EPIC Resolute Hospital Billing Fundamentals Exam Questions And Answers Verified 100% Correct

EPIC Resolute Hospital Billing Fundamentals Exam Questions And Answers Verified 100% Correct Cash Management - ANSWER -Handles bank reconciliation in Epic, Creates cash records in Epic to indicate a deposit has been received in the bank, Puts cash records into Cash Control Groups Cash Control Groups - ANSWER -List of checks deposited in the bank that need to be posted in the system, Matched against remittance file from the payer Billed Amount (Posting Term) - ANSWER -The total of all charges on the claim. Sent on the claim to the payer. Allowed Amount (Posting Term) - ANSWER -The maximum reimbursement calculated. Comes from the payer's remittance & your contract Not Allowed Amount (Posting Term) - ANSWER -The difference between billed and allowed amounts. Written off as contractual adjustment Paid Amount (Posting Term) - ANSWER -The total amount paid by the payer for the claim. Posted as a payment Patient Responsibility (Posting Term) - ANSWER -The amount passed on to the patient. NRP to self-pay (or secondary coverage) Reason Codes - ANSWER -indicate why a payer is not paying an amount on the claim for example, denying a claim Follow-Up Record - ANSWER -Flag on an insurance bucket based on payer's response What are the 3 Follow-Up record types? - ANSWER -Underpayment, Overpayment and Denial Billed Amount (Contracts Term) - ANSWER -Total of charges on the claim sent to the payer Expected Amount (Contracts Term) - ANSWER -Maximum expected reimbursement calculated by the contract build in Epic Allowed Amount (Contract term) - ANSWER -Maximum reimbursement calculated by the payer, coming from the payer's remittance Paid Amount (Contract Term) - ANSWER -Total amount paid by the payer for that claim, coming from the payer's remittance Variance occurs when... - ANSWER -When the allowed amount differs from the expected amount Post Type - ANSWER -Defines the distribution method for the payment (which HARs get money first) HAR - ANSWER -Stores all HB charges, payments, and adjustments for a patient's encounter Min Days - ANSWER -Minimum number of days between discharge and initiate billing Initiate Billing - ANSWER -Moment we attempt to assign liability for the balance of the HAR Open Status - ANSWER -All hospital accounts start in this status DNB - ANSWER -Edit checks run during this time. Allows for Min Days to occur Billed - ANSWER -Successfully initiated billing Closed - ANSWER -Balance is $0 Liability Buckets - ANSWER -Assign and track financial liability for an HB HAR throughout the revenue cycle Created - ANSWER -All buckets start in this status. No communication Outstanding - ANSWER -Balance has been communicated and the claim or statement has been sent Closed Status - ANSWER -No balance exists on the bucket Workqueue - ANSWER -Worklist that identifies HARs, transactions, or claims that need manual review. Candidate for Billing (CFB) - ANSWER -Accounts Receivable dollars held in the system due to Charge Review, DNB Errors, Stop Bills, Claim Errors. etc. Money you could be asking someone to pay but are not. Contact Serial Number (CSN) - ANSWER -A visit or admission specific identifier Charge Router - ANSWER -Checks charges for errors Clinical Workflow - ANSWER -Majority of hospital charges in EPIC are generated through Tx Inquiry - ANSWER -Shows all financial details Account Summary - ANSWER -Shows the general overview of the patient Status Summary - ANSWER -Shows all errors in the patient's account