Epic Resolute Hospital Billing Fundamentals – Exam Questions and Correct Answers (Graded A+ New Modified Exam)

Pass the Epic Resolute Hospital Billing Fundamentals exam on your first attempt with this comprehensive set of exam questions and verified correct answers graded A+. Covers hospital account structure (HAR stores all HB charges, payments, adjustments for a patient encounter; linked to one EPT and one EAR; assigns guarantor and payor), revenue cycle statuses (Open status for all new accounts; DNB period for edit checks and Min Days; Billed status after successful initiate billing; Closed status when balance is $0), billing holds (Stop Bill holds HB HAR in three places: Initiate Billing, Claims Processing, Statement Processing; can be placed manually or automatically), charge management (Revenue Guardian identifies HARs with missing charges; Charge Router checks charges for errors; Tx Inquiry shows all financial details; Account Summary shows general patient overview; Status Summary shows all errors; History shows all documented notes), coverage and claims (Coverage Manager controls which coverages attach to HB HAR; Claim Definition File/CDF formats claims and performs error checking), claim edits (User Error from end-user missing/incorrect information; Master File Error from missing/incorrect background build like NPIs, place of service codes, federal tax IDs), late charges (Late Replacement Claim creates new claim with new+old charges; Late Charge Claim creates claim with only late charges; Late Charge Write-Off writes off late charges without new claim; Late Charge Addition combines all charges on current claim, available only if late charges exist after account billed but before claim sent), outstanding claim resolution (No Response triggers claim aging to workqueue; Correct Payment records payment and reason codes; Denial creates follow-up record to workqueue; Variance occurs when allowed amount differs from expected amount based on contract), posting terminology (Billed Amount = total charges on claim; Allowed Amount = maximum reimbursement from payer's remittance; Not Allowed Amount = difference between billed and allowed written off as contractual adjustment; Paid Amount = total paid by payer; Patient Responsibility = amount passed to patient), cash management (handles bank reconciliation, creates cash records, puts cash into Cash Control Groups; Cash Control Groups list checks deposited that need posting, matched against remittance file), follow-up records (flag on insurance bucket based on payer response; three types: Underpayment, Overpayment, Denial), liability buckets (assign and track financial liability through revenue cycle: Created status initially, Outstanding after claim/statement sent, Closed when no balance exists), workqueue (worklist identifying HARs, transactions, or claims needing manual review), Candidate for Billing (CFB) (AR dollars held due to Charge Review, DNB errors, Stop Bills, Claim Errors; money not yet billed), CSN (Contact Serial Number as visit-specific identifier), clinical workflow (majority of hospital charges generated through clinical workflow in Epic), Min Days (minimum days between discharge and initiate billing), and contract terms (Billed Amount on claim, Expected Amount from contract build, Allowed Amount from payer, Paid Amount from remittance, Variance when allowed differs from expected, Post Type defines payment distribution method to HARs).