Download RPB300 Resolute Professional Billing Administration exam with correct answers and more Exams Nursing in PDF only on Docsity!
RPB300||\||\ Resolute||\||\ Professional||\||\ Billing||\||\
Administration||\||\ exam||\||\ with||\||\ correct||\||\ answers
Charge||\||\ Triggering ______||\||\ can||\||\ stem||\||\ from||\||\ 3 ||\||\ sources:||\||\ Charge||\||\ Router||\||\ Charge||\||\ Entry,||\||\ Clinical||\||\ Applications,||\||\ and||\||\ Non- Epic||\||\ Applications.||\||\ Once||\||\ Clinical||\||\ Activity||\||\ is||\||\ entered||\||\ into||\||\ the||\||\ system||\||\ it||\||\ triggers||\||\ charges||\||\ for||\||\ the||\||\ activities. Billing||\||\ Status The||\||\ setting||\||\ that||\||\ allows||\||\ a||\||\ procedure||\||\ to||\||\ be||\||\ used||\||\ in||\||\ Resolute||\||\ Professional||\||\ Billing.||\||\ Procedures||\||\ must||\||\ be||\||\ billing||\||\ active||\||\ to||\||\ be||\||\ used||\||\ in||\||\ manual||\||\ charge||\||\ entry||\||\ and||\||\ the||\||\ charge||\||\ router||\||\ can||\||\ only||\||\ route||\||\ billing||\||\ active||\||\ procedures||\||\ to||\||\ Resolute||\||\ Professional||\||\ Billing. Record||\||\ Purpose All||\||\ procedure||\||\ records||\||\ with||\||\ a||\||\ procedure||\||\ type||\||\ of||\||\ Charged||\||\ are||\||\ configured||\||\ with||\||\ a||\||\ ______.||\||\ The||\||\ three||\||\ ______(es)||\||\ are||\||\ orderable,||\||\ performable,||\||\ and||\||\ chargeable.
- When||\||\ an||\||\ orderable/performable||\||\ procedure||\||\ is||\||\ triggered||\||\ from||\||\ clinical||\||\ charge
||\||\ sources,||\||\ the||\||\ procedure||\||\ record||\||\ sent||\||\ to||\||\ the||\||\ Charge||\||\ Router||\||\ is||\||\ not||\||\ a||\||\ CPT||\||\ or||\||\ HCPCS||\||\ code||\||\ and||\||\ must||\||\ be||\||\ 'translated'||\||\ into||\||\ a||\||\ chargeable||\||\ procedure||\||\ code||\||\ for||\||\ billing. * Orderable "Someone||\||\ please||\||\ do||\||\ this,"||\||\ inactive||\||\ billing||\||\ status,||\||\ clinically||\||\ active,||\||\ custom||\||\ code||\||\ type Performable "This||\||\ has||\||\ been||\||\ done" Chargeable "Lets||\||\ get||\||\ paid||\||\ for||\||\ this,"||\||\ active||\||\ billing||\||\ status,||\||\ not||\||\ clinically||\||\ active,||\||\ CPT||\||\ code||\||\ type Charge||\||\ Capture||\||\ Navigator A||\||\ section||\||\ for||\||\ providers||\||\ to||\||\ manually||\||\ enter||\||\ additional||\||\ procedures||\||\ performed||\||\ during||\||\ a||\||\ visit||\||\ that||\||\ cannot||\||\ be||\||\ accurately||\||\ added||\||\ automatically.||\||\ This||\||\ section||\||\ is||\||\ also||\||\ useful||\||\ for||\||\ reviewing||\||\ charges.||\||\ A||\||\ provider||\||\ can||\||\ review||\||\ charges||\||\ that||\||\ were||\||\ entered||\||\ by||\||\ someone||\||\ else,||\||\ such||\||\ as||\||\ a||\||\ resident,||\||\ or||\||\ automatically||\||\ generated. Charge||\||\ Capture||\||\ Window
Context-Based||\||\ Charging Imaging||\||\ procedures||\||\ can||\||\ be||\||\ charged||\||\ differently||\||\ based||\||\ on||\||\ whether||\||\ it||\||\ was||\||\ performed||\||\ in||\||\ an||\||\ inpatient||\||\ or||\||\ outpatient||\||\ setting. Lab||\||\ Charging When||\||\ a||\||\ provider||\||\ places||\||\ an||\||\ order||\||\ for||\||\ a||\||\ patient||\||\ to||\||\ get||\||\ a||\||\ lab||\||\ test,||\||\ the||\||\ patient||\||\ goes||\||\ to||\||\ get||\||\ the||\||\ lab||\||\ and||\||\ the||\||\ test||\||\ is||\||\ performed||\||\ and||\||\ triggers||\||\ a||\||\ charge||\||\ when||\||\ a||\||\ certain||\||\ action||\||\ occurs,||\||\ such||\||\ as||\||\ verifying||\||\ the||\||\ results. Medication||\||\ Charging Your||\||\ organization||\||\ can||\||\ decide||\||\ to||\||\ charge||\||\ for||\||\ medications||\||\ when||\||\ they||\||\ are||\||\ dispensed||\||\ in||\||\ Epic||\||\ or||\||\ when||\||\ they||\||\ are||\||\ administered. Charge||\||\ building||\||\ Fields
Procedure||\||\ Number:||\||\ Internal||\||\ record||\||\ ID||\||\ in||\||\ Epic.||\||\
This||\||\ is||\||\ typically||\||\ the||\||\ same||\||\ ID||\||\ as||\||\ the||\||\ Code||\||\ field.
Billing||\||\ Status:||\||\ Determines||\||\ whether||\||\ the||\||\
procedure||\||\ is||\||\ allowed||\||\ to||\||\ be||\||\ brought||\||\ into||\||\ the||\||\ billing||\||\ system,||\||\ such||\||\ as||\||\ Professional||\||\ Billing.||\||\ This||\||\ is||\||\ a||\||\ required||\||\ field.
Patient-Friendly||\||\ Name:||\||\ Holds||\||\ a||\||\ patient-friendly||\||\
name||\||\ that||\||\ your||\||\ organization||\||\ can||\||\ display||\||\ to||\||\ patients||\||\ in||\||\ MyChart||\||\ or||\||\ on||\||\ statements.
Code:||\||\ Holds||\||\ the||\||\ code||\||\ to||\||\ be||\||\ displayed||\||\ in||\||\ the||\||\
system||\||\ and||\||\ sent||\||\ on||\||\ claims||\||\ and||\||\ statements.
Code||\||\ Type:||\||\ Determines||\||\ the||\||\ type||\||\ of||\||\ charge,||\||\ such||\||\
as||\||\ CPT||\||\ or||\||\ HCPCS.
Procedure||\||\ Type:||\||\ Indicates||\||\ the||\||\ procedure||\||\ should||\||\
be||\||\ used||\||\ as||\||\ a||\||\ charge||\||\ (not||\||\ a||\||\ payment||\||\ or||\||\ adjustment).||\||\ This||\||\ is||\||\ a||\||\ required||\||\ field.
Debit/Credit:||\||\ Determines||\||\ how||\||\ the||\||\ procedure||\||\
will||\||\ impact||\||\ the||\||\ balance||\||\ on||\||\ a||\||\ patient's||\||\ account.
Hospital||\||\ Claim||\||\ Procedure||\||\ Type:||\||\ Determines||\||\ if||\||\ a||\||\
charge||\||\ is||\||\ considered||\||\ a||\||\ professional||\||\ or||\||\ technical||\||\ charge||\||\ for||\||\ claims||\||\ purposes. **||\||\ Code||\||\ can||\||\ differ||\||\ from||\||\ Procedure||\||\ Number||\||\ if||\||\ the||\||\ code||\||\ contains||\||\ multiple||\||\ procedures||\||\ bundled||\||\ into||\||\ one.||\||\ For||\||\ example||\||\ and||\||\ immunization||\||\ can||\||\ contain ||\||\ both||\||\ an||\||\ admin||\||\ fee||\||\ and||\||\ procedure||\||\ fee||\||\ so||\||\ the||\||\ code||\||\ can||\||\ bundle||\||\ multiple||\||\ charges||\||\ together. Charge||\||\ Router
Fee||\||\ Schedule Have||\||\ a||\||\ record||\||\ type||\||\ of||\||\ procedure||\||\ and||\||\ are||\||\ defined ||\||\ as||\||\ a||\||\ procedure||\||\ and||\||\ amount.||\||\ They||\||\ are||\||\ used||\||\ to||\||\ determine||\||\ billed||\||\ amounts/prices,||\||\ reimbursement/||\||\ allowed||\||\ amounts||\||\ and||\||\ discount||\||\ amounts.||\||\ You||\||\ have||\||\ to||\||\ link||\||\ a||\||\ ______||\||\ to||\||\ a||\||\ fee||\||\ schedule||\||\ group||\||\ in||\||\ order||\||\ for||\||\ it||\||\ to||\||\ work. Fee||\||\ Schedule||\||\ Group||\||\ (FSG) Tells||\||\ the||\||\ systems||\||\ WHEN||\||\ and||\||\ under||\||\ which||\||\ conditions||\||\ to||\||\ use||\||\ your||\||\ fee||\||\ schedules.||\||\ Attributes||\||\ include:||\||\ Service||\||\ Area,||\||\ Location,||\||\ Department,||\||\ Financial||\||\ Division,||\||\ Financial||\||\ Sub||\||\ Division,||\||\ Bill||\||\ Area,||\||\ Participation||\||\ Status,||\||\ Provider||\||\ Type,||\||\ Provider||\||\ ,||\||\ Financial||\||\ Class,||\||\ and/or||\||\ POS||\||\ Type||\||\ (AND||\||\ relationship||\||\ between||\||\ these||\||\ eligibility||\||\ requirements).||\||\ Can||\||\ also||\||\ contain||\||\ multiple||\||\ fee||\||\ schedules||\||\ in||\||\ one||\||\ group.||\||\ Within||\||\ a||\||\ specific||\||\ eligibility||\||\ group||\||\ (i.e.||\||\ two||\||\ providers...||\||\ the||\||\ relationship||\||\ is||\||\ OR) Fee||\||\ Schedule||\||\ Modifier This||\||\ allows||\||\ a||\||\ procedure||\||\ to||\||\ be||\||\ listed||\||\ multiple||\||\ times||\||\ within||\||\ a||\||\ fee||\||\ schedule||\||\ with||\||\ different||\||\ dollar||\||\
amounts||\||\ dependent||\||\ on||\||\ modifier.||\||\ It||\||\ is||\||\ not||\||\ possible||\||\ to||\||\ list||\||\ the||\||\ same||\||\ procedure||\||\ multiple||\||\ times||\||\ within||\||\ a||\||\ fee||\||\ schedule||\||\ without||\||\ a||\||\ difference||\||\ in||\||\ the||\||\ modifier||\||\ data||\||\ per||\||\ row. Percentage||\||\ Change||\||\ Modifier Changes||\||\ the||\||\ price||\||\ by||\||\ the||\||\ percentage||\||\ specified.||\||\ For||\||\ Example:||\||\ If||\||\ you||\||\ want||\||\ a||\||\ procedure||\||\ price||\||\ to||\||\ be||\||\ increased||\||\ by||\||\ a||\||\ certain||\||\ amount||\||\ for||\||\ a||\||\ specific||\||\ procedure. Total||\||\ amount Calculated||\||\ using||\||\ the||\||\ following||\||\ equation:||\||\ Amount||\||\ =||\||\ Base||\||\ Charge||\||\ +||\||\ (Unit||\||\ Charge||\||\ *||\||\ Quantity).||\||\ If||\||\ base||\||\ charge||\||\ is||\||\ left||\||\ blank,||\||\ the||\||\ base||\||\ charge||\||\ is||\||\ automatically||\||\ $ Modifiers Can||\||\ be||\||\ directly||\||\ associated||\||\ with||\||\ procedures||\||\ to||\||\ change||\||\ the||\||\ amount||\||\ for||\||\ a||\||\ specific||\||\ procedure/modifier||\||\ combination. Charge||\||\ Specific||\||\ Benefit||\||\ Summary Can||\||\ be||\||\ a||\||\ useful||\||\ diagnostic||\||\ tool||\||\ to||\||\ troubleshoot||\||\ pricing||\||\ issues.||\||\ Reports||\||\ side||\||\ bar.||\||\ ______||\||\ will||\||\ show||\||\
Only||\||\ charges||\||\ receive||\||\ a||\||\ ______;||\||\ payments||\||\ and||\||\ adjustments||\||\ do||\||\ not. If||\||\ there||\||\ is||\||\ no||\||\ direct||\||\ matches||\||\ between||\||\ provider||\||\ ______||\||\ and||\||\ department||\||\ ______||\||\ then||\||\ the||\||\ options||\||\ are||\||\ to||\||\ allow||\||\ only||\||\ the||\||\ provider's||\||\ ______,||\||\ the||\||\ department's||\||\ ______,||\||\ all||\||\ bill||\||\ areas,||\||\ or||\||\ no||\||\ ______.||\||\ The||\||\ most||\||\ commonly||\||\ used||\||\ options||\||\ are||\||\ either||\||\ the||\||\ provider's||\||\ ______(s)||\||\ or||\||\ the||\||\ department's||\||\ ______.||\||\ If||\||\ there||\||\ is||\||\ only||\||\ one||\||\ ______||\||\ in||\||\ the||\||\ list,||\||\ the||\||\ system||\||\ will||\||\ automatically||\||\ assign||\||\ it||\||\ to||\||\ a||\||\ charge.||\||\ If||\||\ there||\||\ is ||\||\ more||\||\ than||\||\ one||\||\ ______||\||\ to||\||\ choose||\||\ from,||\||\ then||\||\ the||\||\ charge||\||\ can||\||\ qualify||\||\ for||\||\ a||\||\ PB||\||\ Charge||\||\ Review||\||\ workqueue||\||\ where||\||\ a||\||\ user||\||\ can||\||\ manually||\||\ assign||\||\ a||\||\ ______||\||\ from||\||\ the||\||\ allowed||\||\ list. Financial||\||\ Subdivision can||\||\ be||\||\ used||\||\ to||\||\ group||\||\ bill||\||\ areas Financial||\||\ Division can||\||\ be||\||\ used||\||\ to||\||\ group||\||\ financial||\||\ subdivisions||\||\ and||\||\ bill||\||\ areas Provider||\||\ &||\||\ Resource||\||\ master||\||\ file||\||\ (SER)
Contains||\||\ records||\||\ for||\||\ clinicians||\||\ such||\||\ as||\||\ nurses,||\||\ physicians,||\||\ and||\||\ resources||\||\ such||\||\ as||\||\ room||\||\ and||\||\ ultrasound||\||\ machines. Provider||\||\ Attributes||\||\ master||\||\ file||\||\ (PAT) Settings||\||\ to||\||\ define||\||\ service||\||\ and||\||\ billing||\||\ provider||\||\ effective||\||\ dates||\||\ are||\||\ found||\||\ in||\||\ the||\||\ Provider||\||\ Effective||\||\ dates||\||\ and||\||\ attributes||\||\ screen||\||\ in||\||\ text Service||\||\ Provider||\||\ vs.||\||\ Billing||\||\ Provider The||\||\ ______||\||\ Provider||\||\ is||\||\ the||\||\ provider||\||\ who||\||\ actually||\||\ saw||\||\ the||\||\ patient||\||\ and||\||\ rendered||\||\ care||\||\ for||\||\ a||\||\ procedure.||\||\ A||\||\ ______||\||\ provider||\||\ does||\||\ not||\||\ always||\||\ appear||\||\ on||\||\ a||\||\ claim.||\||\ For||\||\ insurance||\||\ filing||\||\ purposes, ||\||\ the||\||\ ______||\||\ provider||\||\ appears||\||\ on||\||\ the||\||\ claim||\||\ form||\||\ as ||\||\ the||\||\ provider.||\||\ The||\||\ Provider||\||\ Effective||\||\ Dates||\||\ and||\||\ Attributes||\||\ screen||\||\ allows||\||\ you||\||\ to||\||\ define||\||\ a||\||\ provider ||\||\ as||\||\ effective||\||\ based||\||\ on||\||\ certain||\||\ criteria||\||\ such||\||\ as||\||\ service||\||\ area,||\||\ department,||\||\ or||\||\ location||\||\ for||\||\ a||\||\ specified||\||\ period||\||\ of||\||\ time.||\||\ These||\||\ date||\||\ ranges||\||\ are||\||\ used||\||\ in||\||\ charge||\||\ review||\||\ workqueue||\||\ rules||\||\ to||\||\ prevent||\||\ users||\||\ from||\||\ entering||\||\ charges||\||\ for||\||\ ineffective||\||\ providers. Bill||\||\ Area||\||\ master||\||\ File||\||\ (BIL)
(temporary||\||\ transaction||\||\ master||\||\ file)||\||\ Each||\||\ Charge||\||\ Session||\||\ is||\||\ a||\||\ single||\||\ TAR||\||\ record ETR (permanent||\||\ transaction||\||\ master||\||\ file)||\||\ Each||\||\ individual||\||\ charge||\||\ is||\||\ a||\||\ single||\||\ ETR||\||\ record.||\||\ Permanent||\||\ Charge||\||\ (once||\||\ posted||\||\ to||\||\ the||\||\ Guarantor||\||\ Account) Charge||\||\ Review||\||\ Workqueue||\||\ Rules Errors-||\||\ Must||\||\ be||\||\ fixed||\||\ by||\||\ the||\||\ end||\||\ user Warning-||\||\ Can||\||\ be||\||\ skipped Routing-||\||\ further||\||\ restricts||\||\ which||\||\ charge||\||\ sessions||\||\ qualify||\||\ for||\||\ a||\||\ workqueue.||\||\ If||\||\ no||\||\ routing||\||\ rules||\||\ are||\||\ used||\||\ in||\||\ a||\||\ workqueue,||\||\ the||\||\ system||\||\ routes||\||\ a||\||\ charge||\||\ session||\||\ to||\||\ all||\||\ workqueues||\||\ it||\||\ qualifies||\||\ for||\||\ with||\||\ error||\||\ or||\||\ warning||\||\ rules.||\||\ If||\||\ routing||\||\ rules||\||\ are||\||\ used,||\||\ a||\||\ charge||\||\ session||\||\ is||\||\ routed||\||\ to||\||\ workqueues||\||\ only||\||\ when||\||\ at||\||\ least||\||\ one||\||\ of||\||\ the||\||\ routing||\||\ rules||\||\ is||\||\ met||\||\ in||\||\ addition||\||\ to||\||\ at||\||\ least||\||\ one||\||\ error||\||\ or||\||\ warning||\||\ rule.||\||\ Routing||\||\ rules||\||\ cannot||\||\ catch||\||\ charge||\||\ sessions||\||\ on||\||\ their||\||\ own. If||\||\ you||\||\ want||\||\ to||\||\ edit||\||\ a||\||\ rule||\||\ present||\||\ in||\||\ multiple||\||\ workqueues||\||\ make||\||\ sure||\||\ you||\||\ make||\||\ a||\||\ copy||\||\ unless||\||\
you||\||\ want||\||\ it||\||\ to||\||\ change||\||\ everywhere||\||\ else||\||\ it||\||\ already ||\||\ exists TO||\||\ qualify||\||\ for||\||\ a||\||\ Charge||\||\ review||\||\ WQ||\||\ using||\||\ routing||\||\ rules,||\||\ a||\||\ charge||\||\ session||\||\ must||\||\ qualify||\||\ for||\||\ one||\||\ routing||\||\ rule||\||\ and||\||\ one||\||\ error/||\||\ warning||\||\ rule PB||\||\ Revenue||\||\ Guardian||\||\ Check Looks||\||\ for||\||\ MISSING||\||\ charges||\||\ for||\||\ given||\||\ Encounters.||\||\ Can||\||\ access||\||\ data||\||\ from||\||\ the||\||\ patient's||\||\ chart||\||\ and||\||\ use||\||\ it||\||\ in||\||\ addition||\||\ to||\||\ charge||\||\ criteria||\||\ to||\||\ identify||\||\ specific||\||\ accounts||\||\ where||\||\ charges||\||\ may||\||\ be||\||\ missing. In||\||\ order||\||\ for||\||\ an||\||\ encounter||\||\ to||\||\ qualify||\||\ for||\||\ a||\||\ ______,||\||\ the||\||\ encounter||\||\ must: ·||\||\ Meet||\||\ the||\||\ account||\||\ criteria ·||\||\ Meet||\||\ the||\||\ encounter||\||\ criteria||\||\ (if||\||\ used) ·||\||\ Lack||\||\ the||\||\ expected||\||\ charges Best||\||\ Practices||\||\ Advisory||\||\ (BPA) Provide||\||\ targeted,||\||\ patient-specific||\||\ clinical||\||\ guidance||\||\ to||\||\ clinicians||\||\ from||\||\ many||\||\ clinical||\||\ workflows||\||\ in||\||\ Hyperspace.||\||\ ______(s)||\||\ scan||\||\ the||\||\ entire||\||\ patient||\||\ record||\||\ and||\||\ can||\||\ display||\||\ notifications||\||\ based||\||\ on||\||\ key||\||\ pieces||\||\ of||\||\ clinical||\||\
||\||\ need||\||\ to||\||\ be||\||\ reviewed||\||\ before||\||\ being||\||\ posted.||\||\ Staff||\||\ can||\||\ edit,||\||\ approve,||\||\ and||\||\ deny||\||\ adjustments||\||\ from||\||\ a||\||\ workqueue. Adjustment||\||\ Approval||\||\ Level For||\||\ each||\||\ user||\||\ that||\||\ has||\||\ security||\||\ to||\||\ review||\||\ adjustments,||\||\ the||\||\ specific||\||\ level||\||\ a||\||\ user||\||\ can||\||\ approve||\||\ must||\||\ be||\||\ listed||\||\ in||\||\ that||\||\ individual||\||\ user's||\||\ record.||\||\ When||\||\ a||\||\ user||\||\ requests||\||\ or||\||\ approves||\||\ an||\||\ adjustment,||\||\ the||\||\ assigned||\||\ approval||\||\ level||\||\ is||\||\ associated||\||\ with||\||\ the||\||\ adjustment,||\||\ and||\||\ the||\||\ adjustment||\||\ is||\||\ routed||\||\ for||\||\ further||\||\ review,||\||\ if||\||\ needed. Cascading||\||\ tiered||\||\ approval The||\||\ size||\||\ of||\||\ the||\||\ adjustment||\||\ determines||\||\ how||\||\ many||\||\ users||\||\ need||\||\ to||\||\ approve||\||\ it||\||\ before||\||\ it||\||\ is||\||\ accepted.||\||\ All||\||\ adjustments||\||\ start||\||\ at||\||\ the||\||\ lower||\||\ levels||\||\ of||\||\ review.||\||\ At||\||\ each||\||\ level,||\||\ when||\||\ a||\||\ user||\||\ approves||\||\ the||\||\ adjustment,||\||\ it||\||\ either||\||\ moves||\||\ on||\||\ to||\||\ a ||\||\ higher||\||\ level||\||\ for||\||\ additional||\||\ approval||\||\ or||\||\ posts. Bucketed||\||\ tiered||\||\ approval One||\||\ person||\||\ from||\||\ your||\||\ organization||\||\ reviews||\||\ each||\||\ adjustment||\||\ request.||\||\ The||\||\ user||\||\ with||\||\ the||\||\
ability||\||\ to||\||\ approve||\||\ or||\||\ deny||\||\ the||\||\ request||\||\ depends||\||\ on||\||\ the||\||\ dollar||\||\ amount||\||\ of||\||\ the||\||\ pending||\||\ adjustment. Visit||\||\ Filing||\||\ Order Refers||\||\ to||\||\ the||\||\ order||\||\ in||\||\ which||\||\ claims||\||\ are||\||\ sent||\||\ for||\||\ a||\||\ particular||\||\ visit.||\||\ Each||\||\ visit||\||\ stores||\||\ a||\||\ filing||\||\ order||\||\ specific||\||\ to||\||\ that||\||\ visit. Retroadjudication The||\||\ review||\||\ and||\||\ resolution||\||\ of||\||\ changes||\||\ made||\||\ to||\||\ an||\||\ existing||\||\ visit's||\||\ proposed||\||\ filing||\||\ order.||\||\ Happens||\||\ when||\||\ an||\||\ update||\||\ to||\||\ a||\||\ patient's||\||\ filing||\||\ order||\||\ creates||\||\ a||\||\ new||\||\ proposed||\||\ visit||\||\ filing||\||\ order. When||\||\ a||\||\ visit's||\||\ proposed||\||\ filing||\||\ order||\||\ change||\||\ is||\||\ accepted||\||\ (either||\||\ automatically||\||\ or||\||\ manually||\||\ by||\||\ a||\||\ user)||\||\ the||\||\ visit's||\||\ filing||\||\ order||\||\ is||\||\ updated. If||\||\ the||\||\ primary||\||\ coverage||\||\ for||\||\ a||\||\ visit||\||\ is||\||\ changed||\||\ by||\||\ an||\||\ update,||\||\ then||\||\ the||\||\ system||\||\ will||\||\ automatically||\||\ repost||\||\ the||\||\ charges||\||\ from||\||\ the||\||\ visit||\||\ to||\||\ reassign||\||\ them||\||\ to||\||\ the||\||\ proper||\||\ liability.||\||\ This||\||\ will||\||\ only||\||\ happen ||\||\ when||\||\ the||\||\ primary||\||\ coverage||\||\ changes;||\||\ never||\||\ for||\||\ any||\||\ other||\||\ level||\||\ of||\||\ the||\||\ filing||\||\ order. Retro||\||\ Coverage||\||\ Review||\||\ Profile
Help||\||\ your||\||\ organization||\||\ manage||\||\ and||\||\ resolve||\||\ payments||\||\ that||\||\ create||\||\ credit||\||\ balances||\||\ or||\||\ are||\||\ undistributed.||\||\ From||\||\ the||\||\ workqueue,||\||\ some||\||\ credits||\||\ can||\||\ be||\||\ resolved||\||\ automatically||\||\ by||\||\ the||\||\ system||\||\ and||\||\ others||\||\ are||\||\ researched||\||\ and||\||\ resolved||\||\ by||\||\ credit||\||\ analysts. System ||\||\ Credit||\||\ Workqueue Automatic||\||\ Activity||\||\ setup||\||\ and||\||\ mapping||\||\ make||\||\ automatic||\||\ WQ's||\||\ when||\||\ used||\||\ in||\||\ the||\||\ individual||\||\ WQ||\||\ Profiles Credit||\||\ Workqueue||\||\ Profile The||\||\ system||\||\ uses||\||\ the||\||\ service||\||\ area's||\||\ ______||\||\ to||\||\ automatically||\||\ route||\||\ credit||\||\ records||\||\ to||\||\ a||\||\ workqueue.||\||\ Within||\||\ the||\||\ Workqueue||\||\ Routing||\||\ section,||\||\ workqueues||\||\ are||\||\ associated||\||\ with||\||\ rules.||\||\ Credit||\||\ records||\||\ are||\||\ evaluated||\||\ against||\||\ these||\||\ rules ||\||\ in||\||\ the||\||\ order||\||\ listed.||\||\ When||\||\ a||\||\ credit||\||\ record||\||\ meets||\||\ the||\||\ criteria||\||\ of||\||\ the||\||\ rule||\||\ it||\||\ is||\||\ automatically||\||\ routed||\||\ to||\||\ the||\||\ associated||\||\ workqueue. Credit||\||\ Workqueue||\||\ Profile||\||\ Workqueue||\||\ Routing Because||\||\ the||\||\ rules||\||\ in||\||\ Workqueue||\||\ Routing||\||\ are||\||\ prioritized,||\||\ a||\||\ credit||\||\ record||\||\ can||\||\ only||\||\ be||\||\ in||\||\ ONE||\||\
credit||\||\ workqueue||\||\ at||\||\ a||\||\ time. The||\||\ default||\||\ catch-all||\||\ workqueue||\||\ should||\||\ always||\||\ be||\||\ LAST||\||\ in||\||\ priority||\||\ of||\||\ the||\||\ Workqueue||\||\ Routing||\||\ section. Credit||\||\ Workqueue||\||\ Profile||\||\ Automatic||\||\ Activities Credit||\||\ workqueues||\||\ are||\||\ ideally||\||\ designed||\||\ to||\||\ resolve||\||\ credits||\||\ with||\||\ no||\||\ or||\||\ minimal||\||\ manual||\||\ intervention.||\||\ Credit||\||\ analysts||\||\ will||\||\ also||\||\ use||\||\ these||\||\ workqueues||\||\ to||\||\ work||\||\ the||\||\ undistributed||\||\ payments||\||\ and||\||\ credit||\||\ balances||\||\ that||\||\ the||\||\ system||\||\ cannot||\||\ automatically||\||\ resolve. Follow||\||\ Up||\||\ Records||\||\ (FOL) The||\||\ combination||\||\ of||\||\ a||\||\ coverage||\||\ (CVG)||\||\ and||\||\ a||\||\ charge||\||\ (ETR).||\||\ FOL||\||\ =||\||\ CVG||\||\ +||\||\ ETR These||\||\ are||\||\ created||\||\ when||\||\ the||\||\ claim||\||\ is||\||\ accepted||\||\ within||\||\ Epic||\||\ and||\||\ is||\||\ completed||\||\ when||\||\ the||\||\ charge||\||\ becomes||\||\ $0||\||\ for||\||\ that||\||\ PAYER.||\||\ This||\||\ can||\||\ be||\||\ done||\||\ as||\||\ NRP,||\||\ write-off||\||\ or||\||\ paid||\||\ in||\||\ full.||\||\ Can||\||\ only||\||\ be||\||\ in||\||\ one||\||\ WQ||\||\ at||\||\ a||\||\ time Denial||\||\ (BDC)||\||\ Records Each||\||\ denial||\||\ in||\||\ the||\||\ system||\||\ is||\||\ tracked||\||\ as||\||\ a||\||\ ______||\||\ which||\||\ enables||\||\ accurate||\||\ and||\||\ consistent||\||\
