myAvatar Cal-PM OSHPD Regulatory Updates

In Q1 of 2019, Netsmart released updates to myAvatar Cal-PM to support updated state reporting file specifications and format for the Office of Statewide Health Planning and Development (OSHPD) Inpatient Data File. Per OSHPD, the new file format is applicable to client discharges dated Jan. 1, 2019 forward. Before the myAvatar update is installed into a production environment, clients reporting to OSPHD should ensure that all 2018 client discharges have been reported. 


RevConnect and MyAvatar Integration is Here!

We are pleased to announce the integration of RevConnect, the Netsmart Clearinghouse, with myAvatar. This integration allows 837 claim files created in myAvatar to be automatically uploaded onto the RevConnect SFTP site.  This integration automatically downloads and processes 999 acknowledgment files and 277 claim status notification files from the RevConnect SFTP site.  Claim remittance (835) files are also automatically downloaded from RevConnect’s SFTP site and can be auto-loaded and processed if configured to do so.  

What are the benefits?

  • Removes tedious, manual process of moving files from server to the payor portal
  • Removes potential of human error of not uploading all generated 837 files, which could lead to loss of revenue.
  • Eliminates staff inadvertently not downloading all 835 files from all payers, leading to payments not getting posted in myAvatar.

The WellPower recently implemented the integration with RevConnect.  Their staff is now saving nine hours per week by no longer having to manually upload claims files to RevConnect and manually download 835 remittance files from RevConnect.

More capabilities to come

Netsmart has additional capabilities on the road map for 2019.  These features include:

  • Automatic upload of 270 files from files generated in myAvatar to RevConnect
  • Automatic download of 271 files from RevConnect
  • Auto-load compile and post capabilities for 271 files
  • Single sign-on capabilities for RevConnect within myAvatar so users will be automatically logged into RevConnect in a URL widget when they log into myAvatar


In order to utilize the new capabilities released in this update, the organizations must have a subscription to RevConnect. Organizations who are not currently utilizing RevConnect can contact their Client Alignment Executive for information on this solution. 

If your organization has RevConnect and is interested in enabling this capability, please contact your RevConnect EDI specialist for details.


myAvatar 270/271 Enhancements 

Earlier this year, Netsmart released several notable enhancements to the 270/271 Batch Eligibility Verification process. The update allows users to:

  • Set up the Payer ID on the ‘270 section’ in ‘Guarantors/Payors’ to reduce the number of templates required.

  • Submit eligibility with a Medicaid ID as the Subscriber Policy Number for clients who are covered under an MCO. 

  • Submit eligibility requests to Medicaid for clients who have services distributed to self-pay.

  • Set up minimum search options per guarantor based upon the companion guide. Validate that the client has values saved in order for a 270 request to be submitted.

  • Define the dates (past, future, current, date ranges, single date) that will be accepted by the payer.

  • Submit a batch eligibility request with clients and service date ranges that meet specified criteria. 

  • Run eligibility requests with the System Task Scheduler.

  • Export 271 response data into the .CSV files so staff can easily review the eligibility information received. 

Interested? Check out the IA configuration and training guide for these new capabilities on the Netsmart WIKI.