EPIC RHB100: RESOLUTE HOSPITAL BILLING
FUNDAMENTALS
Hospital Billing Accounts Receivable (HB HAR) - Answers - stores all HB charges,
payments and adjustments (transactions) for an encounter
Min Days - Answers - Minimum number of days between discharge and when we
attempt to bill the HAR
Initiate Billing - Answers - moment we attempt to assign liability for the balance of the
HAR
Open Status - Answers - the status that every HAR is in when created through the
duration of a patient's care
Single Billing Office - Answers - a revenue cycle that combines workflows that target the
guarantor or self-pay area
Type - Answers - a field that describes how the HAR is used; either recurring or non-
recurring
Base Class - Answers - a field that groups standard hospital accounts into one of 3
classes including inpatient, outpatient and emergency
Account Class - Answers - a field assigned to an HAR based on the patient class of
encounter
Financial Class - Answers - a field assigned to an HB HAR determined by the primary
coverage for the HAR
Connect Partnerships - Answers - allow healthcare providers and organizations to
combine resources and expertise to provide patient care
Liability Buckets - Answers - assign and track financial liability for an HB HAR
Pre-Billed - Answers - liability bucket that holds charges before they are assigned to
another bucket
Insurance - Answers - the liability bucket that holds charges, payments and adjustments
assigned to specific insurance
Self-Pay - Answers - liability bucket that holds charges, payments, and adjustments
assigned to the guarantor
, Created - Answers - the starting bucket status at which point no communication of
liability has occurred
Outstanding - Answers - bucket status indicating the balance of a bucket has been
communicated through a claim or a statement
Closed - Answers - the bucket status indicating that no balance exists in the bucket
Workqueues - Answers - worklists that identify HARs, transactions or claims that need
manual review
Candidate for Billing (CFB) - Answers - accounts receivable dollars held in the system
due to DNB errors, Stop Bills, Claim Errors, Late Charges, etc.
Billing Activity - Answers - a group of actions that can be used to complete workflows in
the system
Patient Responsibility - Answers - the portion of the balance that the guarantor will be
responsible for in self-pay
Copay - Answers - the flat fee the patient pays, usually at the time services are
rendered
Coinsurance - Answers - percentage of a cost of a procedure or visit which the patient is
expected to pay
Deductible - Answers - amount of money patients must pay each year to cover medical
care expenses before health insurance starts paying
Non-covered services - Answers - services not covered by a patient's insurance
Pre-admission - Answers - the process of gathering important information prior to a
patient's arrival at the hospital
Coverage (CVG) Master File - Answers - represent a subscriber's insurance paying for
visit charges
Guarantor (EAR) Master File - Answers - represents the entity ultimately responsible for
payments
Patient (EPT) Master File - Answers - the number assigned to every patient encounter
that is connected to the HAR for that encounter
Charge Router - Answers - Epic's tool for finding problems with a charge and
determining the appropriate route for a charge when it is generated
FUNDAMENTALS
Hospital Billing Accounts Receivable (HB HAR) - Answers - stores all HB charges,
payments and adjustments (transactions) for an encounter
Min Days - Answers - Minimum number of days between discharge and when we
attempt to bill the HAR
Initiate Billing - Answers - moment we attempt to assign liability for the balance of the
HAR
Open Status - Answers - the status that every HAR is in when created through the
duration of a patient's care
Single Billing Office - Answers - a revenue cycle that combines workflows that target the
guarantor or self-pay area
Type - Answers - a field that describes how the HAR is used; either recurring or non-
recurring
Base Class - Answers - a field that groups standard hospital accounts into one of 3
classes including inpatient, outpatient and emergency
Account Class - Answers - a field assigned to an HAR based on the patient class of
encounter
Financial Class - Answers - a field assigned to an HB HAR determined by the primary
coverage for the HAR
Connect Partnerships - Answers - allow healthcare providers and organizations to
combine resources and expertise to provide patient care
Liability Buckets - Answers - assign and track financial liability for an HB HAR
Pre-Billed - Answers - liability bucket that holds charges before they are assigned to
another bucket
Insurance - Answers - the liability bucket that holds charges, payments and adjustments
assigned to specific insurance
Self-Pay - Answers - liability bucket that holds charges, payments, and adjustments
assigned to the guarantor
, Created - Answers - the starting bucket status at which point no communication of
liability has occurred
Outstanding - Answers - bucket status indicating the balance of a bucket has been
communicated through a claim or a statement
Closed - Answers - the bucket status indicating that no balance exists in the bucket
Workqueues - Answers - worklists that identify HARs, transactions or claims that need
manual review
Candidate for Billing (CFB) - Answers - accounts receivable dollars held in the system
due to DNB errors, Stop Bills, Claim Errors, Late Charges, etc.
Billing Activity - Answers - a group of actions that can be used to complete workflows in
the system
Patient Responsibility - Answers - the portion of the balance that the guarantor will be
responsible for in self-pay
Copay - Answers - the flat fee the patient pays, usually at the time services are
rendered
Coinsurance - Answers - percentage of a cost of a procedure or visit which the patient is
expected to pay
Deductible - Answers - amount of money patients must pay each year to cover medical
care expenses before health insurance starts paying
Non-covered services - Answers - services not covered by a patient's insurance
Pre-admission - Answers - the process of gathering important information prior to a
patient's arrival at the hospital
Coverage (CVG) Master File - Answers - represent a subscriber's insurance paying for
visit charges
Guarantor (EAR) Master File - Answers - represents the entity ultimately responsible for
payments
Patient (EPT) Master File - Answers - the number assigned to every patient encounter
that is connected to the HAR for that encounter
Charge Router - Answers - Epic's tool for finding problems with a charge and
determining the appropriate route for a charge when it is generated
