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EPIC RPB 102 V.2

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
show Patient (e.g., demographics, contact information, PCP, Medical information, employment, etc.)  
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show Guarantor. Person that is financially responsible for the self-pay portion.  
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HAR   show
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show Coverage (Payor, Subscriber). Contains information about a patient's insurance benefits.  
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show Holds PB charges from a visit. Lives on the Guarantor Account. Created automatically when an encounter gets a professional billing filing order. User never creates a PB HAR  
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HB HAR   show
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HB HAR Statuses   show
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show Closed (Not trying to get money) Billed (Trying to collect money--insurance or self-pay)--Liability is assigned Closed  
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What status does the appointment change to once it has been checked in?   show
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show To reconcile the physical money collected with the money posted in the system.  
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Clicking which button automatically matches the money you recorded from your cash drawer with the money posted in the system?   show
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show To reconcile the physical money you collected with the money that you posted in the system  
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show First, try to balance the cash drawer by re-counting and re-entering the contents of your physical money. If it still does not balance, contact a supervisor and enter a reason why the drawer is not balanced.  
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show - Clinicians are not placing orders - Services at outside place of service - Interim clinical staff continue to hand in charge tickets. - Coding from provider documentation  
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Why are there multiple charge entry modules?   show
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show - Charge Router Charge Entry - Professional Billing Charge Entry - Anesthesia Charge Entry  
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Name 2 different options for Preparing Charge Tickets   show
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Charge Entry Batch   show
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Each charge entry batch contains only one charge entry session. True or False.   show
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Each charge entry batch only contains information for one patient's charges. True or False   show
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show TRUE  
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show Processing the batch posts the charges and make them available for billing.  
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Charge Router Review workqueues catch (major/minor) charge errors?   show
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show False. They go through Charge Router Review before they enter the billing systems.  
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Charges can only be entered through manual Charge Entry. True or False.   show
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show A, B, C, and D (all)  
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show Review PB charges for errors.  
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When do Charge Review Workqueues take place?   show
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If a charge session qualifies for multiple workqueues, how do you know what to fix in order to remove the charge session from your workqueue?   show
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show No  
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If you want the chart and account to match, who needs to update the charge?   show
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show Moves session to the deferred tab. It comes back to the active tab when the time expires.  
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You can add new procedures when you access a charge session from charge review. True or False.   show
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List the 3 steps to resolving duplicate charges   show
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Why can't this user perform the function of Delete on a charge session?   show
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What does the Transfer function do to the charge session?   show
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Which buttons in the reviewing and correcting charge errors workflow are security controlled?   show
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show False (it is gone)  
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What is the difference between a warning and error for reviewing and correcting charge errors?   show
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What does the Transfer button in a charge review workqueue do?   show
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show You should resubmit a charge session when you believe it has been corrected.  
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Where are the charges located that are ready and waiting to process for claims?   show
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show Batch scheduler.  
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show Automatic.  
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show To view and correct claims with errors before sending to payors (payor specific checks).  
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Claim Edit workqueues: What are user errors and what are Master file errors and who fixes them?   show
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What does the Claim Edit Workqueue Companion do?   show
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show From the Claim Edit Workqueue Double-Click the claim (or click Edit)  
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show Refresh  
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show CDF (Claim Definition File)  
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show Tests claim errors against the CDF in real time.  
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Once the system creates a run of clean claims, what does an end user do to complete the process?   show
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How do you reprint the paper claims if there was a problem?   show
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What is the purpose of the Claim Run Report?   show
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show Accept the run. This will allow you do perform future follow-up.  
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It is possible to accept a port of a claim run. True or False.   show
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What additional step is needed for electronic claims?   show
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show False, highlight the run and click Print Forms.  
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show To validate that all the paper claims are printed and all of the electronic claims are received by the clearinghouse before the claim run is accepted.  
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After accepting a claim run, it is easy to reprint the claims if needed. True or False.   show
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show Insurance Coverage section of the Assistant  
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Which activity do you perform when the payor did not receive the claim and you need to send them a new claim?   show
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show Note  
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show Defer  
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show Click the Svc Date column heading  
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Where can you view the past activities performed on claims?   show
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show Resubmit Claim sends the entire claim back to the claims queue; the system will determine which charges need to go on the resubmitted claim based on the payors' needs.  
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What does Resubmit Selected do?   show
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What is the consequence of deferring a claim, and why might you defer a claim?   show
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show Cash Control Records: One created per check that is deposited in bank and needs to be posted into Epic. Group: A list of Cash Control records. Cash Control Groups should be created using information from the bank, not information from the payor.  
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show The batch will only be available for use through Enterprise Payment Posting. Enterprise Payment Posting can be used to post both PB and HB payments in the same batch.  
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show Set Defaults Button  
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show True.  
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show True (multiple checks and multiple payors).  
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Confirming a cash control group posts the payments into Epic. True or False.   show
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show TRUE  
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show Next Responsible Party (moves the remaining balance t other next party in the visit's filing order.  
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What type of Action does NAA stand for?   show
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show New Detail: Same check, new invoice New Check: Post from another check  
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show Reimbursement Contracts  
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show Yes (go with what the EOB says not the system).  
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show Set Defaults Button  
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show Click the check-level pencil and select ADD PB Detail  
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Correcting Posting Errors: If you posted to an invoice incorrectly. What do you do?   show
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show Contact supervisor who clicks detail-level pencil and selects Delete Detail (Foundation System)  
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What is the purpose of creating a payment posting batch?   show
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To track the amount of a bank deposit posted in the system, payment posting batches can be linked to?   show
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How do you look up an invoice # in PB Insurance Payment Posting when you can't read it or it doesn't appear on the EOB?   show
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If a payor sends payment for an invoice or patient that does not exist in the system, what should you do?   show
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show FALSE  
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What should you do when the system allowed amount is different from the allowed amount on the EOB?   show
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What should you enter in the Post field when posting a PB denial?   show
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What step in payment posting sends payments to guarantor accounts?   show
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show True.  
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Name one ay you can identify where you made a posting error.   show
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show The Cash Control Group report.  
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What is the difference between a patient record and a guarantor record?   show
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show "False. The Hospital Account (HAR) is the hub for a visit that allows a user to see information stored elsewhere. The Guarantor Account record stores the information about a person or entity ultimately responsible for remaining balances for a visit. Servi  
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Which record contains information about a patient's insurance benefits?   show
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show False. PB HARs are created automatically by the system whenever an encounter gets a PB filing order.  
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show In order to collect a copay, pre-payment or previous balance payment at the front desk.  
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What status does the appointment change to once it has been checked in?   show
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show TRUE  
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show Select a generic coverage and enter information from the card.  
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What is the purpose of the cash drawer in the system?   show
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show "First, try to balance the cash drawer by re-counting and re-entering the contents of your physical money. If it still does not balance, contact a supervisor and enter a reason why the drawer is not balanced."  
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show False. Each charge entry batch can contain an unlimited number of charge entry sessions.  
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show False. The batch can contain charges for an unlimited number of different patients.  
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show True.  
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"Name two conventions for entering a diagnosis code in the Code field on the Charge Entry form."   show
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On the procedure line, what purpose does the Diagnosis field serve?   show
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What is the purposes of processing your batch?   show
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show Major  
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show False, they go through Charge Router Review before they enter the billing systems  
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True or False: Charges can only be entered through manual Charge Entry.   show
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show A, B, C, D  
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What is the difference between a warning and error?   show
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show It moves the charges session from the current workqueue to a designated workqueue.  
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What does this workqueue icon represent?   show
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"True or False: Users review charges in charge review workqueues after the system has posted the charges to the account.temporary and editable."   show
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When should you resubmit a charge session?   show
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show The Delete button is security controlled and isn't available to every user.  
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Where are the charges located that are ready and waiting to process for claims?   show
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show Batch Scheduler.  
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Creating claims is a mostly (manual/automatic) processes.   show
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What Epic record defines all of the possible errors a claim could have?   show
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show End users; corrected in Hyperspace.  
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show Application coordinators or IT staff; corrected outside of Hyperspace.  
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How can you access the step-by-step instructions for how to fix a claim error?   show
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What does the Refresh button in the Companion do?   show
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show Click the Svc Date column heading.  
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Where can you view the past activities performed on claims?   show
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show Call Payor and Note  
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Explain the difference between selecting Resubmit Claim and Resubmit Selected.   show
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What is the consequence of deferring a claim, and under what circumstance might you do so?   show
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True or False: Cash Management lets you track the amount of a deposit posted in the system.   show
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show True (multiple checks and multiple payors)  
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True or False: Confirming a cash control group posts the payments into Epic.   show
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show False. Cash Control Groups can be created automatically by the system based on a bank deposit file.  
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show It is used as a holding tank for the payment information you enter in the system.  
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show Use .p to look up by patient or .a to look up by guarantor account.  
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"If a payor sends payment for an invoice or patient that does not exist in the system, what should you do?"   show
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show FALSE  
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show Override the system amount by entering the amount from the EOB in the Allowed field.  
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What should you enter in the Post field when posting a PB denial?   show
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What step in payment posting sends payments to guarantor accounts?   show
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True or False: A batch must balance before you can process it.   show
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show Run the Pending Payment Posting Batch report (click the Report button).  
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Which tool can you use to review the history and details of a cash control group?   show
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"Claim denials that should be reviewed are caught by the system and placed in which type of workqueues?"   show
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"If a claim must be printed to paper right now, the (demand claim | resubmit claim) activity should be used."   show
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show Correct  
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If a denial cannot be corrected, how can you move the balance to the next payor or guarantor?   show
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"True or False: Statements in Single Billing Office are generated per HAR that the guarantor owes on."   show
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True or False: The system can automatically create statement runs.   show
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show TRUE  
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show A, B, C  
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True or False: Statement runs must be printed before they can be accepted.   show
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show A, B, C  
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"True or False: When a statement run is accepted for a guarantor with both a PB HAR and an HB HAR the status of the self-pay bucket on both HARs is changed to Outstanding."   show
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show True.  
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"Which activity tab displays an overall picture of the guarantor account, including balances, payments, and adjustments? A. Acct Summary B. Hosp Tx Inquiry C. Acct Tx D. Enterprise Guarantor Summary"   show
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"What information is visible in Hosp Tx Inquiry? A. Hospital charges B. Hospital payments C. Hospital adjustments D. Professional charges E. Professional payments F. Professional adjustments"   show
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"True or False: When you use an account activity, multiple actions might be performed on a HAR at once."   show
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True or False: Account Activities can be performed on multiple HARs at the same time.   show
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show "True. Security first determines what could be possible for a user to access. Then, the system filters out user and the context of what they are working on."  
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show False. Stop bills are HAR based.  
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True or False: Demanding a Detail Bill will increase the self-pay follow-up level for a HAR.   show
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show False.  
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show False.  
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"On HB HARs with which of the following statuses can you change the primary coverage? CHOOSE ALL THAT APPLY A. Open B. DNB C. Billed D. Closed"   show
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"True or False: When adding a secondary after a primary has already paid, you should undo billing to bring the HB account back to DNB status."   show
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"If a coverage is not good for any past encounters but you want to record it for future use, which Registration form should you use to add the coverage? Choose only one option. A. Coverage Info B. Cvg & Add'l Info C. Coverages D. Add the coverage in Hospi   show
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show Guarantor  
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"The amount owed on a guarantor's payment plans can be configured using: Select ALL that apply. a. Payment amount b. Name of account c. Number of payments d. Sliding scale"   show
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show A. Add a tickler  
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show False. Payment plans are for a guarantor, meaning one payment plan can and should include all HARs with outstanding balance (both PB and HB)."  
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"A guarantor is responsible for two hospital accounts, both at self-pay follow-up level 3. You include both hospital accounts on an activated payment plan. After you activate the payment plan, but before the terms of that payment plan are included on a st   show
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show Since the balances have not yet appeared on a statement they must be at the base level."  
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show "False. Updates made to the information inside of an existing registration record do not alter the self-pay follow-up level of the attached HARs."  
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show TRUE  
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"How do you change the matched amount for a charge on a PB HAR? Select only one option. A. Enter the correct value in the PB SP field on the lower left of the screen. B. Double-click on the PB HAR C. Press F6 or double click on the charge.   show
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True or False: The control amount for a batch can never be changed.   show
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show True.  
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show B. Refund request.  
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show C. Completed.  
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show B. Transfer  
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show C. Transfer to HB  
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"I'm reviewing an undistributed payment in a credit workqueue. I realize that the guarantor has an undistributed balance on a PB HAR and I decide to move the payment to that balance. Which function allows me to do this? Select all that apply. A. Distribut   show
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"To move a portion of a guarantor payment to another HAR, you must ___________________ the payment. To move the entire payment to another guarantor account you must choose ___________________. A: Transfer; Distribute B: Transfer to Professional Billing; N   show
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"True or False: When working from a payment posted to an HB HAR it is possible to redistribute only a portion of the payment."   show
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show False. They qualify for HB account workqueues.  
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"You need to manually post a refund for a payment currently matched to an HB HAR. In which hospital account maintenance activity can you do this? Select only one answer.A. Prof Tx Inquiry B. Liability Bucket Info C. Enterprise Guarantor Summary D. Account   show
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show "False - you can give end users a security point that allows refund requests to post without being reviewed in Refund Review."  
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show TRUE  
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What is the effect of creating a Debit Adjustment Posting batch that is set to file in real time?   show
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Created by: jwharris77