,Epic Resolute PB Certification Exam 2026,
Epic questions with answers and
rationales
Introduction
This document contains 50 Epic Resolute PB certification-style
questions with answers and rationales covering professional
billing and revenue-cycle workflows. Topics include charge
capture, claims, edits and rejections, payer adjudication,
payment posting, adjustments, guarantors, insurance
sequencing, workqueues, denial management, account research,
patient responsibility, and end-to-end billing workflows.
The material emphasizes practical billing scenarios, including
correcting insurance information, handling duplicate charges
and payments, managing credit balances, prioritizing
workqueues, and addressing recurring denial or rejection root
causes.
Exam Questions and Answers
,1. A biller is reviewing a patient account and notices that a
charge is present, but there is no corresponding insurance
claim. What should the biller check first?
A. Patient's guarantor name
B. Claim status and billing history
C. Provider's schedule
D. Patient's clinical notes
Answer: B. Claim status and billing history
Rationale: Before taking corrective action, the biller should
determine whether the charge has already been billed, held,
rejected, or otherwise prevented from generating a claim.
Practical example: A $250 office visit charge appears on the
account, but no claim was transmitted. Reviewing the billing
history can reveal that the charge is still sitting in a billing
hold.
2. A patient is registered with incorrect guarantor
information. What is the most important reason to correct
it before billing?
A. It changes the patient's diagnosis
B. It ensures financial responsibility is assigned correctly
C. It changes the rendering provider
D. It automatically changes the CPT code
, Answer: B. It ensures financial responsibility is assigned
correctly
Rationale: The guarantor identifies the party financially
responsible for the account. Incorrect guarantor information
can cause statements and balances to be directed incorrectly.
3. A patient has two insurance plans. The primary plan
processes the claim and leaves $80 as patient
responsibility. The secondary plan is expected to process
the remaining amount.
What should the biller verify before transferring the $80 to
the patient?
A. Whether secondary insurance has been billed
B. Whether the patient has changed providers
C. Whether the diagnosis has been deleted
D. Whether the encounter was canceled
Answer: A. Whether secondary insurance has been billed
Rationale: When secondary coverage exists, the remaining
balance should generally be evaluated for secondary billing
before assigning it to the patient.
4. Which item most directly represents a service or
procedure that can be billed?
Epic questions with answers and
rationales
Introduction
This document contains 50 Epic Resolute PB certification-style
questions with answers and rationales covering professional
billing and revenue-cycle workflows. Topics include charge
capture, claims, edits and rejections, payer adjudication,
payment posting, adjustments, guarantors, insurance
sequencing, workqueues, denial management, account research,
patient responsibility, and end-to-end billing workflows.
The material emphasizes practical billing scenarios, including
correcting insurance information, handling duplicate charges
and payments, managing credit balances, prioritizing
workqueues, and addressing recurring denial or rejection root
causes.
Exam Questions and Answers
,1. A biller is reviewing a patient account and notices that a
charge is present, but there is no corresponding insurance
claim. What should the biller check first?
A. Patient's guarantor name
B. Claim status and billing history
C. Provider's schedule
D. Patient's clinical notes
Answer: B. Claim status and billing history
Rationale: Before taking corrective action, the biller should
determine whether the charge has already been billed, held,
rejected, or otherwise prevented from generating a claim.
Practical example: A $250 office visit charge appears on the
account, but no claim was transmitted. Reviewing the billing
history can reveal that the charge is still sitting in a billing
hold.
2. A patient is registered with incorrect guarantor
information. What is the most important reason to correct
it before billing?
A. It changes the patient's diagnosis
B. It ensures financial responsibility is assigned correctly
C. It changes the rendering provider
D. It automatically changes the CPT code
, Answer: B. It ensures financial responsibility is assigned
correctly
Rationale: The guarantor identifies the party financially
responsible for the account. Incorrect guarantor information
can cause statements and balances to be directed incorrectly.
3. A patient has two insurance plans. The primary plan
processes the claim and leaves $80 as patient
responsibility. The secondary plan is expected to process
the remaining amount.
What should the biller verify before transferring the $80 to
the patient?
A. Whether secondary insurance has been billed
B. Whether the patient has changed providers
C. Whether the diagnosis has been deleted
D. Whether the encounter was canceled
Answer: A. Whether secondary insurance has been billed
Rationale: When secondary coverage exists, the remaining
balance should generally be evaluated for secondary billing
before assigning it to the patient.
4. Which item most directly represents a service or
procedure that can be billed?
