Billing Fundamentals Newest Actual
Exam 2024//2025wth Elaborated
Questions And Correct Answers
Which of the following is a purpose of the Enterprise Statement Run Report? Select ALL
that apply
A. Reconciliation tool to compare what Epic indicates was generated to what was
actually generated
B. Reconciliation tool to compare what was sent to a print vendor and what the print
vendor sends back in the receipt
C. Record of which guarantor accounts got a statement and which guarantor accounts
did not get a statement, even though they qualified for the statement run
D. A tool used to determine which guarantors have never received a statement -
CORRECT ANSWER A, B, C
Which of the following happens when a statement run is accepted? Select ALL that
apply
A. The guarantor accounts get stamped with a statement sent date
B. Each HAR included in those statements has its self-pay follow-up level incremented
C. The statement run is removed from Epic
D. Statements are printed - CORRECT ANSWER A, B, C
Which HB HAR statuses allow you to change the primary coverage on an HB HAR?
Choose ALL that apply
A. Open
B. DNB
C. Billed
D. Closed - CORRECT ANSWER A and B
True or False: When adding a secondary coverage after a primary has already paid,
you should undo billing to bring the HAR back to DNB status. - CORRECT ANSWER
False
If a coverage is not effective for any past encounters but you want to record it for future
use, which option in Registration should you use to add the coverage? Choose only
ONE answer.
A. Coverage Info form
B. Add coverage link
C. Guarantor Demographic link
, D. Add the coverage in Hospital Account Maintenance, not Registration - CORRECT
ANSWER B
Where in Account Maintenance can you view information about self-pay and insurance
balances, as well as any payments or adjustments made for all HARs belonging to the
same guarantor? Choose only ONE answer.
A. Account Summary
B. Account Contact
C. Liability Buckets
D. Guarantor Summary - CORRECT ANSWER D
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