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EPIC COG230 Revenue Data Model /Questions And Answers Graded (A+)
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EPIC COG230 Revenue Data Model /Questions And Answers Graded (A+)
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EPIC COG230 Revenue Data Model /Questions AndAnswers Graded (A+)
Quiz :Accounts Receivable - Answer :Outstanding money we expect to receive
in the future
Quiz :Three Transaction Types: - Answer :Charges
Payments
Adjustments
Quiz :Charges occur as a result of: - Answer :Performing services
Quiz :Payments are a result of: - Answer :Receiving money
Quiz :What are adjustments? - Answer :Anything that changes AR (Credit
Adjustments or Debit Adjustments)
Quiz :An example of a credit adjustment is: - Answer :Contractual write-offs
Quiz :An example of a debit adjustment is: - Answer :A refund
Quiz :Debits _______ AR - Answer :Increase (Charges and Debit Adjustments)
Quiz :Credits ________ AR - Answer :Decrease (Payments and Credit
Adjustments)
Quiz :What is the function of a Hospital Account (HAR)? - Answer :Collects
transactions related to an encounter and centralizes encounters, transactions,
insurance, etc.
Quiz :Insurance coverage, is a unique combination of what 3 things? -
Answer :Payer
Plan
Subscriber
Quiz :What is an insurance payer? - Answer :The insurance company
Quiz :What is an insurance plan? - Answer :The set of benefits a patient
receives
,Quiz :What is an insurance subsriber? - Answer :The policy holder
Quiz :What is a guarantor? - Answer :The person ultimately responsible for
payment. This could be the patient or someone else (ie. the subscriber)
Quiz :Who is the insurance member? - Answer :The member is who the
insurance coverage is for. For example, if a subscriber has children. The
children are members of the subscriber's plan.
Quiz :If a patient has multiple coverages, the order in which they are billed is
called the: - Answer :Filing Order
Quiz :True or False
Every Hospital Account must be connected to a guarantor - Answer :True
Quiz :True or False
Every PB Transaction must be connected to a guarantor - Answer :True
Quiz :What are the two hospital applications used to track billing? -
Answer :1. Resolute Professional Billing
2. Resolute Hospital Billing
Quiz :What services do Professional Billing cover? - Answer :Services
performed by clinicians in inpatient or outpatient settings
Quiz :What services do Hospital Billing cover? - Answer :Services and supplies
related to hospital encounters, including: medications, lab charges, imaging,
room and bed charges and more.
Quiz :True or False
Hospital Billing doesn't need to achieve the level of granularity that
Professional Billing needs and does not need to match every payment to each
charge - Answer :True
Quiz :PB transactions are stored in the ___ master file - Answer :ETR
Quiz :HB transactions are stored in the ___ master file - Answer :HTR
Quiz :Which system did EPIC have early on in its' development, Professional or
Hospital Billing? - Answer :Professional Billing
, Quiz :What is the purpose of a Single Billing Office (SBO)? - Answer :SBO is a
billing mode that combines HB and PB balances into a single guarantor
statement. Thus, creating simpler statements for easier management for
guarantors.
Quiz :Diakeishaye goes to the doctor for a physical. This generates one charge
for $50. A claim is sent to Aetna, which sends a check for $35, saying there is a
$5 patient portion. $10 gets written off, and the rest is sent to Diakeishaye's
mother, Leslie, who sends in a check two days later
Which transactions occurred? - Answer :One charge, two payments, one credit
adjustment
Quiz :Diakeishaye goes to the doctor for a physical. This generates one charge
for $50. A claim is sent to Aetna, which sends a check for $35, saying there is a
$5 patient portion. $10 gets written off, and the rest is sent to Diakeishaye's
mother, Leslie, who sends in a check two days later
Which billing system is this likely being tracked in? - Answer :Professional
Quiz :Diakeishaye goes to the doctor for a physical. This generates one charge
for $50. A claim is sent to Aetna, which sends a check for $35, saying there is a
$5 patient portion. $10 gets written off, and the rest is sent to Diakeishaye's
mother, Leslie, who sends in a check two days later
Who is the guarantor? - Answer :Leslie
Quiz :Diakeishaye goes to the doctor for a physical. This generates one charge
for $50. A claim is sent to Aetna, which sends a check for $35, saying there is a
$5 patient portion. $10 gets written off, and the rest is sent to Diakeishaye's
mother, Leslie, who sends in a check two days later
Who is likely the subscriber of the coverage? - Answer :Leslie
Quiz :Which tables contain guarantor information in Caboodle and in Clarity? -
Answer :Clarity: ACCOUNT
Caboodle: GuarantorDim
Quiz :What are the four separate guarantor balances? - Answer :Total Balance
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