EPIC RHB390 EXAM QUESTIONS AND CORRECT ANSWERS
When care cbuckets ccreated? c- cCORRECT cANS✔✔Pre-billed cand cself-pay care ccreated cautomatically cwhen cHAR cis ccreated. c
Insurance cBuckets care ccreated cwhen cINITIATE cBILLING cis csuccessful cand cthere cis ca ccoverage crecord cvalid cfor cthe
cencounter.
Bucket cTypes c- cCORRECT cANS✔✔PRE-BILLED
INSURANCE c
SELF-PAY
How care cbuckets cused cin cthe crevenue ccycle? c- cCORRECT cANS✔✔They cassign cand ctrack cfinancial cliability cfor can cHB cHAR
Hospital cAccount cStatuses c- cCORRECT cANS✔✔Open, cDNB c(discharged cnot cbilled), cBilled, cClosed
Hospital cAccount c(HAR) c- cCORRECT cANS✔✔HARs cstore call cHB ccharges, cpayments, cand cadjustments cfor can cencounter
Min cDays c- cCORRECT cANS✔✔Minimum cnumber cof cdays cbetween cdischarge cand cwhen cwe cattempt cto cassign cliability cfor
cthe cHB cHAR
Initiate cBilling c- cCORRECT cANS✔✔The cpoint cin cthe cRevenue cCycle cwhen cwe cattempt cto cbill cthe cHAR
Bucket cstatuses c- cCORRECT cANS✔✔Created
Outstanding
Closed
What cholds cthe chospital ccharges cfor ca chospital-based cencounter?
A. cGuarantor caccount
B. cCoverage crecord
C. cHospital caccount c- cCORRECT cANS✔✔C. cHospital caccount
True cor cFalse: cAll cliability cbuckets care ccreated cwhen cyou cinitiate cbilling con cthe chospital caccount. c- cCORRECT
cANS✔✔False. cThe cSelf-pay cand cPre-billed cbuckets care ccreated cwhen cthe chospital caccount cis ccreated. cThe cprimary
cinsurance cbucket cis ccreated cwhen cyou cinitiate cbilling. cNon-primary cinsurance cbuckets care ccreated cafter can cNRP c(next
cresponsible cparty) caction cperformed con cthe cprevious cinsurance cbucket.
A chospital caccount cmust chave ca cstatus cof cwhat cto cbe cconsidered cfor cclaims cprocessing? cChose conly cONE canswer.
A. cOpen
B. cCreated
C. cDNB
D. cBilled
E. cOutstanding
F. cClosed c- cCORRECT cANS✔✔D. cBilled
Allowed cAmount c- cCORRECT cANS✔✔the ctotal camount callowed cas csent cby cthe cpayer
Expected cAmount c- cCORRECT cANS✔✔the ctotal camount callowed cas ccalculated cby cyour ccontract
Follow-up cRecords c- cCORRECT cANS✔✔When cyou creceive cremittance cfrom ca cpayer, cunderpayments,
overpayments, cand cdenials care cautomatically cflagged cby cthe csystem
Contractual cvariance c- cCORRECT cANS✔✔Caused cby ca cdifference cbetween cthe cALLOWED cand cEXPECTED camounts.
Posted cWrite-off c- cCORRECT cANS✔✔Contractual cadjustment ctaken.
When cconfiguring ccontractual cwrite-offs, cwhat care ctwo cthings cthat cneed cto cbe cconsidered c- cCORRECT cANS✔✔1. cWhen cto
cpost cthe cwrite-off
2. cWhat cwrite-off cto cpost
, Write-Off cExpected c- cCORRECT cANS✔✔Posts cthe cwrite-off caccording cto cthe ccontract cin cEpic. c(trust cus)
Write-Off cPayer c- cCORRECT cANS✔✔Posts cthe cwrite-off caccording cto cthe cpayer. c(trust cthem)
Suppress cWrite-off c- cCORRECT cANS✔✔No ccontractual cadjustment cis cposted. cAdjustment cmust cbe cmade cmanually cby ca
cuser. c(trust cno-one)
Write-Off cExpected
and cVariance
Separately c- cCORRECT cANS✔✔Total cwrite-off cbased con cpayer camount, cbut cbroken cinto:
cExpected cwrite-off
cVariance cbetween cexpected cand callowed
(trust cboth)
NRP c- cCORRECT cANS✔✔next cresponsible cparty
Full cNRP c- cCORRECT cANS✔✔Performs can cNRP caction, cwhich cmoves cthe centire cremaining cbalance cto cthe cnext
cresponsible cparty.
No cNRP c(None) c- cCORRECT cANS✔✔Suppresses cNRP. cDoes cnot cperform cthe cNRP caction.
Accelerated cNRP c- cCORRECT cANS✔✔Performs can caccelerated cNRP caction, cwhich cmoves conly cthe cpatient
responsibility cto cthe cnext cresponsible cparty.
Follow-up cRecord c- cCORRECT cANS✔✔Generated cupon cposting cvariances, cbased con cthe cpayers cresponse cto ca cclaim.
cRequires cmanual cfollow-up, cunderpayments. cOverpayments, cand cdenials care cautomatically cflagged cby csystem
ENVIRONMENT c- cCORRECT cANS✔✔- cA cseries cof csoftware cprograms cthat ccontract cbuilders cuse.
POC c- cCORRECT cANS✔✔- cProof cOf cConcept c- cenvironment cused cto ccomplete cinitial cbuild cby ccreated cor cediting crecords.
BLD c- cCORRECT cANS✔✔-
TST c- cCORRECT cANS✔✔- ctest cenvironment cconfigured cto cclosely csimulate cPRD, cused cto ctest cbuild cbefore csending cto
cPRD
PRD c- cCORRECT cANS✔✔- cProduction cfinal clive cenvironment cwhere call cend cusers cdo ctheir cwork.
SUP c- cCORRECT cANS✔✔(Support) c- caccessed cfor ctrouble-shooting cproduction cissues. cProduced cas ca cnightly ccopy cof cPRD
cused cto ctest cbuild con creal cpatient cdata cbefore cit cis cmigrated cto cPRD
DATA cCURIER c- cCORRECT cANS✔✔migration ctool cto cmove cdata cbetween cenvironments
6. cRESOLUTE cHOSPITAL cBILLING cCONTRACT cTRACKER c- cCORRECT cANS✔✔planning ctool cin cGalaxy chelps cyou
cprioritize cthe cbuild crequired cand ctimelines cbased con cyour cavailable cresources
COMPONENT c- cCORRECT cANS✔✔- cgroup cof cthings cthat chave ccontact cdates cand ccan cbe creused
COMPONENT cGROUP c- cCORRECT cANS✔✔- cgroup cof ctwo cor cmore ccomponents.
Payment cmechanism c- cCORRECT cANS✔✔determines creimbursement cfor cservices; chow cthe cexpected creimbursement cis
ccalculated cbased con cfactors csuch cas ca cfee cschedule cor c% cof cbilled.
CONTACT c- cCORRECT cANS✔✔- ceffective cdates cfor cthe cinformation ccontained cin cthe ccontract. cWhen ca cpayer cmakes can
cupdate cto cthe cterms, cyou cdo cNOT cmake ca cnew ccontract, cyou ccreate ca cnew ccontact con cthe cexisting ccontract cand cupdate
cthe cterms. cThis callows cfor chistorical creference cof cterms cand cthe cmaintenance cof cfuture cterms cthat cthe csystem ccan
cautomatically capply cto cthe cappropriate cclaims
True cor cFalse: cA ccontractual cvariance cin cEpic cis cdefined cas cthe cdifference cbetween cthe cexpected creimbursement camount
cand cthe cpaid camount cfrom cthe cpayer. c- cCORRECT cANS✔✔False. cA cvariance cis cthe cdifference cbetween cthe cexpected
camount cand cthe callowed camount.
True cor cFalse: cWhen cwork con ca cfollow-up crecord cis ccomplete, cyou cshould cdelete cthe cfollow-up crecord. c- cCORRECT
cANS✔✔False; ca cfollow-up crecord ccan cbe cclosed cto cindicate cthat cthe cissue chas cbeen cresolved, cbut cit ccannot cbe cdeleted.
True cor cFalse: cA cfollow-up crecord cthat chas cbeen ccompleted ccan calways cbe cre-opened. c- cCORRECT cANS✔✔True. cFollow-
up crecords ccan cbe cre-opened cmanually cby ca cuser cor cautomatically cby cthe csystem c(example: cthe
payer crecoups cand cthe ccorrection ccauses ca cnew cvariance).
True cor cFalse: cThe cRe-evaluate cexpected creimbursement coption cfrom cthe cbucket caction cbutton cis ca creal-time cprocess,
cmeaning cit cwill crun cthe cclaim cthrough cthe ccontract cwhen cyou cperform cthe caction. c- cCORRECT cANS✔✔True.
Jenny crecently creceived ccare cat cyour corganization. cBased con cyour ccontract, cAcme cInsurance
owes c$1305.50 cfor cJenny's ccare. cHowever, cwhen cAcme csends cpayment, cthey csend conly c$1200.
This c$1200 cwould cbe cdefined cas cwhich cof cthe cfollowing? cChose conly cONE canswer.
When care cbuckets ccreated? c- cCORRECT cANS✔✔Pre-billed cand cself-pay care ccreated cautomatically cwhen cHAR cis ccreated. c
Insurance cBuckets care ccreated cwhen cINITIATE cBILLING cis csuccessful cand cthere cis ca ccoverage crecord cvalid cfor cthe
cencounter.
Bucket cTypes c- cCORRECT cANS✔✔PRE-BILLED
INSURANCE c
SELF-PAY
How care cbuckets cused cin cthe crevenue ccycle? c- cCORRECT cANS✔✔They cassign cand ctrack cfinancial cliability cfor can cHB cHAR
Hospital cAccount cStatuses c- cCORRECT cANS✔✔Open, cDNB c(discharged cnot cbilled), cBilled, cClosed
Hospital cAccount c(HAR) c- cCORRECT cANS✔✔HARs cstore call cHB ccharges, cpayments, cand cadjustments cfor can cencounter
Min cDays c- cCORRECT cANS✔✔Minimum cnumber cof cdays cbetween cdischarge cand cwhen cwe cattempt cto cassign cliability cfor
cthe cHB cHAR
Initiate cBilling c- cCORRECT cANS✔✔The cpoint cin cthe cRevenue cCycle cwhen cwe cattempt cto cbill cthe cHAR
Bucket cstatuses c- cCORRECT cANS✔✔Created
Outstanding
Closed
What cholds cthe chospital ccharges cfor ca chospital-based cencounter?
A. cGuarantor caccount
B. cCoverage crecord
C. cHospital caccount c- cCORRECT cANS✔✔C. cHospital caccount
True cor cFalse: cAll cliability cbuckets care ccreated cwhen cyou cinitiate cbilling con cthe chospital caccount. c- cCORRECT
cANS✔✔False. cThe cSelf-pay cand cPre-billed cbuckets care ccreated cwhen cthe chospital caccount cis ccreated. cThe cprimary
cinsurance cbucket cis ccreated cwhen cyou cinitiate cbilling. cNon-primary cinsurance cbuckets care ccreated cafter can cNRP c(next
cresponsible cparty) caction cperformed con cthe cprevious cinsurance cbucket.
A chospital caccount cmust chave ca cstatus cof cwhat cto cbe cconsidered cfor cclaims cprocessing? cChose conly cONE canswer.
A. cOpen
B. cCreated
C. cDNB
D. cBilled
E. cOutstanding
F. cClosed c- cCORRECT cANS✔✔D. cBilled
Allowed cAmount c- cCORRECT cANS✔✔the ctotal camount callowed cas csent cby cthe cpayer
Expected cAmount c- cCORRECT cANS✔✔the ctotal camount callowed cas ccalculated cby cyour ccontract
Follow-up cRecords c- cCORRECT cANS✔✔When cyou creceive cremittance cfrom ca cpayer, cunderpayments,
overpayments, cand cdenials care cautomatically cflagged cby cthe csystem
Contractual cvariance c- cCORRECT cANS✔✔Caused cby ca cdifference cbetween cthe cALLOWED cand cEXPECTED camounts.
Posted cWrite-off c- cCORRECT cANS✔✔Contractual cadjustment ctaken.
When cconfiguring ccontractual cwrite-offs, cwhat care ctwo cthings cthat cneed cto cbe cconsidered c- cCORRECT cANS✔✔1. cWhen cto
cpost cthe cwrite-off
2. cWhat cwrite-off cto cpost
, Write-Off cExpected c- cCORRECT cANS✔✔Posts cthe cwrite-off caccording cto cthe ccontract cin cEpic. c(trust cus)
Write-Off cPayer c- cCORRECT cANS✔✔Posts cthe cwrite-off caccording cto cthe cpayer. c(trust cthem)
Suppress cWrite-off c- cCORRECT cANS✔✔No ccontractual cadjustment cis cposted. cAdjustment cmust cbe cmade cmanually cby ca
cuser. c(trust cno-one)
Write-Off cExpected
and cVariance
Separately c- cCORRECT cANS✔✔Total cwrite-off cbased con cpayer camount, cbut cbroken cinto:
cExpected cwrite-off
cVariance cbetween cexpected cand callowed
(trust cboth)
NRP c- cCORRECT cANS✔✔next cresponsible cparty
Full cNRP c- cCORRECT cANS✔✔Performs can cNRP caction, cwhich cmoves cthe centire cremaining cbalance cto cthe cnext
cresponsible cparty.
No cNRP c(None) c- cCORRECT cANS✔✔Suppresses cNRP. cDoes cnot cperform cthe cNRP caction.
Accelerated cNRP c- cCORRECT cANS✔✔Performs can caccelerated cNRP caction, cwhich cmoves conly cthe cpatient
responsibility cto cthe cnext cresponsible cparty.
Follow-up cRecord c- cCORRECT cANS✔✔Generated cupon cposting cvariances, cbased con cthe cpayers cresponse cto ca cclaim.
cRequires cmanual cfollow-up, cunderpayments. cOverpayments, cand cdenials care cautomatically cflagged cby csystem
ENVIRONMENT c- cCORRECT cANS✔✔- cA cseries cof csoftware cprograms cthat ccontract cbuilders cuse.
POC c- cCORRECT cANS✔✔- cProof cOf cConcept c- cenvironment cused cto ccomplete cinitial cbuild cby ccreated cor cediting crecords.
BLD c- cCORRECT cANS✔✔-
TST c- cCORRECT cANS✔✔- ctest cenvironment cconfigured cto cclosely csimulate cPRD, cused cto ctest cbuild cbefore csending cto
cPRD
PRD c- cCORRECT cANS✔✔- cProduction cfinal clive cenvironment cwhere call cend cusers cdo ctheir cwork.
SUP c- cCORRECT cANS✔✔(Support) c- caccessed cfor ctrouble-shooting cproduction cissues. cProduced cas ca cnightly ccopy cof cPRD
cused cto ctest cbuild con creal cpatient cdata cbefore cit cis cmigrated cto cPRD
DATA cCURIER c- cCORRECT cANS✔✔migration ctool cto cmove cdata cbetween cenvironments
6. cRESOLUTE cHOSPITAL cBILLING cCONTRACT cTRACKER c- cCORRECT cANS✔✔planning ctool cin cGalaxy chelps cyou
cprioritize cthe cbuild crequired cand ctimelines cbased con cyour cavailable cresources
COMPONENT c- cCORRECT cANS✔✔- cgroup cof cthings cthat chave ccontact cdates cand ccan cbe creused
COMPONENT cGROUP c- cCORRECT cANS✔✔- cgroup cof ctwo cor cmore ccomponents.
Payment cmechanism c- cCORRECT cANS✔✔determines creimbursement cfor cservices; chow cthe cexpected creimbursement cis
ccalculated cbased con cfactors csuch cas ca cfee cschedule cor c% cof cbilled.
CONTACT c- cCORRECT cANS✔✔- ceffective cdates cfor cthe cinformation ccontained cin cthe ccontract. cWhen ca cpayer cmakes can
cupdate cto cthe cterms, cyou cdo cNOT cmake ca cnew ccontract, cyou ccreate ca cnew ccontact con cthe cexisting ccontract cand cupdate
cthe cterms. cThis callows cfor chistorical creference cof cterms cand cthe cmaintenance cof cfuture cterms cthat cthe csystem ccan
cautomatically capply cto cthe cappropriate cclaims
True cor cFalse: cA ccontractual cvariance cin cEpic cis cdefined cas cthe cdifference cbetween cthe cexpected creimbursement camount
cand cthe cpaid camount cfrom cthe cpayer. c- cCORRECT cANS✔✔False. cA cvariance cis cthe cdifference cbetween cthe cexpected
camount cand cthe callowed camount.
True cor cFalse: cWhen cwork con ca cfollow-up crecord cis ccomplete, cyou cshould cdelete cthe cfollow-up crecord. c- cCORRECT
cANS✔✔False; ca cfollow-up crecord ccan cbe cclosed cto cindicate cthat cthe cissue chas cbeen cresolved, cbut cit ccannot cbe cdeleted.
True cor cFalse: cA cfollow-up crecord cthat chas cbeen ccompleted ccan calways cbe cre-opened. c- cCORRECT cANS✔✔True. cFollow-
up crecords ccan cbe cre-opened cmanually cby ca cuser cor cautomatically cby cthe csystem c(example: cthe
payer crecoups cand cthe ccorrection ccauses ca cnew cvariance).
True cor cFalse: cThe cRe-evaluate cexpected creimbursement coption cfrom cthe cbucket caction cbutton cis ca creal-time cprocess,
cmeaning cit cwill crun cthe cclaim cthrough cthe ccontract cwhen cyou cperform cthe caction. c- cCORRECT cANS✔✔True.
Jenny crecently creceived ccare cat cyour corganization. cBased con cyour ccontract, cAcme cInsurance
owes c$1305.50 cfor cJenny's ccare. cHowever, cwhen cAcme csends cpayment, cthey csend conly c$1200.
This c$1200 cwould cbe cdefined cas cwhich cof cthe cfollowing? cChose conly cONE canswer.
