RPB102: Epic Resolute Professional
Billing Fundamentals
Patient Filing Order - ANS Every coverage the patient has ever had whether or not it's still effective
Prelude - ANS Enterprise Registration. Hold the basic patient, guarantor account and coverage data
K
Cadence - ANS Scheduling. Schedule and check in visits. Collect visit specific data.
C
Resolute Professional Billing - ANS Billing for professional services. UB and CMS claim forms
available.
LO
Single Billing Office - ANS Using an integrated set of tools to send a statement both hospital and
professional self-pay balances and follow-up on those balances. Requires the use of an encounter-specific
account called a hospital account (HAR) in both HB and PB.
HAR - ANS Hospital Account Record. Encounter-specific account.
YC
Retro Adjudication - ANS review and resolution of changes made to an existing visit's filing order.
Triggered when an update to a patient's filing order creates a new proposed visit filing order.
Visit Filing Order - ANS Which coverages to send a claim & in what order
D
- Filing order saved per visit
- Finalized when a visit is checked in
- Claims sent based on visit filing order
U
Guarantor - ANS Person/entity financially responsible
ST
A patient can have *** guarantor accounts - ANS Multiple
Accident related guarantor account types - ANS work comp or third party liability
Encounter form number - ANS Created when a visit is checked in
Contact Serial Number (CSN) - ANS Created when the appointment is scheduled
When are POS payments posted to the account? - ANS Immediately
In the foundation system, which of the following payment types can be partially refunded using the
Patient Refund module?
, Check
Cash
Credit Card - ANS Cash & Credit Card
True or False: In the foundation system, the front desk user can use the patient refund module to issue a
refund? - ANS False
True or False: When creating a coverage record in the system, you must choose the correct Payer and
Group Number listed on the subscriber's insurance card. - ANS False: Payer and Plan
K
True or False: A patient can have more than one guarantor account. - ANS True. However, only one
guarantor can be linked to a visit.
C
True or False: It is possible to refund payments collected at the front desk the same day they are collected.
- ANS True
LO
Master Files - ANS hold information about a particular type of data.
Each master file is also known by a three-letter abbreviation known as - ANS an INI
Records - ANS hold information about a particular data entry.
YC
Contacts - ANS hold date-specific information for a particular record
Items - ANS store discrete pieces of information about a record
Facility - ANS presents your entire healthcare organization. You will only have one facility record per
D
oganization
Service Area - ANS used to separate distinct business entities (accounts receivable) within an
U
organization.
(Revenue) Locations - ANS present the actual hospitals and clinics within the organization.
ST
Place of Service - ANS represents a facility or organization that is not an actual part of your
organizations hierarchy and is financially separate from your organization.
Department/Units - ANS places where users work and patients receive care.
True or False: A patient who has been seen multiple times at your hospital should have multiple patient
records in Epic. - ANS False, the patient will have one patient record with multiple contacts
Which entity is used to track changes to data over time?
A. Records
Billing Fundamentals
Patient Filing Order - ANS Every coverage the patient has ever had whether or not it's still effective
Prelude - ANS Enterprise Registration. Hold the basic patient, guarantor account and coverage data
K
Cadence - ANS Scheduling. Schedule and check in visits. Collect visit specific data.
C
Resolute Professional Billing - ANS Billing for professional services. UB and CMS claim forms
available.
LO
Single Billing Office - ANS Using an integrated set of tools to send a statement both hospital and
professional self-pay balances and follow-up on those balances. Requires the use of an encounter-specific
account called a hospital account (HAR) in both HB and PB.
HAR - ANS Hospital Account Record. Encounter-specific account.
YC
Retro Adjudication - ANS review and resolution of changes made to an existing visit's filing order.
Triggered when an update to a patient's filing order creates a new proposed visit filing order.
Visit Filing Order - ANS Which coverages to send a claim & in what order
D
- Filing order saved per visit
- Finalized when a visit is checked in
- Claims sent based on visit filing order
U
Guarantor - ANS Person/entity financially responsible
ST
A patient can have *** guarantor accounts - ANS Multiple
Accident related guarantor account types - ANS work comp or third party liability
Encounter form number - ANS Created when a visit is checked in
Contact Serial Number (CSN) - ANS Created when the appointment is scheduled
When are POS payments posted to the account? - ANS Immediately
In the foundation system, which of the following payment types can be partially refunded using the
Patient Refund module?
, Check
Cash
Credit Card - ANS Cash & Credit Card
True or False: In the foundation system, the front desk user can use the patient refund module to issue a
refund? - ANS False
True or False: When creating a coverage record in the system, you must choose the correct Payer and
Group Number listed on the subscriber's insurance card. - ANS False: Payer and Plan
K
True or False: A patient can have more than one guarantor account. - ANS True. However, only one
guarantor can be linked to a visit.
C
True or False: It is possible to refund payments collected at the front desk the same day they are collected.
- ANS True
LO
Master Files - ANS hold information about a particular type of data.
Each master file is also known by a three-letter abbreviation known as - ANS an INI
Records - ANS hold information about a particular data entry.
YC
Contacts - ANS hold date-specific information for a particular record
Items - ANS store discrete pieces of information about a record
Facility - ANS presents your entire healthcare organization. You will only have one facility record per
D
oganization
Service Area - ANS used to separate distinct business entities (accounts receivable) within an
U
organization.
(Revenue) Locations - ANS present the actual hospitals and clinics within the organization.
ST
Place of Service - ANS represents a facility or organization that is not an actual part of your
organizations hierarchy and is financially separate from your organization.
Department/Units - ANS places where users work and patients receive care.
True or False: A patient who has been seen multiple times at your hospital should have multiple patient
records in Epic. - ANS False, the patient will have one patient record with multiple contacts
Which entity is used to track changes to data over time?
A. Records
