Reviewing and Correcting Charge Errors Flashcards
What is the name of the module in the system that automatically creates claim runs?
Batch Scheduler
Where do end users find the list of claims with errors that need to be worked before they are sent to payors?
Claim edit Workqueue
Which type of claim error can be fixed by an end user?
User file errors
When you are working in a claim edit workqueue, you can ccess the………, a tool that helps you fix the errors on the claim, by clicking on the error hyperlink.
Claim edit workqueue companion.
Which type of claim error needs to be fixed by an application coordinator or IT person?
Master file errors
What’s the difference between clicking New Detail and New Check on the insurance payment posting form?
New detail is the same check new invoice and new check is a different check
Why are cash control groups created in epic?
Only posting money you have actually received
What are the final two steps of insurance payment posting that allow the payments to be posted to the account?
Close and Process
T/F? The only difference between posting a recoupment and a regular payments is that when you post the recoupment you should enter a negative paid amount.
False.
Where in the system do you find the list of outstanding claims that require follow up?
Follow-up workqueue
In a follow-up workqueue, which activity would you perform in each of the following circumstances?
a) a denial was legitimate and the balance should be passed on to the next entity in the filing order
b) You want to record a summary of all the actions you took while working the claim
a) NRP (next responsible party)
b) note
What is the purpose of a charge review workqueue?
to review pb charges for errors
When does the charge review workqueue review the charges?
while charges are still temporary
If a charge session qualifies for multiple workqueues, how do you know what to fix in order to remove the charge session from your workqueue?
Look at the system comments section to fix issues associated with your workqueue
If a charge session is from a clinical source, do changes in the charge session update the clinical chart?
no
If you want the chart and account to match, who needs to update the charge?
the provider
What does defer do?
moves the session to the deferred tab-comes back to the active tab when the session closes
What are a few reasons you might use force resubmit?
timely filing, not a duplicate claim, error is not an error
Which buttons in correcting charge errors are security controlled?
delete and force resubmit.
T/F? When deleting a session in a charge review workqueue, the charge session is removed from your wq, but can still be worked on by others?
False
What is the difference between a warning and an error?
A warning is a soft stop that you can ignore. An error is a hard stop that you have to fix.
What does the transfer button in a charge review workqueue do?
It moves the charge session from the current wq to a designated wq
T/F? Users review charges in charge review wq’s after the system has posted charges to the account?
False. Users review charges before the system posts them to the account, while the charges are still considered temporary and editable.
When should you resubmit a charge session?
When you beleive it has been corrected.
Why are duplicate charge sessions sent to a supervisor?
The delete button is security controlled and isnt available to every user.
