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Name the four registration records in SBO
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T or F: The PB HAR is manually created by the end user
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EPIC
RPB102
| Question | Answer |
|---|---|
| Name the four registration records in SBO | Patient, Guarantor, Coverage and HAR |
| T or F: The PB HAR is manually created by the end user | FALSE |
| What should you do if you search for the payor when creating coverage and it doesn't exist? | Put in generic coverage |
| A statement (bill) is sent to who's address in registration? | Guarantor |
| What does a red stop sign represent? | Required Field |
| What does a yellow yield sign represent? | Recommended |
| Name the two charge entry Control Amount options and how they are different from each other? | Count and Hash. Count is the number of charges and Hash is the SUM (adding) them up. |
| T or F: Charges caught in the PB charge review workqueues are posted and part of AR. | False |
| What is the name of the module in the system that automatically creates claim runs? | Batch Scheduler |
| Where do end users find the list of claims with errors that need to be worked before they are sent to payors? | Claim Edit WQ |
| What type of claim error can be fixed by an end user? | Soft |
| What type of claim error needs to be fixed by an application coordinator or IT person? | Hard |
| What's the difference between New Detail and New Check on the Insurance Payment Posting form? | New Detail- same check, new invoice New Check- new check to post money from |
| Why are cash control groups created in EPIC? | To keep track of money/lockboxes/deposits |
| What is the difference between a Patient and Guarantor record? | Patient- receiving care Guarantor- responsible for charges/bill |
| Which record contains information about Patient's Ins info? | Coverage |
| What is the Enterprise Payment button used for? | To take a co-pay, pre-pay or payment on account |
| What does the status change to when a patient has been checked in? | Arrived |
| Tor F: When you schedule a walk in appointment, the system automatically selects the first available time slot? | True |
| What is the purpose of the cash drawer in the system? | To reconcile the physical money collected with what was posted in system |
| What do you do when the cash drawer is out of balance? | First, re-count and re-enter the physical money. If it still doesn't balance, contact a supervisor and enter a reason why it didn't balance. |
| What is the purpose of processing your batch? | It posts the charges and makes them available for billing |
| T or F: One charge ticket is the equivalent of one charge entry session? | True |
| T or F: One charge entry batch only contains information for one patient's charges? | False- they can contain a unlimited number of charge entry sessions |
| Charge Router Review WQ catch what kind of charge errors? | Major |
| T or F: Charges can only be entered through manual charge entry? | FALSE |
| What four things does the Charge Router do? | Checks errors, routes charges from clinic apps to billing apps, contains workqueues, and allows for manual entry of charges |
| What is the difference between a warning and an error? | Warning is recommended- soft stop Error- Have to fix before moving on- hard stop |
| What does the Transfer button do in a charge review work queue? | Moves it from the current wq to a designated wq... you chose where it goes. |
| T or F: Users review charges in charge review wq's after the system has posted the charges to the account? | FALSE before they post, when they are still temporary and can be fixed. |
| What tool in the system automates processes? | Batch Scheduler |
| Creating claims is mostly a (manual/automatic) process? | Automatic |
| Where are the charges located that are ready and waiting to process for claims? | Claims queue |
| Who corrects user errors? Where are these corrected? | End users, Hyperspace |
| Who corrects Master file errors? Where are these corrected? | Application coordinators or IT staff, corrected outside of Hyperspace |
| How can you access step by step instructions on how to fix a claim error? | Click on the error link in the claim edit assistant |
| What does the Test button in the companion do? | Tests claim errors against the CDF in real time. |
| How do you prioritize your workqueue to work the claims with the oldest service dates first? | Click the Svc Date column heading |
| Where can you view past activities preformed on claims? | Activity History in the assistant; Follow up Activities section in the WQ info display |
| After calling a payor about an outstanding bill claim, you want to document the conversation. Where do you go? | Call Payor and Note |
| What is the difference between selecting Resubmit Claim and Resubmit Selected? | Resubmit claim sends the entire claim back to the claims queue and Resubmit selected allows you to choose which charges from the claim go back to the claims queue and are resubmitted. |
| What happens when you defer a claim? And why would you do so? | Defer moves the claim off your Active tab(worklist) and sends it to the User Deferred Tab. You send it there so you don't have to work on it until say a week later when the payment was due |
| T or F: Cash management lets you track the amount of a deposit posted in the system? | TRUE |
| T of F: Multiple checks can be combined into one cash control group? | TRUE |
| T or F: Confirming a cash control group posts the payment into EPIC | FALSE- Cash Control groups are representations of the bank deposit |
| T of F: Cash control groups must be created manually in Epic? | FALSE- they are created automatically by the system based on a bank deposit file. |
| What is the purpose of creating a payment posting batch? | It's a holding tank for the payment information you enter in the system |
| How do you look up an invoice number in PB Ins Pymt Posting when you can't read it or doesn't appear on EOB? | .p by patient or .a by guarantor account |
| T or F: An allowed amount always automatically appears on the Ins Pymt posting form | FALSE |
| What should you do when the system allowed amount is different from the allowed amount on the EOB? | Override the system and enter the amount from the EOB in the allowed field |
| What should you enter in the POST field when posting a PB denial? | Claim Denied |
| What step in payment posting sends payments to guarantor accounts? | Processing the batch |
| T of F: A batch must balance before you can process it | TRUE |
| Name one way you can identify where you made a posting error? | Run the Pending Payment Posting Batch report |
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