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myEvolv NX 11.0.0075.01 Acceptance Tests

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ECS-52978 Summary | Details
Critical Information Agency Intake
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Agency Placement [EDIT]
  • Client Search
  • Critical Information
Scenario 1: Validate Client Agency Intake Date Can Be Updated in Different Time Zones
Specific Setup:
  • Client currently enrolled in agency.
  • Have the ability to change time zone.
Steps
  1. Navigate to "Client > Client Information > Critical Information > Enrollment Information".
  2. Select desired Client.
  3. Open Agency Intake form.
  4. Change the intake date to one day before the current intake date.
  5. Save and validate changes are saved.
  6. Logout.
  7. Change device to a different time zone.
  8. Login to myEvolv.
  9. Navigate to "Client > Client Information > Critical Information > Enrollment Information".
  10. Select desired Client.
  11. Open Agency Intake form.
  12. Change the intake date to one day before the current intake date.
  13. Save and validate changes are saved.
Topics
• Client
ECS-56090 Summary | Details
Cost Center and Program Unit Linked to Claims Hierarchy
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Billing Batch Management 2.0 Form Set
  • Billing Batches Management
  • Billing Provider Number Type
  • BillingProcessHistory
  • Claim 2.0 [EDIT]
  • Client Finance Related Information Form Set
  • Cost Center Definitions
  • Critical Information
  • FinanceClaims
  • Group Programs Subform
  • Payers of Agency
  • Payor-Facility License Link Subform
  • Plans/Contracts by Payer and Receiver
  • Program Enrollment [Edit]
  • All People with Benefit Assignments with LOS
  • Billing Run Request Limit People Subform
  • Client Search
  • Immediate Billing Run Request [ADD]
  • Service Facilities Form Set
  • Service Facilities Listing
  • Service Facility [EDIT]
  • Submitter Information
Scenario 1: Validate Cost Center Hierarchy
Specific Setup:
  • System is set up with Cost Centers Units.
  • Requires at least one claim that can be reprocessed.
  • Claim is set up with "Cost Center" set on rate setup.
Steps
  1. Navigate to "Finance > Claim/Invoice Processing > Batch Listing > Billing Batches Management".
  2. Search for desired claim.
  3. Open the claim and validate it contains "Cost Center" from rate setup.
  4. Close the claim.
  5. Navigate to "Agency > Service Locations > Sites/Residentials > General Information".
  6. Select "Facility" associated with claim.
  7. Scroll to "Programs/Services Operated".
  8. Set the "Override Cost Center" on the program row associated with the claim.
  9. Save.
  10. Navigate to "Finance > Claim/Invoice Processing > Batch Listing > Billing Batches Management".
  11. Reprocess the batch.
  12. Click on the claim link to open the claim.
  13. Validate "Cost Center Code" on "Accounting Info" is contains the "Cost Center Override" from the "Facility Program Link".
  14. Close claim.
  15. Navigate to "Agency > Service Locations > Sites/Residentials > General Information".
  16. Select "Facility" associated with claim.
  17. Scroll to "Licensing".
  18. Set the "Override Cost Center" on the Payor/Plan row associated with the claim.
  19. Save.
  20. Navigate to "Finance > Claim/Invoice Processing > Batch Listing > Billing Batches Management".
  21. Reprocess the batch.
  22. Click on the claim link to open the claim.
  23. Validate "Cost Center Code" on "Accounting Info" is contains the "Cost Center Override" from the "Facility Licensing Link".
  24. Close claim.
  25. Click on "Client" name link the "Billing Batch Claims Review" window.
  26. Click on "Enrollment Information".
  27. Click "Actions" on the program associated with the claim.
  28. Select "Correct/Close Program Enrollment".
  29. Click on "Cost Center Override", select a record.
  30. Save and Close.
  31. Reprocess batch.
  32. Click on the claim link to open the claim.
  33. Validate "Cost Center Code" on "Accounting Info" is contains "Cost Center" set on "Program Enrollment".
  34. Close the claim.
Scenario 2: Validate Cost Center Override On Consolidated Claims
Specific Setup:
  • Requires two services that have been billed and they are set with "Service Line Consolidation".
  • Both services should have same "Cost Center" on rate setup.
Steps
  1. Navigate to "Finance > Claim/Invoice Processing > Batch Listing > Billing Batches Management".
  2. Search for desired claim.
  3. Open the claim and validate it contains "Cost Center" from rate setup.
  4. Close the claim.
  5. Navigate to "Agency > Service Locations > Sites/Residentials > General Information".
  6. Select "Facility" associated with claim.
  7. Scroll to "Programs/Services Operated".
  8. Set the "Override Cost Center" on the program row associated with the claim.
  9. Save.
  10. Navigate to "Finance > Claim/Invoice Processing > Batch Listing > Billing Batches Management".
  11. Reprocess the batch.
  12. Validate there is one consolidated claim.
  13. Click on the claim link to open the claim.
  14. Validate "Cost Center Code" on "Accounting Info" is contains the "Cost Center Override" from the "Facility Program Link".
  15. Close claim.
  16. Navigate to "Agency > Service Locations > Sites/Residentials > General Information".
  17. Select "Facility" associated with claim.
  18. Scroll to "Licensing".
  19. Set the "Override Cost Center" on the Payor/Plan row associated with the claim.
  20. Save.
  21. Navigate to "Finance > Claim/Invoice Processing > Batch Listing > Billing Batches Management".
  22. Reprocess the batch.
  23. Validate there is one consolidated claim.
  24. Click on the claim link to open the claim.
  25. Validate "Cost Center Code" on "Accounting Info" is contains the "Cost Center Override" from the "Facility Licensing Link".
  26. Close claim.
  27. Click on "Client" name link the "Billing Batch Claims Review" window.
  28. Click on "Enrollment Information".
  29. Click "Actions" on the program associated with the claim.
  30. Select "Correct/Close Program Enrollment".
  31. Click on "Cost Center Override", select a record.
  32. Save and Close.
  33. Reprocess batch.
  34. Validate there is one consolidated claim.
  35. Click on the claim link to open the claim.
  36. Validate "Cost Center Code" on "Accounting Info" is contains "Cost Center" set on "Program Enrollment".
  37. Close the claim.
Topics
• Client • Finance • Finance Setup
ECS-56884 Summary | Details
Nexus – Invoice for Educational Services
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Alternative Claim Output
  • Benefit Assignment [EDIT]
  • Billing Batches Management
  • Claim 2.0 [EDIT]
  • Claim Output
  • Claim Output Ready
  • Claim Receivers Setup Form Set
  • Claims Maintenance NX Form Set
  • Client Finance Related Information Form Set
  • FinanceClaims
  • Receiver Information - All
  • Receiver Information Generic [EDIT]
  • Related People
  • Relationship - Family Table
Scenario 1: “Nexus – Invoice for Educational Services” Custom Invoice for Nexus Family Healing (Nexus)
Specific Setup:
  • Billing batch with at least one claim that has multiple service lines.
  • Client should have Benefit Assignment billing setup for service.
  • Available Guardian/Parent to link to Client's Benefit Assignment.
  • A second Billing batch with one claim that only has one service line.
  • Alternative Claim Output Format set to "Nexus – Invoice for Educational Services".
Steps
  1. Navigate to "Finance > Claim Maintenance > Automatic > Claim Information".
  2. Search for 1st desired claim from setup.
  3. Take note of 1st Service Lines "Units" and 1st Billed Services "Program Modifier".
  4. Navigate to "Finance > Claim/Invoice Processing > Batch Listing > Billing Batches Management".
  5. Filter for desired batch.
  6. Click "Actions > Nexus – Invoice for Educational Services".
  7. Generate the output.
  8. Validate "Days" under the “Membership” segment and the “Total Number of Education Service” matches "Units" from step 3.
  9. Validate "Comments" section under "Billing Information" contains "Program Modifier" from step 3.
  10. Validate Parent's (Guardian's) Full Name, Address, City, State, and Zip Code under "Parent Information" section is blank.
  11. Navigate to "Client > Client Information > Personal Information > Benefit Assignments".
  12. Search for desired client from claim.
  13. Add a Guardian/Parent to the "Name of Insured (If not Client)" section for the Benefit Assignment.
  14. Navigate to "Finance > Claim/Invoice Processing > Batch Listing > Billing Batches Management".
  15. Filter for desired batch.
  16. Click "Actions > Nexus – Invoice for Educational Services".
  17. Generate the output.
  18. Validate Parent's (Guardian's) Full Name, Address, City, State, and Zip Code under "Parent Information" section matches "Name of Insured (If not Client)" person.
  19. Navigate to "Finance > Claim/Invoice Processing > Batch Listing > Billing Batches Management".
  20. Filter for desired batch with only 1 service.
  21. Click "Actions > Nexus – Invoice for Educational Services".
  22. Generate the output.
  23. Validate "Days" under the “Membership” segment and the “Total Number of Education Service” matches "Units" for that service.
Topics
• Finance • Finance Setup
ECS-59277 Summary | Details
Inbound Messages Configured For Payload "V2"
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Address by ZIP code Subform
  • Agency Referral Personal Information [EDIT]
  • Alternative IDs Subform
  • Benefit Assignment [EDIT]
  • Import File Templates
  • Import Services Form Set
  • Marital History Sub Form Subform
  • Referral Information Form Set
  • Referral Search
Scenario 1: Inbound EPICADT04 and EPICADT08- Create, Update Patient- Validate Version "V2" Payload Functionality
Specific Setup:
  • A referral record that will be added into the system. This will be the "EPICADT04" record.
  • A second referral record to update a pre-existing referral in the system, This will be the "EPICADT08" record.
  • The user knows the values in the fields.
Steps
  1. Send the "EPICADT04" record, this will be the new referral.
  2. Navigate to "Taskbar > System Maintenance > Import Services > Import File Log".
  3. Select the template used, "EPIC Create New Referral".
  4. Validate no errors occurred for the import.
  5. Navigate to "Referral > Agency Referral > Referral Information > Demographics".
  6. Validate the referral was added.
  7. Validate the demographic data that was sent is accurate.
  8. Navigate to the "Benefit Assignments" tab.
  9. Validate the benefit assignment data matches what was sent.
  10. Update the referral with the "EPICADT08" record.
  11. Validate modifications sent were updated on the referral record.
  12. Validate changes in the address create a new address line.
  13. Resend the same data files a second time.
  14. Validate the extra send does not modify the records or add additional records.
Scenario 2: Inbound Orchard - Validate Version "V2" Payload Functionality
Specific Setup:
  • A referral and client record that will be added into the system.
  • The user knows the values in the fields.
Steps
  1. Send the "Orchard" record, this will be the new referral.
  2. Navigate to "Taskbar > System Maintenance > Import Services > Import File Log".
  3. Select the template used.
  4. Validate no errors occurred for the import.
  5. Navigate to Referral > Agency Referral > Referral Information > Demographics".
  6. Validate the referral was added.
  7. Validate the demographic data that was sent is accurate.
  8. Navigate to "Client > Client Information > Personal Information > Demographics".
  9. Select the client.
  10. Validate the demographic data that was sent is accurate.
Topics
• CareConnect • Third Party Solution
ECS-59315 Summary | Details
Claim Submission
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Action Based Run - Claim Action Types
  • ActionsView
  • All Clients With Security Listing by PeopleID
  • AR Management
  • Billing Batch Management 2.0 Form Set
  • Billing Batches Management
  • Billing Request Action Based Run [ADD]
  • BillingProcessHistory
  • Cash Receipts for Remittance
  • Claim 2.0 [EDIT]
  • Claim Output Ready
  • Claim/Invoice Batch [VIEW]
  • FinanceClaims
Scenario 1: Validate Resubmit With Bulk Calculate Rate Includes Additional Units
Specific Setup:
  • Requires claims that can be remitted.
  • Scenario works with at least 5 claims.
  • Services for each of the billed claims have been edited so that they rebill with more units.
Steps
  1. Navigate to "Finance > Remittance Processing > Remittance Application > AR Management".
  2. Select desired remittance check.
  3. Set parameter's to search for desired claims.
  4. Click "Denied" link to group the claims together.
  5. Click "Bulk Actions" button.
  6. Select "Resubmit".
  7. Check the desired claims to be included in the "Action Based Run".
  8. At the bottom of the screen click "Remaining Balance" and select "Calculate Rate - Billing".
  9. Save.
  10. Navigate to "Finance > Claim/Invoice Processing > Batch Listing > Billing Batches Management".
  11. Click "New Run" and select and "Action Based Run".
  12. Set desired description.
  13. Click on "Action Type" and select "Resubmit".
  14. Set desired date range.
  15. Scroll to "Run for Receiver".
  16. Validate desired "Receiver" is listed with the amount of claims that were checked with "Bulk Resubmit and Calculate Rate".
  17. Check the "Receiver" checkbox.
  18. Click "Save".
  19. Wait for billing to run.
  20. Validate the billing run returns desired claims.
  21. Click on the "Claim" link.
  22. Validate the claims generated with the next "Submission # 2".
  23. Validate the claim generated with the expected number of units.
Scenario 2: Validate Bulk Calculate Rate Adjustment/Replacement Claims
Specific Setup:
  • Scenario works with claims that have been paid.
  • Services have been changed to include new units.
Steps
  1. Navigate to "Finance > Remittance Processing > Remittance Application > AR Management".
  2. Select desired remittance check.
  3. Set parameter's to search for desired claims.
  4. Click "Paid" link to group the claims together.
  5. Click "Bulk Actions" button.
  6. Select "Adjustment/Replacement".
  7. Check the desired claims to be included in the "Action Based Run".
  8. At the bottom of the screen click "Remaining Balance" and select "Calculate Rate - Billing".
  9. Save.
  10. Navigate to "Finance > Claim/Invoice Processing > Batch Listing > Billing Batches Management".
  11. Click "New Run" and select and "Action Based Run".
  12. Set desired description.
  13. Click on "Action Type" and select "Adjustment/Waterfall".
  14. Set desired date range.
  15. Scroll to "Run for Receiver".
  16. Validate desired "Receiver" is listed with the amount of claims that were checked with "Bulk Adjustment and Calculate Rate".
  17. Check the "Receiver" checkbox.
  18. Click "Save".
  19. Wait for billing to run.
  20. Validate the billing run returns desired claims.
  21. Click on the "Claim" link.
  22. Validate the claims generated with the correct "Submission # 2".
  23. Validate the claim generated with the correct number of units.
  24. Click on the claim to view the "Accounting Info".
  25. Validate the "Journal Entries" contain desired amount.
Topics
• Finance
ECS-59330 Summary | Details
Printing Test/Assessment
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Client Search
  • Client Service Entry
  • Print Preview
Scenario 1: Validate Printing An Assessment With Multiple SubReports
Specific Setup:
  • Requires an assessment with multiple "SubReports" on various areas of the event.
  • Questions on the assessment are also flagged with "Two questions on one row".
Steps
  1. Navigate to "Client > Case Management > Service Management > Service Entry".
  2. Select desired client.
  3. Click on desired "Completed Event".
  4. Click "Print" and select "Print Form".
  5. Validate the assessment prints and displays desired "SubReports".
Topics
• Assessments
ECS-59556 Summary | Details
Recreate To New Payer Action
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • 837 File
  • AR Management
  • Cash Receipts for Remittance
  • Claim 2.0 [EDIT]
  • Claim Output Ready
  • Claim Service Lines NX Subform
  • Claim/Invoice Batch [VIEW]
  • Claims Submission For Remittance NX [EDIT]
  • FinanceClaims
Scenario 1: Validate Recreate To New Payer Action
Specific Setup:
  • Requires a client with a billed service.
  • Client must have a new "Primary Benefit Assignment" the service can be rebilled to.
Steps
  1. Navigate to "Finance > Remittance Processing > Remittance Application > AR Management".
  2. Select desired remittance.
  3. Set parameters to search for desired claim.
  4. Add a "Denial" status.
  5. Click "Add Action"
  6. Under "Action" select "Recreate To New Payer".
  7. Validate "Submit To" field only the new "Primary" payer is listed.
  8. Save.
  9. Wait for billing to run.
  10. Open the "Action Based Billing Run".
  11. Create Output.
  12. Validate the contains only "Primary Payer" information.
Topics
• Finance • Finance Setup • Widgets
ECS-59733 Summary | Details
Nexus – Invoice for Educational Services
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Alternative Claim Output
  • Billing Batches Management
  • Claim 2.0 [EDIT]
  • Claim Output
  • Claim Output Ready
  • Claim Receivers Setup Form Set
  • Claims Maintenance NX Form Set
  • Client Finance Related Information Form Set
  • Critical Information
  • Receiver Information - All
  • Receiver Information Generic [EDIT]
Scenario 1: "Nexus - Invoice for Educational Services" - Validate "Program Modifier" Displays under Billing Information "Comments"
Specific Setup:

Internal Testing Only

Steps

Internal Testing Only
Topics
• Finance

myEvolv_NX_11.0.0075.01_Details.csv