PROFESSIONAL BILLING
FUNDAMENTALS COMPLETE
SOLUTION 100% VERIFIED ANSWERS
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Patient Filing Order - Correct answer.Every coverage the patient has ever had whether or not it's still
effective
Prelude - Correct answer.Enterprise Registration. Hold the basic patient, guarantor account and
coverage data
Cadence - Correct answer.Scheduling. Schedule and check in visits. Collect visit specific data.
Resolute Professional Billing - Correct answer.Billing for professional services. UB and CMS claim forms
available.
Single Billing Office - Correct answer.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 - Correct answer.Hospital Account Record. Encounter-specific account.
Retroadjudication - Correct answer.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 - Correct answer.Which coverages to send a claim & in what order
- Filing order saved per visit
, - Finalized when a visit is checked in
- Claims sent based on visit filing order
Guarantor - Correct answer.Person/entity financially responsible
A patient can have *** guarantor accounts - Correct answer.Multiple
Accident related guarantor account types - Correct answer.work comp or third party liability
Encounter form number - Correct answer.Created when a visit is checked in
Contact Serial Number (CSN) - Correct answer.Created when the appointment is scheduled
When are POS payments posted to the account? - Correct answer.Immediately
In the foundation system, which of the following payment types can be partially refunded using the
Patient Refund module?
Check
Cash
Credit Card - Correct answer.Cash & Credit Card
True or False: In the foundation system, the front desk user can use the patient refund module to issue a
refund? - Correct answer.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. - Correct answer.False: Payer and Plan
True or False: A patient can have more than one guarantor account. - Correct answer.True. However,
only one guarantor can be linked to a visit.