Transactions: Professional Billing Flashcards

1
Q

In PB, what is the fundamental unit of AR and drives the majority of reporting?

A

The transaction.

Aug. 2021, 3.3

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2
Q

Is matching unique to PB?

A

Yes.

Aug. 2021, 3.3

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3
Q

What allows payments from guarantors and insurance companies to be connected to the providers who performed the services?

A

Matching

Aug. 2021, 3.3

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4
Q

Why is it good practice to check the documentation about a Clarity column before you decide to use it in a report?

A

Clarity column names don’t always fully explain what they contain.

Don’t assume that you know what a column does.

(Aug. 2021, 3.5-6)

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5
Q

What does the ETR master file use to track changes to transactions?

A

Details, not contacts, track the events that modify transactions.

(Aug. 2021, 3.7)

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6
Q

What does the “TDL” in CLARITY_TDL_TRAN stand for?

A

TDL = transaction detail line

Aug. 2021, 3.7

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7
Q

What do detail types tell?

A

The full story of what happens to PB transactions.

Aug. 2021, 3.7

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8
Q

What do new PB posts refer to in Chronicles?

A

New ETR records (will always have new transaction IDs)

Aug. 2021, 3.7

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9
Q

What do detail types represent?

A

As new rows are added to the table, they represent either:

  1. Newly posted transactions
  2. Modifications and actions taken on previously posted transactions

(Aug. 2021, 3.7)

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10
Q

What do details types 10 and up (10s - 60s) represent?

A

A modification or an action.

Aug. 2021, 3.8

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11
Q

What detail types inherit values from its original posting?

A

Detail types 10 and up (10s - 60s)

Aug. 2021, 3.8

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12
Q

List the detail types for original posts?

A

Detail types 1-6

  1. New Charge
  2. New Payment
  3. New Debit Adjustment
  4. New Credit Adjustment
  5. Payment Reversal
  6. Credit Adjustment Reversal

(Aug. 2021, 3.8)

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13
Q

Define voids.

A

Undo transactions.

Voids:
• are not new transactions
• will inherit transaction IDs from the transaction they modify

(Aug. 2021, 3.8)

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14
Q

List the detail types for voids?

A
10s
• 10 - Void Charge
• 11 - Void Payment
• 12 - Void Debit Adjustment
• 13 - Void Credit Adjustment

(Aug. 2021, 3.8)

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15
Q

When can debit transactions be voided?

A

At any time.

(Debit transaction = charge)

(Aug. 2021, 3.9)

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16
Q

When can credit transactions be voided?

A

On the same day the credit was posted.

Aug. 2021, 3.9

17
Q

When can credit transactions be reversed?

A

Any day after the day the transaction was posted.

This creates a new (debit adjustment) transaction that cancels the first.

(Credit transaction = payment)

(Aug. 2021, 3.9)

18
Q

What are detail types 5 and 6 a result of?

A

Reversals

  1. Payment Reversal
  2. Credit Adjustment Reversal

(Aug. 2021, 3.9)

19
Q

Are debit transactions ever reversed?

A

No

Aug. 2021, 3.9

20
Q

Define refunds.

A

Refunds are a return of money that was paid to the organization.

(Aug. 2021, 3.9)

21
Q

Are refunds credit adjustments?

A

No. Refunds are debit adjustments (detail type 3)

Aug. 2021, 3.9

22
Q

Which billing system uses matching?

A

Professional Billing

Aug. 2021, 3.9

23
Q

Define matching.

A

Matching is a process used in Professional Billing that connects a debit and a credit.

(Aug. 2021, 3.9)

24
Q

What two transactions can be matched to modify the balance?

A
  1. Debit
  2. Credit

(Aug. 2021, 3.9)

25
Q

How is matching information tracked?

A

Matching information is tracked using detail types (CLARITY_TDL_TRAN)

(Aug. 2021, 3.9)

26
Q

What are the two ways to document payment reversals in Professional Billing?

A
  1. Positive Payments
  2. Debit Adjustments

Epic recommends that your organization tracks payment reversals as positive payments.

(Aug. 2021, 3.12)

27
Q

List the detail types for debit matching.

A
  1. Charge -> Payment
  2. Charge -> Credit Adjustment
  3. Debit Adjustment -> Payment
  4. Debit Adjustment -> Credit Adjustment

(Aug. 2021, 3.11)

28
Q

List the detail types for credit matching.

A
  1. Credit Adjustment -> Charge
  2. Credit Adjustment -> Debit Adjustment
  3. Payment -> Charge
  4. Payment -> Debit Adjustment

(Aug. 2021, 3.11)

29
Q

List the detail types for actions.

A
  1. Change Payor
  2. Transfer Responsibility
  3. Resubmit
  4. Claim Denied
  5. Research

(Aug. 2021, 3.12)

30
Q

List the detail types for collecting.

A
  1. Claim
  2. Bill

(Aug. 2021, 3.12)

31
Q

Detail type 20s are _____ matching rows.

A

Debit. Meaning they show how the debits connect to their associated credits.

(Aug. 2021, 3.16)

32
Q

What detail types represent a modification or action?

A

Detail types 10 and up (10s - 60s)

Aug. 2021, 3.7

33
Q

Detail type 30s are _____ matching rows.

A

Credit. Meaning they show how the credits connect to their associated debits.

(Aug. 2021, 3.17)

34
Q

True or False:

When two transactions are matched, the information on each transaction is connected.

A

True

Aug. 2021, 3.17

35
Q

True or False:
It is only when transactions are matched that we can answer the question “how much money were we paid for this type of service?” or “how much money did this provider earn our organization?”

A

True

Aug. 2021, 3.17

36
Q

When does bad debt occur?

A

When guarantors are unable or unwilling to pay and the organization has stopped trying to collect the balance.

(Aug. 20021, 3.21)

37
Q

Is external AR similar to bad debt?

A

Yes, but may reflect other types of collections.

Aug. 2021, 3.21