Exam| Complete Questions and Correct Verified
Answers/ Graded A+ (Brand New!!)
1. A charge posts with a price of $77.00. This amount is the
______.
A. Allowed Amount
B. Expected Reimbursement Amount
C. Billed Amount
D. Not Allowed Amount
Answer: C
Rationale: The Billed Amount is the total charge amount for a
service—the price sent out on the claim to the payer. It is the
starting point for reimbursement calculations .
1
,2. Your reimbursement contract build calculates that you will
be able to receive $64.00 from the payer and patient. This is
the ________.
A. Allowed Amount
B. Expected Reimbursement Amount
C. Billed Amount
D. Not Allowed Amount
Answer: B
Rationale: The Expected Reimbursement Amount is the amount
built in your reimbursement contract that you expect to collect
from the payer and patient based on contract terms .
3. The payer's calculation matches your contract and the
payer agrees that you should be able to collect $64.00. This is
the ________.
A. Allowed Amount
B. Expected Reimbursement Amount
2
,C. Billed Amount
D. Not Allowed Amount
Answer: A
Rationale: The Allowed Amount is the maximum amount an
insurer will pay for a given service—the actual collectable
amount on the EOB from the payer that matches your contract
terms .
4. The difference between the price of the charge ($77.00) and
what the payer agrees you should collect ($64.00) is $13.00.
This is the ________.
A. Allowed Amount
B. Expected Reimbursement Amount
C. Billed Amount
D. Not Allowed Amount
Answer: D
3
, Rationale: The Not Allowed Amount is the difference between
the Billed Amount and the Allowed Amount—the amount that is
written off as a contractual adjustment .
5. What is the primary purpose of reimbursement contracts in
Epic?
A. To change the price of charges
B. To compare expected allowed amounts to actual payments
received
C. To schedule patient appointments
D. To register new patients
Answer: B
Rationale: Reimbursement contracts allow you to compare the
allowed amount you expect to receive from a payer to what you
actually receive for every charge associated with that payer.
They do NOT affect the price of a charge .
4