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Chapter ||11- ||19- ||Resolute ||
Professional ||Billing ||
Fundamentals ||Questions ||With ||
Answers ||
The ||patient‐level ||in ||Registration ||stores ||a || ||of ||every || coverage ||that's ||been ||added ||to ||the ||patient's ||guarantor ||account﴾s﴾ Patient ||Filing ||order ||- ||patient ||filing ||order ||serves ||to ||be ||a ||database ||of || every ||coverage ||a ||patient ||used ||historically. True ||or ||False: Patient ||Filing ||order ||includes ||coverages ||from ||different ||guarantor || accounts ||and ||even ||coverages ||that ||were ||previously ||termed. True ||filing ||order ||refers ||to ||the ||order ||in ||which ||claims ||are ||sent || for ||a ||particular ||visit. Visit
True ||or ||False: Visit ||Filing ||order ||includes: -Filing ||order ||saved ||per ||visit -Finalized ||when ||visit ||is ||created -Claims ||sent ||based ||on ||visit ||filing ||order False -Filing ||order ||saved ||per ||visit -Finalized ||when ||visit ||is ||check ||in -Claims ||sent ||based ||on ||visit ||filing ||order True ||or ||False: There ||is ||system ||configuration ||that ||determines ||exactly ||which || coverages ||from ||a ||patient ||filing ||order ||are ||used ||in ||the ||visit ||filing || order. ||Defining ||a ||visit's ||filing ||order ||is ||based ||on ||characteristics ||of || the ||visit ||(e.g. ||dental, ||behavioral ||health, ||vision, ||etc). True ||is ||the ||review ||and ||resolution ||of ||changes ||made ||to ||an || existing ||visit's ||filing ||order.
When ||do ||existing ||visits ||that ||have ||new ||proposed ||visit ||filing ||orders || evaluated ||by ||customizable ||system ||Retroadjudication ||logic. During ||a ||nightly ||batch ||job During ||a ||nightly ||batch ||Retroadjudication, ||the ||system ||can || automatically ||accept ||or ||reject ||filing ||order ||changes. ||What || workqueue ||can ||the ||system ||route ||visits ||to ||which ||then ||can ||be || analyzed ||by ||billing ||users? Retro ||Review ||Workqueue True ||or ||False: Retroadjudication, ||by ||accepting ||the ||filing ||order ||change ||in ||the || workqueue, ||you ||only ||updated ||the ||filing ||order ||for ||this ||specific ||visit. || No ||other ||visit's ||filing ||order ||will ||change. True True ||or ||False: A ||line ||in ||a ||Retro ||Review ||workqueue ||is ||a ||guarantor ||account
False Which ||of ||the ||following ||can ||cause ||a ||visit ||to ||be ||evaluated ||in ||a ||Retro || Review ||workqueue? ||Choose ||ALL ||that ||apply: A. ||Adding ||a ||new ||coverage ||to ||a ||patient's ||filing ||order B. ||Creating ||a ||new ||patient C. ||Removing ||a ||coverage D. ||Changing ||the ||filing ||order ||on ||the ||patient A. ||Adding ||a ||new ||coverage ||to ||a ||patient's ||filing ||order C. ||Removing ||a ||coverage D. ||Changing ||the ||filing ||order ||on ||the ||patient What ||two ||options ||are ||available ||in ||the ||Retro ||Review ||workqueue? Accept ||Change ||and ||Reject ||Change In ||the ||Retro ||Review ||workqueue, ||Accept ||Change ||accepts ||the ||filing || order ||change ||alters ||the ||visit's ||filing ||order. ||If ||the ||primary ||coverage || changes ||what ||occurs? The ||charges ||are ||voided ||and ||reposted.
Using ||SBO, ||self-pay ||patient ||payment ||plans ||must ||be ||created ||for ||PB ||and ||HB ||balances. False ||- ||Payment ||plans ||can ||be ||created ||for ||the ||combined ||balance. Below ||describes ||what ||concept? Guarantors ||receive ||one ||statement ||per ||guarantor ||account ||using || Epic's ||flexible ||SmartText ||tools ||which ||allows ||for ||easier || customizable ||formatting. ||For ||organizations ||billing ||both ||hospital || and ||professional ||charges, ||statements ||can ||combine ||a ||guarantor's ||HB ||and ||PB ||self‐pay ||balance, ||which ||saves ||on ||processing ||and ||postage || costs ||for ||paper ||statements. Single ||Billing ||Office True ||or ||False: From ||a ||single ||workflow ||staff ||can ||post ||a ||single ||guarantor ||payment || toward ||both ||professional ||and ||hospital ||self‐pay ||balances. True True ||or ||False: SBO ||Self-pay ||follow- ||up ||benefits ||include ||aging ||of ||self‐pay ||balances || is ||tracked ||at ||the ||visit ||level, ||allowing ||you ||to ||take ||action ||on ||specific ||
visit ||accounts ||that ||get ||to ||a ||certain ||age. ||Business ||office ||staff ||use ||the || same ||features ||and ||workflows ||to ||follow ||up ||on ||both ||professional ||and || hospital ||self‐pay ||balances True In ||SBO, ||what ||is ||used ||to ||hold ||charges ||in ||both ||Hospital ||Billing ||(HB || HAR) ||and ||Professional ||Billing ||(PB ||HAR/visit ||account)? Hospital ||account ||records ||(HARs) True ||or ||False: PB ||visit ||account ||and ||PB ||HAR ||are ||synonymous True What ||three ||HB ||HAR ||hospital ||base ||classes ||are ||there? -Inpatient -Outpatient -Emergency
True ||or ||False: All ||charges ||from ||a ||single ||encounter ||will ||be ||placed ||on ||the ||same ||PB || visit ||account. True In ||SBO, ||what ||is ||a ||default ||HAR? All ||professional ||credit ||transactions ||and ||some ||professional ||debit || adjustments ||are ||stored ||on ||a ||guarantor's ||default ||HAR. ||A ||default || HAR ||is ||automatically ||created ||each ||time ||a ||guarantor ||account ||is || created. How ||many ||default ||HAR ||can ||a ||guarantor ||account ||have? A ||guarantor ||account ||will ||only ||have ||one ||default ||HAR. True ||or ||False: The ||status ||of ||a ||HAR ||describes ||where ||the ||HAR ||is ||in ||the ||revenue || cycle. True
True ||or ||False: HB ||HAR ||Open ||Status ||is ||used ||while ||patient ||is ||still ||admitted ||and || charges ||are ||being ||generated. True True ||or ||False: HB ||HAR ||DNB ||(Discharged ||Not ||Billed) ||Status ||is ||when ||HAR ||has || charges ||but ||liability ||has ||not ||yet ||been ||assigned. ||This ||status ||is ||also || used ||for ||PB ||visit ||accounts. False- ||DNB ||﴾Discharged ||Not ||Billed﴾ ||HB ||HAR ||status ||when ||HAR || has ||charges ||but ||liability ||has ||not ||yet ||been ||assigned. ||This ||status ||is || NOT ||used ||for ||PB ||visit ||accounts. What ||status ||is ||used ||for ||PB ||visit ||account ||or ||HB ||HAR ||status ||when || liability ||has ||been ||assigned. Billed ||- ||(Post ||to ||account) What ||status ||is ||used ||for ||PB ||visit ||account ||or ||HB ||HAR ||status ||when || there ||is ||no ||liability. Closed
Of ||the ||three ||HAR ||types ||defined ||in ||this ||lesson, ||which ||of ||the || following ||is ||NOT ||encounter‐specific? ||Choose ||only ||ONE ||answer. A. ||HB ||HAR B. ||PB ||visit ||account C. ||Default ||HAR C. ||Default ||HAR What ||Epic ||tools ||can ||decrease ||the ||number ||of ||statements ||sent ||after || an ||encounter. e‐check ||in, ||estimates, ||and ||pre‐payments True ||or ||False: Patient ||estimates ||are ||available ||after ||a ||service ||along ||with ||pre‐ payments. False ||- ||Patient ||estimates ||are ||available ||prior ||to ||service ||along ||with || pre‐payments.
||makes ||it ||easy ||for ||guarantors ||to ||receive ||notifications || regarding ||their ||balances ||before ||even ||receiving ||a ||statement, ||through ||the ||use ||of ||real‐time ||balance ||and ||automatic ||billing ||notifications. MyChart True ||or ||False: Patients ||are ||also ||able ||to ||make ||online ||payments ||with ||or ||without ||an || active ||MyChart ||account ||while ||also ||managing ||their ||balances ||in ||real || time ||through ||setting ||up ||payment ||plans ||or ||requesting ||financial || assistance. True True ||or ||False: Patients ||can ||be ||notified ||as ||soon ||as ||they ||have ||new ||self‐pay ||balances, ||after ||balances ||appear ||on ||a ||statement, ||through ||automated ||real‐time ||balance ||notifications. False ||- ||Patients ||can ||be ||notified ||as ||soon ||as ||they ||have ||new ||self‐pay || balances, ||even ||BEFORE ||those ||balances ||appear ||on ||a ||statement, || through ||automated ||real‐time ||balance ||notifications. True ||or ||False:
self‐pay ||balance ||and ||would ||like ||a ||convenient ||link ||to ||view ||their || balance ||information. True What ||is ||Hello ||World? If ||licensed ||to ||use ||Hello ||World, ||an ||organization ||can ||utilize ||Hello || World ||functionality ||for ||both ||one‐way ||and ||two‐way ||SMS || communication ||within ||Epic. What ||is ||available ||in ||Hello ||World? Make ||a ||payment Agree ||to ||payment ||plan ||terms Request ||financial ||assistance Confirm ||an ||appointment Confirm ||their ||arrival ||to ||the ||clinic True ||or ||False: Guarantors ||can ||set ||up ||a ||payment ||plan ||in ||MyChart ||without || assistance ||from ||customer ||service.
True When ||are ||HARs ||eligible ||to ||appear ||on ||a ||statement? Once ||HARs ||have ||a ||self‐pay ||balance, ||they ||are ||eligible ||to ||appear ||on || a ||statement. In ||Single ||Billing ||Office, ||statements ||are ||generated ||at ||what ||level? Guarantor ||level ||- ||A ||statement ||includes ||all ||eligible ||HB ||HARs ||and || PB ||visit ||accounts ||with ||a ||self‐pay ||balance ||for ||a ||single ||guarantor || account. True ||or ||False: In ||Single ||Billing ||Office, ||statements ||are ||automatically ||processed || every ||night. ||Once ||a ||guarantor ||receives ||their ||first ||statement, ||they || are ||placed ||on ||a ||regular ||cycle ||until ||their ||balance ||is ||paid. True What ||statement ||cycle ||is ||this?
Family ||Billling One ||guarantor ||account ||record ||is ||shared ||between ||multiple ||patient || records. Individual ||Billing One ||guarantor ||account ||record ||is ||needed ||for ||each ||patient ||record, || even ||if ||the ||guarantor ||is ||the ||same ||person. ||Most ||organizations ||use || individual ||billing. What ||are ||some ||reasons ||that ||you ||might ||want ||to ||hold ||a ||statement? Minimum ||guarantor ||account ||balance ||not ||met Guarantor ||address ||has ||no ||zip ||code Credit ||balance ||on ||the ||guarantor ||account True ||or ||False: In ||the ||Foundation ||System, ||MyChart ||users ||are ||enrolled ||by ||default || in ||paperless ||billing.
True The ||system ||generates ||statements ||through ||an ||automated ||nightly || process. ||This ||overnight ||process ||does ||what? A ||statement ||run, ||prints ||the ||statements ||to ||paper ||or ||a ||file, ||and || generates ||a ||report ||showing ||which ||statements ||were ||produced. Before ||a ||statement ||can ||qualify ||for ||a ||statement ||run ||it ||must ||do || what? Must ||pass ||through ||all ||statement ||qualifiers. What ||must ||you ||do ||after ||you ||validate ||that ||the ||system ||properly || generated ||statements? You ||need ||to ||complete ||the ||statement ||run ||in ||the ||system. ||This ||step ||is ||called ||accepting ||the ||statement ||run. True ||or ||False:
