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Billing Fundamentals > Chapters 11, 12, & 13 > Flashcards

Chapters 11, 12, & 13 Flashcards

1
Q

What is patient filing order?

A

Every coverage the patient has ever had. (Whether or not it is still active)

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2
Q

What is a Visit Filing Order?

A

Confirmation of correct insurance order by front desk at time of check in.

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3
Q

True or False: By accepting the filing order change in the work queue, you updated the filing order for all previous visits for the patient.

A

False, filing orders are specific for every visit

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4
Q

True or False: A line in a Retro Review work queue is a guarantor account.

A

False.

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5
Q

Which of the following can cause a visit to be evaluated in a Retro Review? Choose all that apply.
A. Adding a new coverage to the patients filing order
B. Creating a new patient
C. Removing a coverage
D. Changing the filing order on the patient

A

A. Adding a new coverage to the patients filing order

C. Removing a coverage

D. Changing the filing order on the patient

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6
Q

What are the 3 effects of accepting a statement run?

A
  1. Removes the run
  2. Stamps accounts with a statement date
  3. Can start the self aging process
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7
Q

What is a patient history score?

A

A patient history score summarizes whether a guarantor has historically paid off balances promptly. They are scored 1 (slow to pay balances) to 5 (quick to pay off balances).

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8
Q

True or False: the system can be configured to automatically create statement runs?

A

True

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9
Q

Which of the following is a purpose of the enterprise statement run report? Choose all that apply.
A. Reconciliation tool to compare where epic indicates was generated to what was actually generated
B. Reconciliation tool to compare what was sent to a print vendor and what the print vendor sends back in the receipt
C. Record of which guarantor accounts got a statement and which guarantor accounts did not get a statement, even though they qualified for the statement run
D. A tool used to determine which guarantors have never received a statement

A

A. Reconciliation tool to compare where epic indicates was generated to what was actually generated
B. Reconciliation tool to compare what was sent to a print vendor and what the print vendor sends back in the receipt
C. Record of which guarantor accounts got a statement and which guarantor accounts did not get a statement, even though they qualified for the statement run

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10
Q

True or False: non sufficient funds fees are matched to a specific transaction on an account.

A

False

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11
Q

True or False: The way to resolve a check with non-sufficient funds is to void the payment in the system.

A

False

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12
Q

To resolve the NSF payment, first locate the visit that contains the payment in Prof TX Inquiry. Then click the ____ button and select the _____ option.

A

Functions and Batch Adjustment Posting

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13
Q

True or False: The NSF payment reversal procedure is not matched to any transactions because it is a stand alone debit adjustment

A

False, the payment reversal is matched to the NSF payment.

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14
Q

True or False: The NSF fee procedure will not be matched to any transactions because it is a stand alone debit adjustment.

A

True

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15
Q

What do Credit Work queues contain?

A
  1. Overposted payments (ex. payment causing a credit balance on a charge; payer pays more than what was due)
  2. Undistributed Pre-Payment (ex. posted payment that is not fully attached to charges; pre-payment)
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16
Q

What is the function of the Foundation System?

A

It is configured to automate the resolution of most undistributed and overposted payments. These automatic activities are preformed as part of an overnight batch process.

17
Q

What are the steps to resolve undistributed credits?

A
  1. Check for outstanding balance
  2. Check for future balances (appts, charges in charge review, charges with ins balance)
  3. Refund the payment
18
Q

True or False: An undistributed payment is one that has not yet been posted to a guarantor account.

A

False. An undistributed payment is posted to a guarantor account. It just has not been matched to charges on that account.

Billing Fundamentals (9 decks)

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