EPIC COG230 Revenue Data Model
Actual Exam Latest Update 2025
Questions and Correct Answers Rated A+
Accounts Receivable -Answer-Outstanding money we expect to
receive in the future
Three Transaction Types: -Answer-Charges
Payments
Adjustments
Charges occur as a result of: -Answer-Performing services
Payments are a result of: -Answer-Receiving money
What are adjustments? -Answer-Anything that changes AR (Credit
Adjustments or Debit Adjustments)
An example of a credit adjustment is: -Answer-Contractual write-offs
An example of a debit adjustment is: -Answer-A refund
Debits _______ AR -Answer-Increase (Charges and Debit
Adjustments)
Credits ________ AR -Answer-Decrease (Payments and Credit
Adjustments)
What is the function of a Hospital Account (HAR)? -Answer-Collects
transactions related to an encounter and centralizes encounters,
transactions, insurance, etc.
,Insurance coverage, is a unique combination of what 3 things? -
Answer-Payer
Plan
Subscriber
What is an insurance payer? -Answer-The insurance company
What is an insurance plan? -Answer-The set of benefits a patient
receives
What is an insurance subsriber? -Answer-The policy holder
What is a guarantor? -Answer-The person ultimately responsible for
payment. This could be the patient or someone else (ie. the
subscriber)
Who is the insurance member? -Answer-The member is who the
insurance coverage is for. For example, if a subscriber has children.
The children are members of the subscriber's plan.
If a patient has multiple coverages, the order in which they are billed is
called the: -Answer-Filing Order
True or False
Every Hospital Account must be connected to a guarantor -Answer-
True
True or False
Every PB Transaction must be connected to a guarantor -Answer-
True
, What are the two hospital applications used to track billing? -Answer-
1. Resolute Professional Billing
2. Resolute Hospital Billing
What services do Professional Billing cover? -Answer-Services
performed by clinicians in inpatient or outpatient settings
What services do Hospital Billing cover? -Answer-Services and
supplies related to hospital encounters, including: medications, lab
charges, imaging, room and bed charges and more.
True or False
Hospital Billing doesn't need to achieve the level of granularity that
Professional Billing needs and does not need to match every payment
to each charge -Answer-True
PB transactions are stored in the ___ master file -Answer-ETR
HB transactions are stored in the ___ master file -Answer-HTR
Which system did EPIC have early on in its' development,
Professional or Hospital Billing? -Answer-Professional Billing
What is the purpose of a Single Billing Office (SBO)? -Answer-SBO is
a billing mode that combines HB and PB balances into a single
guarantor statement. Thus, creating simpler statements for easier
management for guarantors.
Diakeishaye goes to the doctor for a physical. This generates one
charge for $50. A claim is sent to Aetna, which sends a check for $35,
saying there is a $5 patient portion. $10 gets written off, and the rest is
Actual Exam Latest Update 2025
Questions and Correct Answers Rated A+
Accounts Receivable -Answer-Outstanding money we expect to
receive in the future
Three Transaction Types: -Answer-Charges
Payments
Adjustments
Charges occur as a result of: -Answer-Performing services
Payments are a result of: -Answer-Receiving money
What are adjustments? -Answer-Anything that changes AR (Credit
Adjustments or Debit Adjustments)
An example of a credit adjustment is: -Answer-Contractual write-offs
An example of a debit adjustment is: -Answer-A refund
Debits _______ AR -Answer-Increase (Charges and Debit
Adjustments)
Credits ________ AR -Answer-Decrease (Payments and Credit
Adjustments)
What is the function of a Hospital Account (HAR)? -Answer-Collects
transactions related to an encounter and centralizes encounters,
transactions, insurance, etc.
,Insurance coverage, is a unique combination of what 3 things? -
Answer-Payer
Plan
Subscriber
What is an insurance payer? -Answer-The insurance company
What is an insurance plan? -Answer-The set of benefits a patient
receives
What is an insurance subsriber? -Answer-The policy holder
What is a guarantor? -Answer-The person ultimately responsible for
payment. This could be the patient or someone else (ie. the
subscriber)
Who is the insurance member? -Answer-The member is who the
insurance coverage is for. For example, if a subscriber has children.
The children are members of the subscriber's plan.
If a patient has multiple coverages, the order in which they are billed is
called the: -Answer-Filing Order
True or False
Every Hospital Account must be connected to a guarantor -Answer-
True
True or False
Every PB Transaction must be connected to a guarantor -Answer-
True
, What are the two hospital applications used to track billing? -Answer-
1. Resolute Professional Billing
2. Resolute Hospital Billing
What services do Professional Billing cover? -Answer-Services
performed by clinicians in inpatient or outpatient settings
What services do Hospital Billing cover? -Answer-Services and
supplies related to hospital encounters, including: medications, lab
charges, imaging, room and bed charges and more.
True or False
Hospital Billing doesn't need to achieve the level of granularity that
Professional Billing needs and does not need to match every payment
to each charge -Answer-True
PB transactions are stored in the ___ master file -Answer-ETR
HB transactions are stored in the ___ master file -Answer-HTR
Which system did EPIC have early on in its' development,
Professional or Hospital Billing? -Answer-Professional Billing
What is the purpose of a Single Billing Office (SBO)? -Answer-SBO is
a billing mode that combines HB and PB balances into a single
guarantor statement. Thus, creating simpler statements for easier
management for guarantors.
Diakeishaye goes to the doctor for a physical. This generates one
charge for $50. A claim is sent to Aetna, which sends a check for $35,
saying there is a $5 patient portion. $10 gets written off, and the rest is
