HB390 EPIC CERTIFICATION EXAM 2026: 100+
QUESTIONS AND 100% VERIFIED ANSWERS |
GRADED A+ | GUARANTEED PASS!!
1. Which of the following correctly defines contract modeling as it is performed in
Epic? Choose only ONE answer:
A. Taking expected reimbursement information and comparing it against predicted
future patient data.
B. Comparing changes to the actual contract against predicted future patient data.
C. Comparing price changes against payer billed estimates for the upcoming fiscal
year.
D. Taking changes to the contract or pricing data and comparing it against
historical claims data already in the system.
- answer-D. Taking changes to the contract or pricing data and comparing it
against historical claims data already in the system.
A certain contract term that you are building only applies for inpatient claims.
What type of extension will you need to build this contract line?
A. Selection
B. Pricing
C. Stopping
D. Group
- answer-A. Selection
A contract term states that implant charges are reimbursed at 90% only if the total
amount of charges for implants exceeds $2,000. Otherwise implants are not
reimbursed. What type of extension do you need to build this into your contract?
A. Selection
B. Pricing
C. Stopping
D. Group
- answer-A. Selection
,The term "Implant charges over $2,000" determines which claims and which
services on that claim are reimbursed (selection extension). It does not define how
they are reimbursed (pricing extension).
A hospital must have a status of what to be considered claims processing?
A. Open
B. Created
C. DNB
D. Billed
E. Outstanding
F. Closed
- answer-D. Billed
A negotiated contract term for your organization defines a service with both a
revenue code and a DRG code. Which of the following will you need to build to
define the service for this contract line?
Select all that apply.
A. Component
B. Component Group
C. Stopping Condition
D. Payment Mechanism
- answer-A. Component
B. Component Group
Access and edit a Locale record
- answer-1. Access Text.
2. Select Resolute Hospital Billing.
3. Press ENTER to select the default department.
4. Follow this path: Master File Maintenance > Medicare PPS Related > Locale
5. At the Locale prompt, type " Locale" and press ENTER.
6. Select the most recent contact by typing the Contact Number and press ENTER
7. Use PAGE DOWN to go to the Medicare IPPS Reimbursement Settings ‐
National screen.
8. Modify these values:
Labor related Std Amt: 4298.69
Labor related portion: 0.701
Nonlabor related Std Amt:
1833.54 Nonlabor related portion:
0.299 Fixed loss threshold: 26200.00
9. Press SHIFT + F7 to exit the locale record.
, Access and edit a pricing extension
- answer-1. In Classic, open the " HB XR ‐ Medicare IP IPPS" extension record.
2. With your extension open, click Edit on the bottom right of the screen.
3. Change the % of Reimbursement parameter to be "103.5".
4. Change the Locale parameter to be " Locale".
5. Click Accept.
Access the Contracts thread on the UserWeb
- answer-1. Log in to the UserWeb.
2. On the left side of your screen, under your photo, click in the Search bar under
the word Topics.
3. Search for "contracts".
4. The top search item is the Contracts thread. Click it
5. On the top of your screen click the Follow star to turn it yellow
Access the Medicare IPPS Toolkit on the UserWeb
- answer-1. Log in to the UserWeb.
2. On the left side of your screen, under your photo, click in the Search bar under
the word Topics.
3. Search for "contracts".
4. The top search item is the Contracts thread. Click it
5. On the top of your screen click the Follow star to turn it yellow
APC
- answer-Ambulatory payment classification; A payment methodology in which
services paid under the prospective payment system are classified into groups that
are similar clinically and in terms of the resources they require; a payment rate is
established for each APC.
APC Grouping is done directly in Epic. The base information comes from CMS as
Addendum B. The information from this file can be turned into an import for the
PCM ﴾payment classification mapping﴿ Masterfile.
Batch Scheduler
- answer-Reevaluation is not real‐time; the report and any actions are taken
overnight using a batch job in the Batch Scheduler. You will find the report the
next day in Reporting Workbench.
QUESTIONS AND 100% VERIFIED ANSWERS |
GRADED A+ | GUARANTEED PASS!!
1. Which of the following correctly defines contract modeling as it is performed in
Epic? Choose only ONE answer:
A. Taking expected reimbursement information and comparing it against predicted
future patient data.
B. Comparing changes to the actual contract against predicted future patient data.
C. Comparing price changes against payer billed estimates for the upcoming fiscal
year.
D. Taking changes to the contract or pricing data and comparing it against
historical claims data already in the system.
- answer-D. Taking changes to the contract or pricing data and comparing it
against historical claims data already in the system.
A certain contract term that you are building only applies for inpatient claims.
What type of extension will you need to build this contract line?
A. Selection
B. Pricing
C. Stopping
D. Group
- answer-A. Selection
A contract term states that implant charges are reimbursed at 90% only if the total
amount of charges for implants exceeds $2,000. Otherwise implants are not
reimbursed. What type of extension do you need to build this into your contract?
A. Selection
B. Pricing
C. Stopping
D. Group
- answer-A. Selection
,The term "Implant charges over $2,000" determines which claims and which
services on that claim are reimbursed (selection extension). It does not define how
they are reimbursed (pricing extension).
A hospital must have a status of what to be considered claims processing?
A. Open
B. Created
C. DNB
D. Billed
E. Outstanding
F. Closed
- answer-D. Billed
A negotiated contract term for your organization defines a service with both a
revenue code and a DRG code. Which of the following will you need to build to
define the service for this contract line?
Select all that apply.
A. Component
B. Component Group
C. Stopping Condition
D. Payment Mechanism
- answer-A. Component
B. Component Group
Access and edit a Locale record
- answer-1. Access Text.
2. Select Resolute Hospital Billing.
3. Press ENTER to select the default department.
4. Follow this path: Master File Maintenance > Medicare PPS Related > Locale
5. At the Locale prompt, type " Locale" and press ENTER.
6. Select the most recent contact by typing the Contact Number and press ENTER
7. Use PAGE DOWN to go to the Medicare IPPS Reimbursement Settings ‐
National screen.
8. Modify these values:
Labor related Std Amt: 4298.69
Labor related portion: 0.701
Nonlabor related Std Amt:
1833.54 Nonlabor related portion:
0.299 Fixed loss threshold: 26200.00
9. Press SHIFT + F7 to exit the locale record.
, Access and edit a pricing extension
- answer-1. In Classic, open the " HB XR ‐ Medicare IP IPPS" extension record.
2. With your extension open, click Edit on the bottom right of the screen.
3. Change the % of Reimbursement parameter to be "103.5".
4. Change the Locale parameter to be " Locale".
5. Click Accept.
Access the Contracts thread on the UserWeb
- answer-1. Log in to the UserWeb.
2. On the left side of your screen, under your photo, click in the Search bar under
the word Topics.
3. Search for "contracts".
4. The top search item is the Contracts thread. Click it
5. On the top of your screen click the Follow star to turn it yellow
Access the Medicare IPPS Toolkit on the UserWeb
- answer-1. Log in to the UserWeb.
2. On the left side of your screen, under your photo, click in the Search bar under
the word Topics.
3. Search for "contracts".
4. The top search item is the Contracts thread. Click it
5. On the top of your screen click the Follow star to turn it yellow
APC
- answer-Ambulatory payment classification; A payment methodology in which
services paid under the prospective payment system are classified into groups that
are similar clinically and in terms of the resources they require; a payment rate is
established for each APC.
APC Grouping is done directly in Epic. The base information comes from CMS as
Addendum B. The information from this file can be turned into an import for the
PCM ﴾payment classification mapping﴿ Masterfile.
Batch Scheduler
- answer-Reevaluation is not real‐time; the report and any actions are taken
overnight using a batch job in the Batch Scheduler. You will find the report the
next day in Reporting Workbench.
