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Epic > RHB300 > Flashcards

RHB300 Flashcards

1
Q

True or False

HSD Settings can be configured in both Classic and Text

A

True: Some are configured in Classic and some in Text

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2
Q

How do you enable Single Billing Office (SBO)?

A

Set in the Enterprise Billing Profile, then linked to a service area

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3
Q

True or False

The order of the lines in the Coverager Manager table does not matter

A

False: Table reads from top down, exceptions need to be listed before defaults

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4
Q

True or False

Coverage Manager can add a stop bill to a HB HAR when there is a coverage change for the guarantor connected to the account.

A

True

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5
Q

True or False

Billing activities can have default values configured for their actions

A

True

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6
Q

True or False

You can lock and individual action within an activity to prevent the end user from changing the configuration

A

True

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7
Q

For productivity reporting, you want to give more weight or importance to an activity. What item can you have configured to do this?

A

Activity Score

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8
Q

Why should you not lock the note portion of a billing activity?

A

Because if the note is locked, staff will not be able to add any text to the standard text the note begins with

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9
Q

Your collections users are able to use an activity and you want to grant your customer service users access to the same activity. What can you configure to do this?

A

Allowed Security Classes

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10
Q

True or False

A DNB with type “error” can be override by a user

A

False: Only warnings can be overridden

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11
Q

Which of the following are true of DNB checks?
A. Many DNB checks are included in Foundation System.
B. You can create custom DNB checks using rules.
C. DNB checks can be applied to an account at any point in the revenue cycle
D. You can configure which DNB checks to run before min days
E. A Stop Bill on an account will not prevent Initiate Billing unless the appropriate DNB check for Stop Bills is listed in the HSD

A

A, B, D, E

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12
Q

True or False

The number of Min Days can vary based on organization defined restrictions

A

True

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13
Q

True or False

The Expected Charges form of Revenue Guardian checks specify the charges that have errors you are looking for on a hospital account

A

False: The Expected Charges shows the “good” charges

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14
Q

When are Revenue Guardian checks evaluated?

A

Initiate Billing

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15
Q

A payer defines that for recurring visits the hospital accounts should be billed monthly and always on the last day of the month. What value should go in the LENGTH field to accomplish this?

A

L

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16
Q

True or False

A payer defines consecutive accounts as the following:
* Inpatient account following an emergency account for the same issue that happens within 2 days of each other.

True or False: Three rows of the consecutive accounts tables are needed to define this:
* One row for 0 days between
* Second row for 1 day between
* Third row for 2 days between

A

False: Only one is needed as the number of days is specified as the Max Days not Total Days

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17
Q

Identify the most specific level for configuring variance thresholds.

A

Plan

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18
Q

A difference between which two values identifies a contractual variance?

A

Expected amount and allowed amount

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19
Q

Jenny recently received care at your organization. Based on your contract, Acme Insurance owes $1305.50 for Jenny’s care. However, when Acme sends payment, they send only $1200. This $1200 would be defined as what?

A

Paid Amount

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20
Q

Amber recently received care at your organization. Acme insurance sends back the following information:
* Allowed Amount: $1300.00
* Paid: $1250.00
* Pt. Responsibility: $50.00

Your contract with Acme calculates the expected amount should be $1400.00. Based on that, how much of a contractual variance exists in this scenario?

A

$100.00

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21
Q

Intergalactic Healthcare received a payment from Northern Lights Insurance Company that triggered an underpayment follow-up record.
* Billed Amount: $5,000
* Expected Amount: $4,000
* Allowed Amount: $3,000
* Posted Write-Off: $2,000

Which Write-Off option is being used for this variance?

A

Write-Off Payer (Billed Amount - Allowed Amount)

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22
Q

True or False

FPL Information must be collected for a guarantor in order for that guarantor to receive a self-pay discount

A

False

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23
Q

True or False

If a minimum balance is defined in a sliding scale table row, then the minimum balance will be billed to the guarantor even if the discount amount would otherwise cause the balance to fall below what is listed as the minimum balance.

A

True

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24
Q

True or False

HB Self-Pay discounts can be automatically posted as soon as charges post to the hospital account

A

False: Posted when balances are moved to self-pay bucket

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25
Q

True or False

Adustments due to prepay discounts can be applied automatically

A

True

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26
Q

True or False

In Single Billing Office, an Enterprise statement will always be a guarantor-level statement.

A

True

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27
Q

Which of the following statements best describes Drop Cycle statement processing?
* Guarantor statement prints immediately after every visit with a self-pay liability
* Guarantor is eligible for statement as soon as self-pay liability exists for charges that are part of a closed system batch
* Guarantor statements will be processed on a regular schedule, regardless of when the guarantor’s liability becomes self-pay
* Drop Cycle statement processing is the method by which multiple guarantor’s self-pay balances are billed on a single statement

A

Guarantor is eligible for statement as soon as self-pay liability exists for charges that are part of a closed system batch

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28
Q

Which of the following are true about Charge Review Workqueues?
* Workqueue rules can be configured as either errors or warnings
* Routing rules can be configured as either errors or warnings
* Errors can be overridden
* Warnings can be overridden

A

A, D

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29
Q

Charges caught in HB Charge Review workqueues are which type of record?

A

HTT

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30
Q

Which of the following are true about routing rules?
* Routing rules can improve system performance
* Routing rules are an initial filter
* Routing rules are not configurable with custom evaluation logic
* Routing rules define the problem within a workqueue
* Routing rules can be used to further divide a workflow, such as by financial class or last name

A

A, B, E

31
Q

True or False

It is possible to build a rule from within a workqueue

A

True

32
Q

An account workqueue has three routing rules and four workqueue rules. For how many rules must an account qualify?

A

Four

33
Q

You want end users to jump to a specific activity within the Hospital Account activity each time they select an account within your workqueue. Which field do you populate that allows for this functionality?

A

Acct Maint Activity

34
Q

True or False

It is possible to add multiple users to multiple workqueues at one time

A

True

35
Q

True or False

While a workqueue is set to Single Item Mode, users should “Skip” all accounts that need to be followed-up with later

A

False: Should use defer

36
Q

You would like the workqueue to be sorted first based on days in workqueue and then based on account balance. Users still need to have the flexibility to sort by account name in certain circumstances. Which option should you configure for this workqueue?

A

Set Default Sort Order

37
Q

Which of the following are types of system action queues?
* Bucket
* Account
* Guarantor
* Invoice
* Encounter

A

Bucket, Account, Guarantor

38
Q

True or False

System action queues use rules to identify which records (HARs, Buckets, or Guarantor accounts) to take action on

A

True

39
Q

True or False

The order of the system action queues listed in Queue Priority does not matter as all system action queues are evaluated against each bucket/account/guarantor every time

A

False

40
Q

True or False

Account system action queues are performed before bucket system action queues

A

False

41
Q

What steps must be taken for estimate templates to be available in MyChart?

A

Estimate templates must be marked as available for self-service

42
Q

What is the purpose of an estimate template?

A

Estimate templates allow an end user or patien to choose a single estimate template and the correct charge codes are pulled into the estimate without any additional work on the user or patient’s part

43
Q

What record represents a given service and must exist in order to post a charge to a hospital?

A

Procedure (EAP)

44
Q

In which master file are prices associated with specific charge codes?

A

Fee Schedule (FSC)

45
Q

True or False

To create an import spreadsheet, you should start from a blank spreadsheet

A

False

46
Q

True or False

The new contact date for your record updates is stored directly in the import spreadsheet

A

False

47
Q

What is a cost center?
* A record used in revenue reporting
* A record of where a charge was performed
* A record used in GL account assignment
* A record used to hold charges with erros

A

A,C

48
Q

How does the system determine which GL pattern record to use for each hospital billing transaction?

A

Compared to rules in the GL Settings form of the HSD. Which rule the transaction matches determines which GL Pattern to use

49
Q

A single credit and single debit GL account is assigned to…

A

Each transaction

50
Q

How would an Extract with a ^ delimiter format display an account ID of 557688 and a refund amount of $45.19 using the Format Financial (9.2 zero-padded) format extension?
* 557688^$45.19
* 557688^00000000045.1900
* 557688^”$45.19”
* 557688^000000045.19

A

D

51
Q

If an extract column is not aligned to meet your vendor’s specifications how can you adjust the formatting for a column?

A

Use the Overrides section
Use the Format Extension Field

52
Q

True or False

The rule of specificity states that the system will use the least specific setting available

A

False

53
Q

True or False

Most of the configuration options for Hospital Billing Settings are stored in the Facility or Service Area level EAF records.

A

False

54
Q

True or False

The Coverage Manager table is evaluated from the top of the list to the bottom, meaning the most specific entries should be placed at the top of the table.

A

True

55
Q

You are a project team member building a billing activity requested by your customer service manager. When you try to test the activity you cannot select it in Hyperspace. What are possible reasons you are not able to select it?

A

The activity is not plugged into the HSD
Your security class is not allowed to use the activity
You are testing the activity ina way that does not make sense

56
Q

True or False

A rule can be used to restrict which HARs qualify for a DNB check

A

True

57
Q

When will hospital accounts be evaluated against a DNB check if the Run Before Min Days field is set to “Yes” on the Discharged-Not-Billed Check Configuration screen in the HSD?

A

Discharge
Initiate Billing

58
Q

A difference between which two values identifies a contractual variance?

A

Expected Amount
Allowed Amount

59
Q

What is the purpose of a workqueue rule in an HB Charge Review workqueue?

A

Defines the charge errors

60
Q

True or False

Charges awaiting approval in a charge review workqueue are posted transactions (HTRs) on HARs

A

False

61
Q

An account workqueue has four routing rules and two workqueue rules. How many of these rules does an account need to meet to qualify for this workqueue?

A

5

62
Q

Which of the following are types of system action queues?
* Bucket
* Hospital Account
* Guarantor Account
* Patient

A

A,B,C

63
Q

You are building a rule to identify encounters in the ED from more than a week ago. You chose a property called HAR\ED Arrival Date. Which operator and value should you choose?

A

HAR\ED Arrival Date < T-7

64
Q

Estimate Templates contain charge codes, which define the…

A

Medical Service that will be billed for

65
Q

Which record stores the prices for EAPs?

A

Fee Schedule

66
Q

You want to set the contact date of your estimate template to be one month in the future. What would you type into the contact date field?

A

M+1

67
Q

You want to use an import to update an existing fee schedule. What steps should be done to correctly do so?
* Export Existing Records
* Update Import Spreadsheet Information
* Create a Flat File
* Scan file
* Move Flat File to Epic Server
* Import data to Chronicles

A

All of the above

68
Q

You get an issue ticket at Go-Live telling you the wrong GL Debit account is being assigned to payments coming from Blue Cross Blue Shield. What problem do you need to fix?

A

Hard telling not knowing, need to investigate first

69
Q

True or False

Adjustment codes will only be assigned a GL credit string and NOT a GL debit string?

A

False

70
Q

How can you modify the format of a PAF column to meet a vendor’s specifications?

A

Configure overrides section
Format Extension

71
Q

The actions a patient can take in MyChart are configured in…

A

The Hospital Billing security class (ECL)

72
Q

A user needs access to the Hospital Account activity. What record should you edit?

A

Hospital Billing security class

73
Q

True or False

Hospital Billing security points can require prerequisite security points

A

True

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