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RPB201
| Question | Answer |
|---|---|
| Epic's Database "Filing Cabinet" | Chronicles |
| Information about one type of entity, "Drawer in filing cabinet" | Master File |
| Collection of items that refer to a single entity "One file in the drawer" | Record |
| A snapshot of the data in the record of a specific moment in time "encounter" "version" | Contact |
| Individual pieces of data inside a record | Items (questions) and Values (answers) |
| Facility | Organization as a whole... "Unity Point" |
| Service Area | Business entity with a SEPARATE accounts receivable |
| Location (Revenue) | Physical building such as clinic, hospital or business office |
| Department | Every user logs into one of these. It's a field in PB charge entry. Appointments are scheduled in these |
| Place of Service | Like a location but not owned by your organization. Used to record WHERE service took place. |
| True/False You can use your mouse to navigate in text? | False |
| Rule of Specificity | When the same setting is set at multiple levels, the system uses the setting from the most specific level. Ex: self pay discounts set up at dept, location, service area or facility. |
| How many service areas can a location be linked to? | One |
| What structural component does Epic use to record services provided by providers outside of organization? | Place of Service |
| A master file that can be tracked over time can have multiple | Contacts |
| What keystroke is used to find help in text? | Shift + F5 |
| User Record (aka User Security Record) | represents an individual user in the system (single employee) "central hub" |
| User Role Record | represents a group of employees ( front desk registration) |
| What are the two types of security points? | Restrictive- removes a function so user can't do it Permissive- gives a function to the user- has MAY in title |
| True/ False A user will not be able to reject a batch in payment posting unless she belongs to a security class 100- MAY reject batch in payment posting. | True |
| True/False A user who needs access to multiple Epic applications needs a single security class that contains security points from multiple applications? | False- you need separate security classes for ever Epic application you need to use |
| Security Class | defines what functionality a group of users can and cannot access. Application specific. Modules and Security Points |
| Modules | large pieces of functionality within an application-about 70% |
| Security Modules examples | Claims, Payment posting, charge entry charge entry report and charge review WQ maintenance |
| What does the user role control? | Startup activities, main toolbar |
| Security Class Override | Grants a different security class to the user when in the service area specified. |
| True/False After populating a user's security record using a copy template future changes to the template will continue to update | False |
| Which two fields on the Resolute PB form of a user record must be populated for that user to access billing tools? | Default Security Class field Authorized Facility field |
| What are the two types of templates? | Copy and Linkable |
| Copy template | You copy a user's security setup directly from a template, then make modifications |
| Linkable template | Linked to user records and are useful for creating and maintaining several groups of users at once. |
| In the provider master file, what is the purpose of the STATUS field? (done in TEXT, doesn't affect charge entry/billing) | Allows you to make the provider active/inactive for scheduling purposes and PCP |
| If you add specialties to a provider record in text, what path to do take in Hyperspace to see it? | PB Charge entry > Session button > Encounter specialty |
| When setting up a non billing provider what else must you make sure is set up in RPB so charge entry works? | Charge Review Work queue rule that looks for non billing providers set up as billing providers. |
| True/False You can require that the control amount of procedure hash is entered in PB Charge Entry? | True |
| Charge entry generic items are configured at which level? | Facility |
| Where is the set up done for Charge Router Charge Entry? | Charge Router Profile |
| Where is the set up done for Professional Billing Charge Entry? | Facility (or service area) Profile > GUI |
| True/False An Administrator can configure custom charge entry instructions for an individual procedure record. | True |
| In a procedure record, what three fields must be set for that record to be active and available for use in Charge Entry? | Billing status, Procedure type and Procedure category |
| What are the Charge Entry restrictions that can be set up for a procedure? | Provider type, Diag, age range, POS type, Sex |
| EAP | Epic All Procedure File |
| What are the three record purposes? | Orderable. Performable. Chargeable. |
| Which part of Epic receives the charge information from the clinical applications and sends (routes) it to billing? | Charge Router |
| Why should orderable procedure records always be separate from chargeable procedure records? | Orders are general and usually not billed for. Charges are preformed and billed out. |
| Which algorithm makes use of the Interval Length, Interval Method and Rounding Method fields? | The algorithm of TIMED |
| True/False The procedure master file contains charge codes along with their prices | False |
| These are the 8 eligibility requirements for a fee schedule group. | PROVIDER, SERVICE AREA, PLACE OF SERVICE TYPE, DEPARTMENT, FINANCIAL CLASS, PROVIDER TYPE, LOCATION AND PARTICIPATING STATUS. |
| Where is the order of search precedence for the fee schedule group requirements? | Service area profile or Facility profile |
| True/False A modifier always affects the price of a charge. | False |
| What is the relationship between rules, criteria, properties, operators and values? | A rule is made up of one or more criteria. Criteria is made up of properties, operators and values |
| True/ False It is possible to have multiple criteria together in one rule? | True |
| Exclusive Workqueues | Catch charge sessions without any errors. Used to audit charges. |
| Non Exclusive Workqueues | Workqueues designed to catch errors/warnings on charges sessions |
| What is the difference between a charge stored in TAR and ETR? | TAR is temporary and ETR is permanant |
| What is the difference between front end and back end workqueues? | Front End- has validation messages when the user tries to accept their session. Back End are evaluated after the charge session leaves the charge entry process |
| What two things must be activated for a charge review workqueue to function? | Workqueue itself and the Rules. |
| What is the purpose of Auto Process field in the Charge Review WQ Maintenance? | Allows a batch job to review charges in the WQ to see if they still qualify fro the rules of the queue. |
| Which report can you run to get a summary of WQ build for service area? | Charge Review Maintenance Report |
| What is the purpose of using routing rules with back end charge review WQ's? | Limits the number of sessions that can qualify for a WQ |
| True/ False You can add an end user to multiple wq's at once? | True |
| What is the purpose of the Batch Scheduler? | Regularly and Automatically run common and or system intense processes when the demand is low- usually overnight. |
| These are processes for Professional Billing that are set up in the Batch scheduler: | Claims Processing, Statement Processing, Nightly Processing, Charge Review Processing and many more |
| What is a mnemonic? | Are the questions in the job template you must answer to define the job's functions. |
| What are three things that need to be created in order to use the Batch Scheduler? | Job, Batch and Run |
| Name three record types in the compartment master file used by PB? | Procedure, Diagnosis and Modifier |
| Why do we add "px" to the end of procedure component names? | To distinguish them from other types of components that can be built in the component master file. |
| True/False You cannot exclude procedure codes from components? | False |
| True/False Multiple self pay discount tables may be used in one service area? | True |
| Give two methods of defining how a self pay discount is calculated | A fee schedule and percentage change |
| What are the two basic pieces of information that must be collected in registration in order for sliding scale disc to work? | Family Size and Family Income |
| True or False- Multiple sliding scale tables may be used in one service area? | True |
| True/False The Federal Poverty Level table must be linked to the service area in Hpyerspace | False- linked to service area in TEXT |
| True/False The sliding scale discount determ table holds the information on the discount amounts | False- It tells the system when to use the different sliding scale tables |
| Which application must you access in Text to add the FPL form to registration | Prelude |
| What are two ways to calculate a discount within a pricing contract? | Attach a fee schedule with the discounted amounts or give a percent discount on a procedure category. |
| How do you link a pricing contract to an account? | Registration, Contract Field on the Coverage and Add'l Info Form. |
| How can you tell if a field with a selected list is coming from a master file or a category list? | In HyperSpace the window will tell you if categories or records (from a master file) have been loaded |
| What would NOT be a suitable synonym for married? Why? | "Marry" would not because it begins with the same letters |
| True/False- You can delete a category value when your system is not live yet | True |
| True/False- A customer cannot add values to a system category list. | True |
| True/False-The department logged into determines the guarantor accounts you can access thru modules such as charge entry & payment posting in any given service area | True |
| The department you log into in Hyperspace impacts both of these: | Registration and Billing |
| When you want to change the department you are currently logged into in Hyperspace, this is what you use: | Change Context |
| True/False- A 'No-Add' item is a value that does not change over time, like date of birth | True |
| True/False- Values for 'Response each time' items can change over time, like marital status | True |
| True/False- Chronicles, Epic's database management system, is unique to Epic's clinical products | False- it is used by all of Epic's software applications |
| True/False- Hyperspace stores patient data | False |
| True/False- Facility level is most generic and Bed level is most specific | True |
| HOD: | Used in areas that schedule patient appointments and admitted patients |
| Virtual Department: | Patients are not scheduled or admitted here |
| Hospital Unit: | Necessary for areas where patients are admitted |
| Outpatient Department: | Used in areas that only schedule appointments |
| True/False- Security Class records are done in Text | True |
| These are examples of _________________ security points: 4- Accept/Reject Bills or Claims 18-Void charges in Account Maintenance | Restrictive |
| True/False- When no security points are listed, user gets 70% functionality because of the module | True |
| In Text, Shift+ F3 does this: | Opens up description of line when there is an asterisk (*) present |
| True/False- Security Points listed on the Security Points screen have no effect unless the corresponding security module has been assigned on the Hyperspace Module Security screen | True |
| You must do this for most security updates to take effect: | Log out and completely exit Hyperspace |
| A special type of user record that can serve as a model for other user records. It helps you maintain user records for multiple users with similar job roles: | User Security Template |
| True/False- The Provider Master File INI is 'SER', which stands for Scheduled Epic Resource | True |
| SER and PAT represent which master files? | Provider & Provider Attributes |
| The PAT master file does this: | Determines if it's a Service Provider or Billing Provider |
| True/False- the SER is not limited to Providers, it can also represent a machine or a room | True |
| _______________________ allows administrators to show warnings/errors to charge entry staff when a data is missing or incorrect. | Charge Entry Validation |
| True/False- Charge Router Charge Entry (CRCE) is a tool used by only inpatient staff | False |
| In Professional Billing Charge Entry configuration, the forms of profile are: | Charge Generic Items and Charge Entry Display |
| In the Batch Options form, the ----------------------------------- controls the letters in the hash. | Procedure Code Hash function |
| When building a charge procedure what 3 options are available in Procedure Type field? | Charge, Payment, and Adjustment |
| True/False- The Default Modifiers section of the Alternate Codes form appears only for procedure records with a type of 'charge' | True |
| ------------------------------are used to limit the use of a procedure in PB Charge Entry. | Charge Restrictions |
| True/False- Related procedures are currently built in the Foundation system. | False |
| True/False- For a validation message in CRCE, a rule must be created & linked to the Charge Router profile at the Facility level | True |
| The 3 modules you may use to enter charges manually are: | CRCE, PB Charge Entry, and Anesthesia |
| The ____________________________tracks/reconciles a set of charges & verifies charges sent to charge router are properly routed | Charge Router Reconciliation Report |
| Clinical applications send charge info to the charge router when these 2 things occur: | Provider closes the encounter or an order is resulted |
| True/False- Fixing a procedure record in a Charge Router Review WQ will automatically remove it from the WQ | False |
| True/False- Each charge is assigned a destination of Resolute HB or PB Billing, or a non-Epic system. Can also be assigned by rules set in Charge Router profile | True |
| _________________________ are defined as a procedure & an amount that determine billed amounts (prices), reimbursement/allowed amounts & discount amounts | Fee Schedules |
| True/False- Fee schedules with Resolute PB will always have 'Procedures' as the type of fee schedule | True |
| In Editing Fee Schedule, if you leave the lines blank, what will happen? | Allows all to access the fee schedule |
| What are the 3 main master files referenced when assigning a price or billed amount to a charge in PB? | FSC, FSG, MOD (Fee Schedule, Fee Schedule Group, Procedure Modifier) |
| Fee schedules must be attached to the ______________________, which tell system when to apply a particular fee schedule | Fee Schedule Groups |
| Fee schedules in a fee schedule group are searched in the order listed here: | Associated Fee Schedules |
| True/False- If a modifier is configured as a % of charge, that change will apply in all service areas as modifiers are not service area specific | True |
| Rules define what ___________________we want the system to find | Scenarios |
| True/False- If the syntax of the rule error message is incorrect, Resolute displays your entry in red when you try to Accept | True |
| When searching for procedure related properties, look for the _____________ property | PxGrp |
| The _______________________move transactions from TAR (Pre-AR) to ETR (Active AR) when the batch is processed | Transaction Filer |
| A WQ is associated with a ____________________when it's created | Service Area |
| Charge Entry Validation checks are built with ____________________ and can be errors or warnings | CER Rules |
| True/False- If a charge session does not qualify for at least one error/warning rule & one routing rule then the session will not be caught by the WQ | True |
| Name the 3 types of rules: | Warning, Error, Routing |
| In the Rule Editor, what does the 'Usage' button do? | Shows where rule is being used |
| True/False- When creating a Front End Edits WQ you must always 'copy from' the Front End Edits WQ (200) that comes with the Foundations system as a starting point | True |
| A 'batch' is a ___________________in the batch scheduler | Group of jobs |
| The 'Job' requires a ________________ that is programmed by Epic | Template |
| Mnemonics that start with an exclamation point (!) indicate that it is _________________. | Required |
| Shift+ F9 in Batch Scheduler will ______________________. | Stop a scheduled run |
| True/False- If your Run is scheduled in Batch Scheduler, you do not need to unschedule it to add additional jobs to the Run | False |
| The _________________in Chronicles is where you access an enhanced Batch Scheduler main menu. | E1D (Run) master file |
| __________________________acts as a management hub for all scheduled batch runs (in the E1D master file) | Status of All Runs |
| ___________________________utility shows detailed chronological schedule of batch scheduler for a future date/time range (in E1D) | View Range Schedule |
| _____________________can be used to create groups of services to define if they should get a self-pay discount, calculate an allowed amount, or identify groups for use in global billing | Components |
| True/False- Once you select a component record type, you may change it | False |
| The _____________________________is a catch-all procedure component record that needs to be created to catch all procedures | All Procedures Component |
| True/False- Self-pay discounts can be enabled or disabled for a given facility, location, or department | True |
| If both self-pay discounts and sliding scales are enabled in a service area, system will try to use ____________________ first | Sliding Scale |
| True/False- Using sliding scales require one end user workflow change, which is collecting family size & income in Registration | True |
| True/False- Discount determination tables are tied to service areas | True |
| True/False- A flat fee rate does not display in charge entry, so the discount field will display as 0% | True |
| In a pricing contract fee schedules are evaluated first, then the ____________________________ | Procedure Category |
| True/False- Pricing contracts can be associated with different entities within an organization-patient visits, guarantor accounts, benefit plans, provider & employers | True |
| At the most basic level items store data as either _______________ or ______________ | Values or Pointers |
| When a pricing contract is used the charge posts to the account reflecting only the reduced amount, not the full/regular billing price. | False- full price is posted as billed amount, then shows the discount as a write-off |
| ____________________ pull information for display by linking to another master file record or category list value | Pointers |
| Name the 3 ways to prevent users from accessing records in the system that you no longer want used | Active/Inactive setting, Soft Delete, or Hard Delete (Chronicles) |
| System, Extendible, and Customer are 3 types of ______________________ | Category Lists |
| In Category List Editor, you know a list is not editable when you get this message: | Release Range: All Categories |
| In Category List Editor, this note "The system's reserved range is From 1 to 99" will identify a list as____________________ | Extendible |
| In Category List Editor, you can identify a list is Customer controlled when you see a message like this: | Release Range: All Customer Owned |
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