Exam Review Flashcards
Where can you see if there are charges pending in Charge Review?
Visits tab on Prof Tx Inquiry open Storyboard select Pending Sessions Tab will show which Charge Review WQ they are in
Describe a line in a PB Charge Review WQ
Charge Sessions that have registration or coding issues that need review
What are the steps to save changes and post charges from a charge review WQ
Accept Changes»_space; Resubmit
Describe when PB Revenue Guardian checks occur
- Encounter is closed or addended
- Charges are posted or voided
- Charges are evaluated in PB Charge Review
- Nightly Processes
Where can you find specific instructions to fix claim errors?
Error Side Bar
Define “Not Allowed Amount”
Difference between billed and allowed amount
Define “Allowed Amount”
What you expect to be reimbursed by a payer. (Generated by a reimbursement contract)
Define “Cash Record”
A single deposited check
What is the purpose of Cash Control Groups?
Cash Control Groups track money deposited in the bank to ensure it gets posted in the system. They represent several cash records(deposited checks).
Define “Control Amount”
The total amount of money to be posted in the batch
What is an example of a Debit Adj?
Refund
What is an example of a Credit Adj?
Write Off
What are the steps to resolve Undistributed Credits?
- Distribute to a self-pay balance
- Check for upcoming charges (ex. appts, charges in charge review, charges with ins. balance)
- Refund payment
What is the purpose of Follow-Up WQs?
- Follow up with payers if no response
- Review denied or underpaid claims by payer
Can a guarantor account by in multiple statement runs at a single time?
No, they can only be included in one statement run at a time
