6.5.1
Create appointment along with invoice
Add item to the invoice associated with the appointment.
Pay the invoice
Claim
urn:uuid:MLK00000BD6A0E3BAF875C9D
6.5.2
A claim can only be made from a paid invoice even with a zero amount partially paid.
Medicare claim info is stored in and associated with an invoice. While the finance info of an invoice could not be altered after being paid, the claim info may be altered and updated for resend. Screenshots in 6.5.1, 6.5.2 and 6.5.3 illustrate such workflow. You can pay (partially) an invoice and claim it at a later date, though the UI design is optimized for claiming right after making payment.
The medical centers generally allows claiming only after (full) payment of the respective invoice. If under some special or exceptional circumstance a claiming is to be made without payment first, the operator may make a zero dollar payment as a workaround.
6.5.3
Similar to 6.5.2, rather than zero amount, you input an amount between 0 and the fully paid amount.
6.5.4
6.5.5
urn:uuid:MLK000000A9651B82C6CAB16
6.5.6
urn:uuid:MLK00000A32799BF0A8E331D
Nowmake the necessary corrections to the claim:
And claim again,
urn:uuid:MLK000002380494B141309C9
6.5.7
A claim can only be made from a paid invoice even with a zero amount partially paid.
Medicare claim info is stored in and associated with an invoice. While the finance info of an invoice could not be altered after being paid, the claim info may be altered and updated for resend. Screenshots in 6.5.1, 6.5.2 and 6.5.3 illustrate such workflow. You can pay (partially) an invoice and claim it at a later date, though the UI design is optimized for claiming right after making payment.
The medical centers generally allows claiming only after (full) payment of the respective invoice. If under some special or exceptional circumstance a claiming is to be made without payment first, the operator may make a zero dollar payment as a workaround.
6.5.8
Claimant is defined in CRM.
Claimant is automatically included when creating an invoice.
6.5.9
As already described in previous test cases, in the CRM, the app may check basic validity of Medicare number and do PVM check.
Also the backend in the morning will walk through appointments of today and do PVM check upon patients involved.
Since the backend service may run idle after 20 minutes by default without coming request, the scheduled check will run as soon as the backend service is running upon the first request. If any of the Medicare number has issues as reported by Medicare Online, the admin/manager may receive an Email message about which ones have issues.
And before sending a claim, the app will check if the last check date of PVM is older than 1 day. If too old, do PVM first before sending the claim.
In summary:
1. PVM are mostly done automatically by a scheduled morning task at the backend.
2. PVM may be done automatically when needed before sending a claim.
3. PVM may be done through interactive UI.
6.5.10
Click on the Referring Practitioner button, you see
And the selection list is defined at:
The application may list the most appropriate ones among all recorded.
urn:uuid:MLK00000DDD40347B77D35F4
urn:uuid:MLK00000EAECF3D696368870
6.5.11
This app does not do Easyclaim.