EPIC RHB390 QUESTIONS & ANSWERS
When are buckets created? - Answers - Pre-billed and self-pay are created
automatically when HAR is created.
Insurance Buckets are created when INITIATE BILLING is successful and there is a
coverage record valid for the encounter.
Bucket Types - Answers - PRE-BILLED
INSURANCE
SELF-PAY
How are buckets used in the revenue cycle? - Answers - They assign and track financial
liability for an HB HAR
Hospital Account Statuses - Answers - Open, DNB (discharged not billed), Billed,
Closed
Hospital Account (HAR) - Answers - HARs store all HB charges, payments, and
adjustments for an encounter
Min Days - Answers - Minimum number of days between discharge and when we
attempt to assign liability for the HB HAR
Initiate Billing - Answers - The point in the Revenue Cycle when we attempt to bill the
HAR
Bucket statuses - Answers - Created
Outstanding
Closed
What holds the hospital charges for a hospital-based encounter?
A. Guarantor account
B. Coverage record
C. Hospital account - Answers - C. Hospital account
True or False: All liability buckets are created when you initiate billing on the hospital
account. - Answers - False. The Self-pay and Pre-billed buckets are created when the
hospital account is created. The primary insurance bucket is created when you initiate
billing. Non-primary insurance buckets are created after an NRP (next responsible
party) action performed on the previous insurance bucket.
A hospital account must have a status of what to be considered for claims processing?
Chose only ONE answer.
A. Open
B. Created
, C. DNB
D. Billed
E. Outstanding
F. Closed - Answers - D. Billed
Allowed Amount - Answers - the total amount allowed as sent by the payer
Expected Amount - Answers - the total amount allowed as calculated by your contract
Follow-up Records - Answers - When you receive remittance from a payer,
underpayments,
overpayments, and denials are automatically flagged by the system
Contractual variance - Answers - Caused by a difference between the ALLOWED and
EXPECTED amounts.
Posted Write-off - Answers - Contractual adjustment taken.
When configuring contractual write-offs, what are two things that need to be considered
- Answers - 1. When to post the write-off
2. What write-off to post
Write-Off Expected - Answers - Posts the write-off according to the contract in Epic.
(trust us)
Write-Off Payer - Answers - Posts the write-off according to the payer. (trust them)
Suppress Write-off - Answers - No contractual adjustment is posted. Adjustment must
be made manually by a user. (trust no-one)
Write-Off Expected
and Variance
Separately - Answers - Total write-off based on payer amount, but broken into:
Expected write-off
Variance between expected and allowed
(trust both)
NRP - Answers - next responsible party
Full NRP - Answers - Performs an NRP action, which moves the entire remaining
balance to the next responsible party.
No NRP (None) - Answers - Suppresses NRP. Does not perform the NRP action.
Accelerated NRP - Answers - Performs an accelerated NRP action, which moves only
the patient
When are buckets created? - Answers - Pre-billed and self-pay are created
automatically when HAR is created.
Insurance Buckets are created when INITIATE BILLING is successful and there is a
coverage record valid for the encounter.
Bucket Types - Answers - PRE-BILLED
INSURANCE
SELF-PAY
How are buckets used in the revenue cycle? - Answers - They assign and track financial
liability for an HB HAR
Hospital Account Statuses - Answers - Open, DNB (discharged not billed), Billed,
Closed
Hospital Account (HAR) - Answers - HARs store all HB charges, payments, and
adjustments for an encounter
Min Days - Answers - Minimum number of days between discharge and when we
attempt to assign liability for the HB HAR
Initiate Billing - Answers - The point in the Revenue Cycle when we attempt to bill the
HAR
Bucket statuses - Answers - Created
Outstanding
Closed
What holds the hospital charges for a hospital-based encounter?
A. Guarantor account
B. Coverage record
C. Hospital account - Answers - C. Hospital account
True or False: All liability buckets are created when you initiate billing on the hospital
account. - Answers - False. The Self-pay and Pre-billed buckets are created when the
hospital account is created. The primary insurance bucket is created when you initiate
billing. Non-primary insurance buckets are created after an NRP (next responsible
party) action performed on the previous insurance bucket.
A hospital account must have a status of what to be considered for claims processing?
Chose only ONE answer.
A. Open
B. Created
, C. DNB
D. Billed
E. Outstanding
F. Closed - Answers - D. Billed
Allowed Amount - Answers - the total amount allowed as sent by the payer
Expected Amount - Answers - the total amount allowed as calculated by your contract
Follow-up Records - Answers - When you receive remittance from a payer,
underpayments,
overpayments, and denials are automatically flagged by the system
Contractual variance - Answers - Caused by a difference between the ALLOWED and
EXPECTED amounts.
Posted Write-off - Answers - Contractual adjustment taken.
When configuring contractual write-offs, what are two things that need to be considered
- Answers - 1. When to post the write-off
2. What write-off to post
Write-Off Expected - Answers - Posts the write-off according to the contract in Epic.
(trust us)
Write-Off Payer - Answers - Posts the write-off according to the payer. (trust them)
Suppress Write-off - Answers - No contractual adjustment is posted. Adjustment must
be made manually by a user. (trust no-one)
Write-Off Expected
and Variance
Separately - Answers - Total write-off based on payer amount, but broken into:
Expected write-off
Variance between expected and allowed
(trust both)
NRP - Answers - next responsible party
Full NRP - Answers - Performs an NRP action, which moves the entire remaining
balance to the next responsible party.
No NRP (None) - Answers - Suppresses NRP. Does not perform the NRP action.
Accelerated NRP - Answers - Performs an accelerated NRP action, which moves only
the patient
