
- Facility Placement Rate should have "DOC Additional Rate" set.
Steps
- Navigate to "Client > Client Information > Critical Information > Enrollment Information".
- Select desired client.
- Click "Display Menu of Actions" and select "New Program Modifier".
- Fill in required fields.
- Set "DOC Points" to desired amount".
- Save.
- Navigate to "Finance > Claim/Invoice Processing > Batch Listing > Billing Batches Management".
- Click "New Run" and select "Start New Billing Run".
- Fill in required fields to bill for desired client.
- Wait for billing to run.
- Open the resulting claim.
- Validate the amount of the claim is the "Rate + (DOC Additional Rate x DOC Points)".
|
Topics
• Finance
|
Front Desk Calendar Staff Appointment Availability
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Active events by Program or Clinic2
- Client Related Task - New [ADD]
- Client Related Task - New [DELETE]
- Client Search
- Client Service Entry
- Front Desk Calendar Appointment [EDIT]
- FrontDeskCalendar
- FrontDeskCheckIn
- People Search with New
- Program by Managing Office and Agency
- Staff - Service Providers (by Staff_id)
- Staff - Service Providers by Program and Facility
Scenario 1: Validate Appointment Slots Showing Unavailable for Booked Appointment Times
Specific Setup:
- Access to Calendar.
- Available Client to schedule event.
Steps
- Navigate to "Client > Case Management > Service Management > Service Entry".
- Select a Client and schedule an appointment with a staff under a desired facility.
- Navigate to "Taskbar > Attendance Check In/Out > Check In/Out > Front Desk NX".
- Click Calendar button.
- Select the staff and Set facility to same as appointment.
- Open the appointment that was created and Validate that the facility is not changed.
- Change the facility.
- Open the appointment that was created and Validate that the facility is not changed.
- Click Advanced search.
- Fill the required fields and validate that the search returns only timeslots available during the day of the appointment and not during the appointment itself.
|
Topics
• Calendar
• Client
• Taskbar
|
Printing Assessments
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Assessment Remarks
- Client
- Client > Case Management > Service Management > Assessments
- Print Preview
- Select Client
Scenario 1: Printing of Assessment Containing All Question Types
Specific Setup:
Client enrolled in program that contains an assessment with all question types.
Steps
- Navigate to "Client > Case Management > Service Management > Service Entry".
- Select a client then add an assessment that contains all question types.
- Fill form and save.
- Reopen form and attempt to Print Form.
- Verify print preview appears.
|
Topics
• Assessments
|
Billed Care Days Report
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- ActionsView
- All Clients With Security for Reports
- AR Management
- Cash Receipts for Remittance
- Report Parameters PickList
- Report Selection Picklist
- Report: Billed Care Days
Scenario 1: Validate Care Days Report Displays Claim
Specific Setup:
- Requires a client with billed "Care Day Placement".
- Rate should be set up with "Is For Care Day Reporting".
- Scenario works with a claim that is "Overpaid".
Steps
- Navigate to "Finance > Reports > General > Billed Care Days".
- Set desired date range
- Select desired "Report Selection".
- Preview the report.
- Validate desired client and billed care days are visible.
- Navigate to "Finance > Remittance Processing > Remittance Application > AR Management".
- Select desired "Remittance".
- Set desired search parameters to pull up desired claim.
- Add an "Action" to the claim, i.e "Overpayment".
- Save.
- Navigate to "Finance > Reports > General > Billed Care Days".
- Set desired date range
- Select desired "Report Selection".
- Preview the report.
- Validate desired client and billed care days are visible.
|
Topics
• Finance Setup
• Reports
|
Placement Disruptions With Program Modifiers
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- 1. Simple Service Entry [ADD]
- Billing Batch Management 2.0 Form Set
- Billing Batches Management
- BillingProcessHistory
- Claim 2.0 [EDIT]
- Client Search
- Client Service Entry
- Facilities Listing by Program
- FinanceClaims
- Immediate Billing Run Request [ADD]
- Placement Disruptions: Respite Placement [ADD]
- Placement Events by Agency/Program - People
- Program by Client's Service Track - Respite
- Program Enrollment Modifier (by Agency)
- Submitter Information
- Unit Table
Scenario 1: Validate Billing Placement Disruptions Includes Program Modifier
Specific Setup:
- Client is enrolled in a Care Day Program.
- Respite Program is a billable Placement Disruption.
- Respite program has a manual service that is billable.
Steps
- Navigate to "Client > Client Information > Critical Information > Placement Disruptions".
- Select "Client" from preconditions.
- Click "Add New".
- Select "Respite" from the New Events drop down list.
- Fill out required fields.
- Select desired "Description" from the "Program Modifier" list.
- Click "Save".
- Navigate to "Finance > Claim/Invoice Processing > Batch Listing > Billing Batches Management".
- Click "New Run" button.
- Select "Start New Billing Run".
- Fill out required fields.
- Select desired Receiver, click "Save".
- Click "Billing Process History".
- Click "Start Billing Now".
- Go back to "Billing Batches Management".
- Open the "Batch".
- Click the Claims ID number link.
- Verify the Placement Disruptions has been billed with the Program Modifier from preconditions.
- Click "Close".
|
Topics
• Client
• Finance
|
Group Appointments In Front Desk Check In
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Group Listing with Security
- Service and Attendance Facilities Listing
- Taskbar > Attendance Check In/Out > Check In/Out > Front Desk NX
- Activities - Group Activities
- Groups > Service Management > Service Management > Service Entry
Scenario 1: Front Desk NX - Validation of Groups Check In Filters
Specific Setup:
- Test system must have two different active groups associated with the same facility.
- Each group must have a "Default Event" and "Default Staff" defined for an active schedule under "Groups > Group > Information > General Information".
- The schedule must have at least one day where both groups are active (i.e. both meet on Mondays).
- Each group must have at least one client actively enrolled with the above schedule that have not been checked in for the day selected for testing.
Steps
- Navigate to "Taskbar > Attendance Check In/Out > Check In/Out > Front Desk NX".
- Populate "Location" with your desired location where both groups are associated.
- Populate "Date" with a day where both groups are scheduled to meet and group members have not yet been checked in.
- Check "Include Group Appointments" checkbox.
- Click "Apply Filters" button.
- Confirm the "Scheduled" column indicates the expected number of appointments.
- Click "Group" and select one of the two groups that is scheduled to meet on this day.
- Click "Apply Filters" button.
- Confirm the "Scheduled" count is reduced by the number of clients scheduled with the other group.
- Scroll through the "Scheduled" column and confirm that only group appointments for the group selected are appearing.
- Click "Group" and select the other group that is scheduled to meet on this day.
- Click "Apply Filters" button.
- Confirm the "Scheduled" count is reduced by the number of clients scheduled with the other group.
- Scroll through the "Scheduled" column and confirm that only group appointments for the group selected are appearing.
- Click "Group" and then click "Clear" to clear this filter.
- If desired, un-check the "Include Group Appointments?" checkbox.
- If desired, clear the "Date" and "Location".
Scenario 2: Front Desk NX - Validate Check In of Group Appointment
Specific Setup:
- Test system must have an active group.
- The group must have a "Default Event" and "Default Staff" defined for an active schedule under "Groups > Group > Information > General Information".
- The group must have several clients actively enrolled with the above schedule that have not been checked in already for this appointment.
Steps
- Navigate to "Taskbar > Attendance Check In/Out > Check In/Out > Front Desk NX".
- Populate "Location" with your desired location where test group is associated.
- Populate "Date" with a day where group is scheduled to meet and group members have not yet been checked in.
- Check "Include Group Appointments" checkbox.
- Click "Group" and select one of the two groups that is scheduled to meet on this day.
- Click "Apply Filters" button.
- Confirm the "Scheduled" column indicates the expected number of appointments.
- Set "Search for Clients" filter at top of "Scheduled" column to desired group member name
- Validate "Scheduled" column is filtered to only show individual(s) with this name.
- Click "Check In" button for this individual.
- Note that the card moves from the "Scheduled" column to the "In Progress" column.
- Set the "Search for Clients" filter at top of "Scheduled" column to desired group member name.
- Validate "Scheduled" column is filtered to only show individual(s) with this name.
- Click "Check In w/ Form" button for this individual.
- Click "Complete Check In" once the check in form loads.
- Note that the card moves from the "Scheduled" column to the "In Progress" column.
- Click the "x" to clear the "Search for Clients" filter at the top of the "Scheduled" column.
- Validate "Scheduled" column is no longer filtered to any specific individual.
- Note the name of another individual scheduled for this group session.
- Navigate to "Groups > Service Management > Service Management > Service Entry".
- Select your test Group making certain to select the appropriate unit.
- Set the "Actual Date" column filter to the date of the appointment you just checked in members for using "MM/DD/YYYY" format.
- Click this row to open the group service on this date.
- Scroll to the "Group Members" SubForm and confirm that the two individuals that were checked in to the appointment are flagged as "Present?".
- Confirm that the individual noted who was not checked in, does not have the "Present?" flag checked.
- Delete your test group service if desired.
- Navigate to "Taskbar > Attendance Check In/Out > Check In/Out > Front Desk NX".
- Click "Apply Filters" button.
- Validate that the group members previously checked in appear in the "Scheduled" bucket and not "In Progress" bucket.
- Clear all filters if desired.
|
Topics
• Front Desk
• Groups
|
Update Refresh Denormalized Process for Performance Improvements
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Client Search
- Critical Information
- Enrollment Transfer Type Look-up Table
- Events To Do Quick Transfer
- Facility Placement for a Person [DELETE]
- Facility Transfer [ADD]
- Message from webpage - Are you sure want to delete Program Enrollment?
- Placement Events by Agency/Program - People2
- Program Enrollment [Delete]
- Program Enrollment From Service Track [ADD]
- Program Listing By Agency and Worker
- Provider Sites by Program (Vacancy)
- Staff - Service Providers (Caseloads - Zip Zones)
- Unit Table
- Worker Role (to a client or in a workgroup) Table
- Client Service Entry
- Program Enrollment [Edit]
- Manage Tasks (for Discharged Client)
- Message from webpage - Click OK if you would like to end all worker assignments for this program. Click Cancel if you would like to leave worker assignments open while ending the program enrollment.
Scenario 1: Validate Client Address Updates After New Enrollment
Specific Setup:
- Requires an existing Client not enrolled into a Care Day program.
- Client has an address listed in demographics.
- Requires a Care Day program.
Steps
- Navigate to "Client > Client Information > Critical Information > Enrollment Information".
- Select a Client.
- Enroll the client into a new program, fill required information and save.
- Refresh Client information.
- Validate location changes to new program enrollment Facility.
- Transfer the facility to another location.
- Refresh Client information.
- Validate location changes to newly transferred program Facility.
- Delete the new program enrollment.
- Refresh Client information.
- Validate location changes to previous program enrollment Facility.
Scenario 2: Validate Enrollment Date Updates On Client Service Entry
Specific Setup:
Existing Client enrollment.
Steps
- Navigate to "Client > Case Management > Service Management > Service Entry".
- Take note of enrollment date for Program.
- Navigate to "Client > Client Information > Critical Information > Enrollment Information".
- Change enrollment date by clicking "Correct Close Program Enrollment" on program.
- Navigate to "Client > Case Management > Service Management > Service Entry".
- Verify enrollment date changed.
Scenario 3: Validate Address Updates When Discharging Client
Specific Setup:
- Requires a Client enrolled into a Care Day program.
- Requires Client with address information.
Steps
- Navigate to "Client > Client Information > Critical Information > Enrollment Information".
- Select Client which is enrolled in a program.
- Validate Client location is same as program facility location.
- Close Program Enrollment for the program.
- Refresh and Validate Clients location reverts to Clients address.
- Revert the Close Program Enrollment.
- Refresh and Validate Client location back to program facility location.
|
Topics
• Client
• Service Entry
|
Agency Discharge Reasons Propagate to Programs
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Agency Discharge [EDIT]
- Agency Re-Admission [EDIT]
- Client Search
- Closing Reasons - Service Track Table
- Critical Information
- Event Definitions (Plain)
- Manage Tasks (for Discharged Client)
- Outcome/Results - Service Track Table
- Program Enrollment [Edit]
Scenario 1: Validate Discharging From Agency Propagates Reasons for Discharge Down to Programs
Specific Setup:
Client admitted to Agency and at least one Program.
Steps
- Navigate to "Client > Client Information > Critical Information > Enrollment Information".
- Select "Client" from preconditions.
- Discharge the Client from Agency, taking note of "Closing Reason" and "Outcome".
- Click "Correct/Close Program Enrollment" and verify "Reason for ending" and "Outcome" match what was chosen during the Agency Discharge.
|
Topics
• Client
|
Service/Case Notes & Planning Approval
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Active events by Program or Clinic
- Calendar
- Client
- Client > Case Management > Plan Development > Planning
- Client Problems
- Client Related Task by Staff Responsible
- Front Desk Check-In Search
- Other Activities (Treatment Plan Steps)
- People Search with New
- Problems Identified (People/Category)
- Program Listing By Agency and Worker
- Schedule Appointment
- Select Client
- Service Plan Review Items
- Staff - Service Providers (by Staff_id) NES
- Supervisor Approval - Filter
- Supervisor Worker Note
- Taskbar > Attendance Check In/Out > Check In/Out > Front Desk Daily Check In
- Taskbar > Supervisor > Supervisor > Service/Case Notes & Planning Approval
- Treatment Plan
- Treatment Plan Library (by Category)
- Treatment Plan Steps
- Activities - Group Activities [ADD]
- Client Search
- Client Service Entry
- Get Date Time [EDIT]
- Select Group
- SupervisorModule
- All Clients With Security Listing by PeopleID
- Service Events for Report
- Staff Subordinates
Scenario 1: Validate Treatment Plan Workflow
Specific Setup:
- Requires access to "Taskbar > Supervisor > Supervisor > Service/Case Notes & Planning Approval".
- Requires a Treatment plan that has been submitted.
Steps
- Navigate to "Taskbar > Supervisor > Supervisor > Service/Case Notes & Planning Approval".
- Set "Filters" for "Treatment Plan" from preconditions.
- Click the "Link" for the plan.
- Validate that the Treatment Plan loads.
Scenario 2: “Service/Case Notes & Planning Approval” – Validate Correct Event Form Pulled and Sub-Reports Displaying Information
Specific Setup:
- "Only Lock Group Events at Group Level" setting enabled under "Agency Setup > Agency > Agency > Agency Information".
- People Event with a SubReport on a form that has a "people_id" as primary join.
- Group Event with different form used for people and group events.
Steps
- Navigate to "Client > Case Management > Service Management > Service Entry".
- Choose a Client and Add Event (from setup).
- Fill form and validate SubReport contains information.
- Save and Submit event.
- Navigate to "Taskbar > Supervisor > Supervisor > Service/Case Notes & Planning Approval".
- Open submitted event and validate SubReport still contains identical information.
- Navigate to "Groups > Service Management > Service Management > Service Entry".
- Choose a Group and Add Event (from setup).
- Navigate to "Taskbar > Supervisor > Supervisor > Service/Case Notes & Planning Approval".
- Open submitted event and validate it opens the group form header, and that there is a "Group Members" list group item.
Scenario 3: Validate Filters Under Supervisor Approval
Specific Setup:
User has multiple subordinate staff.
Steps
- Navigate to "Taskbar > Supervisor > Supervisor > Service/Case Notes & Planning Approval".
- Click "View Filters".
- Clear "From Date" and click "Apply Filters".
- Validate records load.
- Set Filters to desired selection.
- Verify the Results return as expected.
|
Topics
• Calendar
• Client
• Family Cases
• Groups
• Service Entry
• Supervisor
• Taskbar
• Treatment Plans
|
Front Desk Calendar Timeout
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- EvolvCS Client [EDIT]
- FrontDeskCalendar
- FrontDeskCheckIn
Scenario 1: Validate Front Desk Calendar Standalone Closes Upon System Timeout
Specific Setup:
- Access to "Setup > System > EvolvCS System Setup > System Settings/Preferences".
- Access to Calendar.
Steps
- Navigate to "Setup > System > EvolvCS System Setup > System Settings/Preferences".
- Select system.
- Set the "Inactivity Timeout (hh:mm)" to a low interval for testing and Save.
- Log out of and back into the system in order for the new logout timer to be applied.
- Navigate to "Taskbar > Attendance Check In/Out > Check In/Out > Front Desk Daily Check In".
- Click the Calendar button.
- Wait for timeout duration to complete.
- Observe the Calendar will close upon timeout.
|
Topics
• Calendar
• Front Desk
|