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COG230 Revenue Data Model > Transactions: Basics > Flashcards

Transactions: Basics Flashcards

1
Q

List the Epic released Radar dashboards that help your organization track charge review, transactions, workqueues, and more in PB and HB.

A
  1. PB Revenue Integrity Dashboard
  2. HB Revenue Integrity Dashboard

(Aug. 2021, 2.5)

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2
Q

What type of transactions are stored in the ETR master file and may track many details that show a record of how that ETR has changed over time?

A

PB transactions

Aug. 2021, 2.6

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3
Q

What type of transactions are stored in the HTR master file and are considered the most granular level of tracking changes to AR in Hospital Billing?

A

HB transactions

Aug. 2021, 2.6

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4
Q

What type of transactions carry with them many details about the events and changes to those transactions, including voids, matching, and attempts at collection payment?

A

PB transactions

Aug. 2021, 2.10

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5
Q

___ records are stored on a hospital account.

(Hospital accounts contain buckets (HLB records) that organize balances assigned to payers and the payments received from those payers.)

A

HTR records

Aug. 2021, 2.10

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6
Q

Where are HTR records stored?

A

On a hospital account (HAR)

Aug. 2021, 2.10

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7
Q

ETR records are stored on a _______ _______.

A

Guarantor account (EAR)

Aug. 2021, 2.10

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8
Q

When are ETR records and HARs connected?

A

When they are generated for organizations using SBO or VFO.

Aug. 2021, 2.10

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9
Q

True or False:
Regardless of how a payment is entered into the system, they populate the same columns when extracted to Clarity and Caboodle.

A

True

Aug. 2021, 2.11

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10
Q

What are 5 characteristics all transactions have?

A
  1. Service date/ Deposit date
  2. Post date
  3. Procedure code
  4. Guarantor account
  5. Hospital account (HAR)

(Aug. 2021, 2.13-14)

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11
Q

What is the difference between service date and deposit date?

A
  • Service Date - services performed
  • Deposit Date - money recorded in the bank (payment deposited)

(Aug. 2021, 2.13)

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12
Q

What type of transaction could the service date be the same as the post date or it could be in the past?

A

Charge

Aug. 2021, 2.13

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13
Q

For what type of transaction will the service date be the same as the post date?

A

Adjustments.

Exceptions:
Contractual write-offs, whose deposit date will match the deposit date on the corresponding payment.

(Aug. 2021, 2.13)

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14
Q

Define post date.

A

The date a transaction is recorded on the account (guarantor, hospital) and changes the accounts receivable amount.

(Aug. 2021, 2.13)

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15
Q

Procedure records used for payments and adjustments are frequently referred to as what?

A

AR codes

Aug. 2021, 2.13

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16
Q

What is a record in the EAP master file and stores information about the transaction?

A

A procedure code.

Aug. 2021, 2.13

17
Q

What are PB transactions attached to?

A

A guarantor account and cannot exist without it.

Aug. 2021, 2.14

18
Q

What are HB transactions attached to?

A

A hospital account, which is then attached to a guarantor.

Aug. 2021, 2.14

19
Q

True or False:

Every transaction is attached to a hospital account.

A

True.

As of Epic 2018, every transaction is attached to a hospital account.

(Aug. 2021, 2.14)

20
Q

In Epic, what kind of ADJUSTMENTS are refunds?

A

Debit adjustments

Aug. 2021, 2.14

21
Q

What would an organization do if a guarantor or payer pays more than they need to?

A

The organization can send them a refund for the extra amount.

(Aug. 2021, 2.14)

22
Q

What type of transaction has the equal and opposite amount of the original?

A

A reversal.

Sometimes, a transaction is posted in error. In this case, a reversal is posted to “undo” the previously posted transaction.

(Aug. 2021, 2.14)

23
Q

Are voids new transactions?

A

No, voids are simply updates to existing transactions.

Aug. 2021, 2.14

24
Q

True or False:

PB only uses reversals for credits, and only when the reversal takes place after the day the transaction was posted.

A

True.

Aug. 2021, 2.14

25
Q

What type of transaction does Hospital Billing use for reversals?

A

The same type of transaction as the original.

For example, to reverse a charge, another charge transaction is posted with the opposite amount.

(Aug. 2021, 2.14)

26
Q

Is BillingTransactionFact a core revenue table?

A

Yes

Aug. 2021, 2.16

27
Q

List the groups for PB charge transactions.

A
  • Financial Divisions
  • Financial Subdivisions
  • Bill areas

(Aug. 2021, 2.19)

28
Q

How does Hospital Billing group charge transactions?

A

Cost Centers

Aug. 2021, 2.19

29
Q

Why are charge transactions grouped and then stamped on the charge?

A

To create custom sets of departments or providers that make sense together.

(Aug. 2021, 2.19)

30
Q

Define relative value unit (RVU).

A

A form of measurement used to determine the value of a procedure.

(Aug. 2021, 2.20)

31
Q

Why are RVUs only stamped on charge transactions?

A

Because they are part of the procedure’s record.

Aug. 2021, 2.20

32
Q

List the 3 components that RVUs are broken down into.

A
  1. Work: the time, skill, intensity needed to provide a service/perform a procedure
  2. Overhead: the cost of maintaining a practice (rent, non-physician staff costs, and so on)
  3. Malpractice: the cost of malpractice insurance premiums

(Aug. 2021, 2.20)

33
Q

Which billing system stores RVUs on the transaction level?

A

Both billing systems do.

Aug. 2021, 2.20

34
Q

What does Epic need from your organization to report on cost data?

A

An import of your organizations cost data from the cost accounting system into Epic.

The cost information can be stored in a fee schedule and then applied to charges as they are generated.

(Aug. 2021, 2.20)

COG230 Revenue Data Model (12 decks)

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