EPIC COG230 REVENUE DATA MODEL| QUESTIONS AND
ANSWERS VERIFIED 100%| NEWEST EXAM 2025/2026
Accounts Receivable -CORRECT ANSWER Outstanding money we expect to
receive in the future
Three Transaction Types: -CORRECT ANSWER Charges
Payments
Adjustments
Charges occur as a result of: -CORRECT ANSWER Performing services
Payments are a result of: -CORRECT ANSWER Receiving money
What are adjustments? -CORRECT ANSWER Anything that changes AR
(Credit Adjustments or Debit Adjustments)
An example of a credit adjustment is: -CORRECT ANSWER Contractual
write-offs
An example of a debit adjustment is: -CORRECT ANSWER A refund
Debits _______ AR -CORRECT ANSWER Increase (Charges and Debit
Adjustments)
Credits ________ AR -CORRECT ANSWER Decrease (Payments and Credit
Adjustments)
,What is the function of a Hospital Account (HAR)? -CORRECT ANSWER
Collects transactions related to an encounter and centralizes encounters,
transactions, insurance, etc.
Insurance coverage, is a unique combination of what 3 things? -CORRECT
ANSWER Payer
Plan
Subscriber
What is an insurance payer? -CORRECT ANSWER The insurance company
What is an insurance plan? -CORRECT ANSWER The set of benefits a patient
receives
What is an insurance subsriber? -CORRECT ANSWER The policy holder
What is a guarantor? -CORRECT ANSWER The person ultimately
responsible for payment. This could be the patient or someone else (ie. the
subscriber)
Who is the insurance member? -CORRECT ANSWER The member is who the
insurance coverage is for. For example, if a subscriber has children. The
children are members of the subscriber's plan.
If a patient has multiple coverages, the order in which they are billed is called
the: -CORRECT ANSWER Filing Order
True or False
, Every Hospital Account must be connected to a guarantor -CORRECT
ANSWER True
True or False
Every PB Transaction must be connected to a guarantor -CORRECT
ANSWER True
What are the two hospital applications used to track billing? -CORRECT
ANSWER 1. Resolute Professional Billing
2. Resolute Hospital Billing
What services do Professional Billing cover? -CORRECT ANSWER Services
performed by clinicians in inpatient or outpatient settings
What services do Hospital Billing cover? -CORRECT ANSWER Services and
supplies related to hospital encounters, including: medications, lab charges,
imaging, room and bed charges and more.
True or False
Hospital Billing doesn't need to achieve the level of granularity that
Professional Billing needs and does not need to match every payment to each
charge -CORRECT ANSWER True
PB transactions are stored in the ___ master file -CORRECT ANSWER ETR
HB transactions are stored in the ___ master file -CORRECT ANSWER HTR
Which system did EPIC have early on in its' development, Professional or
Hospital Billing? -CORRECT ANSWER Professional Billing
ANSWERS VERIFIED 100%| NEWEST EXAM 2025/2026
Accounts Receivable -CORRECT ANSWER Outstanding money we expect to
receive in the future
Three Transaction Types: -CORRECT ANSWER Charges
Payments
Adjustments
Charges occur as a result of: -CORRECT ANSWER Performing services
Payments are a result of: -CORRECT ANSWER Receiving money
What are adjustments? -CORRECT ANSWER Anything that changes AR
(Credit Adjustments or Debit Adjustments)
An example of a credit adjustment is: -CORRECT ANSWER Contractual
write-offs
An example of a debit adjustment is: -CORRECT ANSWER A refund
Debits _______ AR -CORRECT ANSWER Increase (Charges and Debit
Adjustments)
Credits ________ AR -CORRECT ANSWER Decrease (Payments and Credit
Adjustments)
,What is the function of a Hospital Account (HAR)? -CORRECT ANSWER
Collects transactions related to an encounter and centralizes encounters,
transactions, insurance, etc.
Insurance coverage, is a unique combination of what 3 things? -CORRECT
ANSWER Payer
Plan
Subscriber
What is an insurance payer? -CORRECT ANSWER The insurance company
What is an insurance plan? -CORRECT ANSWER The set of benefits a patient
receives
What is an insurance subsriber? -CORRECT ANSWER The policy holder
What is a guarantor? -CORRECT ANSWER The person ultimately
responsible for payment. This could be the patient or someone else (ie. the
subscriber)
Who is the insurance member? -CORRECT ANSWER The member is who the
insurance coverage is for. For example, if a subscriber has children. The
children are members of the subscriber's plan.
If a patient has multiple coverages, the order in which they are billed is called
the: -CORRECT ANSWER Filing Order
True or False
, Every Hospital Account must be connected to a guarantor -CORRECT
ANSWER True
True or False
Every PB Transaction must be connected to a guarantor -CORRECT
ANSWER True
What are the two hospital applications used to track billing? -CORRECT
ANSWER 1. Resolute Professional Billing
2. Resolute Hospital Billing
What services do Professional Billing cover? -CORRECT ANSWER Services
performed by clinicians in inpatient or outpatient settings
What services do Hospital Billing cover? -CORRECT ANSWER Services and
supplies related to hospital encounters, including: medications, lab charges,
imaging, room and bed charges and more.
True or False
Hospital Billing doesn't need to achieve the level of granularity that
Professional Billing needs and does not need to match every payment to each
charge -CORRECT ANSWER True
PB transactions are stored in the ___ master file -CORRECT ANSWER ETR
HB transactions are stored in the ___ master file -CORRECT ANSWER HTR
Which system did EPIC have early on in its' development, Professional or
Hospital Billing? -CORRECT ANSWER Professional Billing
