RPB390 Epic Certification Practice
Review Test.
A charge posts with a price of $77.00, this is the _______. Choose only one answer.
A. Allowed Amount
B. Expected Reimbursement Amount
C. Billed Amount
D. Not Allowed Amount - CORRECT ANSWER C. Billed Amount
Your reimbursement contract build calculates you will be able to receive $64.00 from the payer and
patient. This is the _____________. Choose only one answer.
A. Allowed Amount
B. Expected Reimbursement Amount
C. Billed Amount
D. Not Allowed Amount - CORRECT ANSWER B. Expected Reimbursement Amount
The payer's calculation matches your contract and the payer agrees that you should be able to collect
$64. This is the ________. Choose only one answer.
A. Allowed Amount
B. Expected Reimbursement Amount
C. Billed Amount
D. Not Allowed Amount - CORRECT ANSWER A. Allowed Amount
4. The difference between the price of the charge and what the payer agrees that you should be able to
collect is $13.00. This is the ________________. Choose only ONE answer.
,A. Allowed Amount
B. Expected Reimbursement Amount
C. Billed Amount
D. Not Allowed Amount - CORRECT ANSWER D. Not Allowed Amount
Billed amount - CORRECT ANSWER total amount charged for a service
The price of a charge sent out on the claim to the payer
Expected reimbursement amount - CORRECT ANSWER The amount built in your reimbursement
contract that you expect to collect.
Allowed amount - CORRECT ANSWER The maximum amount an insurer will pay for any given service.
Actual collectable amount on the EOB from a payer.
Not allowed amount - CORRECT ANSWER difference between billed amount and allowed amount
The difference between the allowed amount and the billed amount that is written off.
Purpose of reimbursement contracts - CORRECT ANSWER 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 particular payer. You can easily track underpayment and undercharging
scenarios when reimbursement contracts are built in Epic.
Reimbursement contracts are only used for calculating reimbursement or allowed amounts and do NOT
affect the price of a charge. Contracts can be configured to perform automatic write ‐offs, or to track and
analyze payer responses against what you expect to receive.
Benefits/challenges of reimbursement contracts - CORRECT ANSWER Pros:
, Increased reporting capabilities
Helpful in negotiations with payers
Auto‐populating allowed amounts in Payment Posting
Ability to route underpayments to work queues for follow ‐up
Cons:
Requires time commitment to set up and maintain
Increased usage = increased maintenance ﴾the more you build, the more you have to maintain ﴿
Information is only as accurate as you make it
End‐user workflows affected by reimbursement contracts
EXAMPLE: Watch as your trainer enters a 99213 for a Benjamin performed by Rob Marino explore
contract details in Hyperspace. - CORRECT ANSWER Reimbursement contract information can appear to
end users in multiple places in Hyperspace. Charge entry staff can see when a contract is associated with
a charge session. The same options are available in charge review. In a charge session, the user can also
see information about allowed amount for a specific charge by selecting the appropriate charge, then
clicking Show Benefit Summary.
Once the charge is posted to the guarantor account, you can then view the expected reimbursement
amount of the charge in PB Transaction Inquiry.
When a contracted payer pays a claim, the expected reimbursement amount from the reimbursement
contract automatically populates the Allowed field for manual payment posting. If there is a discrepancy
between the contract calculation done in Epic and the allowed amount remitted by the payer, the
discrepancy is automatically flagged and can be routed to a Follow ‐up work queue or worked from an
underpayment report.
In which environment do end users perform their daily workflows? Choose ONLY one:
A. POC
B. TST
C. SUP
Review Test.
A charge posts with a price of $77.00, this is the _______. Choose only one answer.
A. Allowed Amount
B. Expected Reimbursement Amount
C. Billed Amount
D. Not Allowed Amount - CORRECT ANSWER C. Billed Amount
Your reimbursement contract build calculates you will be able to receive $64.00 from the payer and
patient. This is the _____________. Choose only one answer.
A. Allowed Amount
B. Expected Reimbursement Amount
C. Billed Amount
D. Not Allowed Amount - CORRECT ANSWER B. Expected Reimbursement Amount
The payer's calculation matches your contract and the payer agrees that you should be able to collect
$64. This is the ________. Choose only one answer.
A. Allowed Amount
B. Expected Reimbursement Amount
C. Billed Amount
D. Not Allowed Amount - CORRECT ANSWER A. Allowed Amount
4. The difference between the price of the charge and what the payer agrees that you should be able to
collect is $13.00. This is the ________________. Choose only ONE answer.
,A. Allowed Amount
B. Expected Reimbursement Amount
C. Billed Amount
D. Not Allowed Amount - CORRECT ANSWER D. Not Allowed Amount
Billed amount - CORRECT ANSWER total amount charged for a service
The price of a charge sent out on the claim to the payer
Expected reimbursement amount - CORRECT ANSWER The amount built in your reimbursement
contract that you expect to collect.
Allowed amount - CORRECT ANSWER The maximum amount an insurer will pay for any given service.
Actual collectable amount on the EOB from a payer.
Not allowed amount - CORRECT ANSWER difference between billed amount and allowed amount
The difference between the allowed amount and the billed amount that is written off.
Purpose of reimbursement contracts - CORRECT ANSWER 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 particular payer. You can easily track underpayment and undercharging
scenarios when reimbursement contracts are built in Epic.
Reimbursement contracts are only used for calculating reimbursement or allowed amounts and do NOT
affect the price of a charge. Contracts can be configured to perform automatic write ‐offs, or to track and
analyze payer responses against what you expect to receive.
Benefits/challenges of reimbursement contracts - CORRECT ANSWER Pros:
, Increased reporting capabilities
Helpful in negotiations with payers
Auto‐populating allowed amounts in Payment Posting
Ability to route underpayments to work queues for follow ‐up
Cons:
Requires time commitment to set up and maintain
Increased usage = increased maintenance ﴾the more you build, the more you have to maintain ﴿
Information is only as accurate as you make it
End‐user workflows affected by reimbursement contracts
EXAMPLE: Watch as your trainer enters a 99213 for a Benjamin performed by Rob Marino explore
contract details in Hyperspace. - CORRECT ANSWER Reimbursement contract information can appear to
end users in multiple places in Hyperspace. Charge entry staff can see when a contract is associated with
a charge session. The same options are available in charge review. In a charge session, the user can also
see information about allowed amount for a specific charge by selecting the appropriate charge, then
clicking Show Benefit Summary.
Once the charge is posted to the guarantor account, you can then view the expected reimbursement
amount of the charge in PB Transaction Inquiry.
When a contracted payer pays a claim, the expected reimbursement amount from the reimbursement
contract automatically populates the Allowed field for manual payment posting. If there is a discrepancy
between the contract calculation done in Epic and the allowed amount remitted by the payer, the
discrepancy is automatically flagged and can be routed to a Follow ‐up work queue or worked from an
underpayment report.
In which environment do end users perform their daily workflows? Choose ONLY one:
A. POC
B. TST
C. SUP
