Entering And Reviewing Charges Ch.4

Question 1

Manuel charge entry

Answer 1

Charge router
charge entry

Question 2

Epic clinical activity

Answer 2

Epic care and etc.

Question 3

Non-epic charging activity

Answer 3

Interface

Question 4

Route charges to billing and error checking

Answer 4

Charge router

Question 5

Physician fees is professional billing error checking

Answer 5

PB charge review WQ.
Pre AR

Question 6

Facility fees is Hospital billing error checking

Answer 6

HB charge review WQ

Pre AR

Question 7

PB charge review WQ sends to

Answer 7

Posted to guarantor account and send the claim to the insurance.

Active AR

Question 8

HP charge review WQ sends it to

Answer 8

Posted to hospital account.

Active AR
HAR encounter

Question 9

Manuel charge entry:

Answer 9

1) Some clinicians might not always do their documentation an epic. For example, they might be documenting in another hospital, EMR, and that Pb charges are built out of epic.

2) Clinicians perform services outside of place of service, such as nurse homes, community hospitals, and had in charge tickets or documentation from which staff enters charges.

3) charges might also be manually entered by analyzing a providers documentation to determine what services were performed.

4) during revenue cycle testing charges might be enter manually as a quick way to create a scenario to test a workflow or some system configuration.

For these reasons, staff will learn how to post charges manually using charge router charge entering .

Question 10

Procedure codes are used to define

Answer 10

What service a provider performed

Question 11

Diagnosis codes are used to describe

Answer 11

Why a provider perform the services

Question 12

There are two types of messages that could appear on the error tab of the sidebar

Answer 12

Errors and warnings:
Errors must be fixed before going forward.
Warnings you should review the problem, but you do not need to fix to change it.

Question 13

Operational decisions:configuration considerations
Which type of validation check should be evaluated during charge router charge entry.

Answer 13

It is recommended to check for the billing critical items for PB and HB during charge entry

Question 14

Operational decisions: Configuration Considerations
Will these validation checks be error or warnings

Answer 14

Because PB and HB chargers can be entered in charge router charge entry planning for validation checks and how they behave (Error vs. Warnings) will need to be discussed since PB and HB have different billing needs for charging.

Question 15

Picture of batch closed and processed

Question 16

You can see how many charges are pending from the visit tab of professional TX inquiry

Answer 16

From the storyboard, and the pending session tab, you can see which charge review WQ in which they are held.

Question 17

Charge router review:
Timing: after charge triggering charges are still in the charge router and before entering PB.
General recommendation : 1) critical billing checks. 2) mainly IT owned and system WQ

Answer 17

Examples: if a provider created a patient on the fly when they saw a patient at an outside place of service to charge session would likely stop in charge router charge entry for staff to finish registering the patient. You cannot post charges for a patient without a guarantor account.
Reporting consideration :
The dollar amounts displayed in reports are estimated dollars amounts .

Question 18

PB charge review: Timing:
When the charges are within the PB before posting.
General recommendation: * enter users, work PB critical, and PB coding specific checks.
* Most PB charges you want to review should go here.

Answer 18

Examples: *a PB placeholder charge was triggered from an epic clinical application and needs to be coded.
* a PB charge is missing a require modifier
* PB charge does not have a link diagnosis
Reporting consideration : the dollar amounts displayed are calculated pre-AR.

Question 19

Re-submitting a charge session

Question 20

Why might you use force resubmit?

Answer 20

*To meet timely filing.

*To bypass errors that do not need to be corrected.

*Need posted charges for testing later in the revenue cycle.

Question 21

PB Revenue Guardian runs:

Answer 21

*When an encounter is closed or addended.

• When charges post or are voided
• When charges are evaluated in PB charge review
• During nightly processing for encounters left unclosed for five days or for encounters that have active revenue garden checks (only the active checks on the counter to see if any have been resolved).

Question 22

PB revenue guardian looks at encounters level information. If you have charging scenarios that you separate encounters except for surgical and anesthesia contacts, they will be considered separately. For example if a patient has a separate lab encounter during admissions, the lab and counter and omissions will be checked separately.

Answer 22

The main purpose of revenue Guardian is finding charges missed due to workflow problems.

Question 23

PB charge review:
Review existing charge sessions with issues:
*the purpose is review charge sessions with define problems
*audit a targeted percentage of clean charge sessions.

Answer 23

Flexibility: charge session criteria

Question 24

PB revenue Guardian checks:
Review encounters for possibly missing charges.
* Review encounters without charges
* Review encounters with current charges, but not all expected charges
* Review encounters with HB charges but missing PB charges

Answer 24

Flexibility: Variety of criteria to search patient’s rules, current charges, BPA’s, etc.

Question 25

Review chapter 4:
True = one charge ticket is the equivalent of one charge entry session.

Answer 25

True

Question 26

Review ch.4 : On the charge line, what purpose does the diagnosis field serve?

Answer 26

Associates the charge with the appropriate diagnosis from the diagnosis tables.

Question 27

Review Ch4: what is the purpose of processing your charge entry batch?

Answer 27

Post clean charges and sends charges to charge review.

Question 28

Review ch4: what is the difference between a warning and an error?

Answer 28

Warnings can be ignored, but arrows must be fixed

Question 29

Review ch4: false= users review charge sessions in charge review WQ after the system has posted the charges to the account

Answer 29

False

Question 30

Review Ch4: When should I use or resubmit a charge session?

Answer 30

When the user thinks all the issues are corrected

Question 31

Review ch.4: where are revenue guardians checks reviewed?

Answer 31

Charge review WQ
Revenue guardian reports