RPB390 Epic Certification questions with accurate
answers
1. What is the import spec used to import Fee Schedules in Chronicles?
Choose ONLY one:
A. Fee Schedule, 100
B. FSC,1300
C. FSC, 200
D. FSG, 1200 Ans✓✓✓ B. FSC,1300
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 Ans✓✓✓ D. Not Allowed Amount
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 Ans✓✓✓ C. Billed Amount
Allowed amount Ans✓✓✓ The maximum amount an insurer will pay for
any given service.
Actual collectable amount on the EOB from a payer.
Anesthesia billing Ans✓✓✓ Anesthesia billing uses many variables when
assigning a price to a charge. In order to correctly assign prices, there is
required fee schedule, procedure, and anesthesia pricing record setup.
Anesthesia billing also uses a conversion factor. The conversion factor is
the dollar amount per unit that the system multiplies by the quantity of
the procedure when pricing anesthesia charges.
Batch Scheduler Ans✓✓✓ a tool that automates many tasks in the system
(like claims and statement processing)
Benefits/challenges of reimbursement contracts Ans✓✓✓ 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
Billed amount Ans✓✓✓ total amount charged for a service
The price of a charge sent out on the claim to the payer
Build a line the MPPR table
EXAMPLE: Payer adheres to CMS's standards in regards to Multiple
Cardiovascular Procedures. Because the technical component has fewer
overhead fees, you will be reimbursed less for the second charge.
Ans✓✓✓ 1. In Classic, make sure you're on the Further Reductions tab of
your contract
2. In the CMS MPPR Rule field, enter "Cardiovascular Rule".
3. In the Technical Component % Reimbursement field enter, "75".
4. Save your contract.
Component Ans✓✓✓ Group common records together
Used to define services/procedures in contracts
Can be reused
, Component group Ans✓✓✓ Used to combine components to further
define services
Configure the Batch Scheduler
EXAMPLE: You need to configure the Batch Scheduler to run and re‐
evaluate all of the charges you posted earlier. Ans✓✓✓ 1. Navigate to the
Professional Billing Programmer Menu in Text
2. From the Professional Billing Programmer Menu in Text, go to Other
System Modules > Batch Scheduler > Job Enter/Edit. 3. At the Job
prompt, enter " 1404 Job".
4. At the Would you like to create a new Job? field, enter "Yes".
5. Click ENTER to allow the system to assign the job an ID.
6. Click ENTER to accept the name.
7. In the Template to use: field, enter template "1404" and press ENTER
twice to accept that template.
8. PAGE DOWN to the Single and Multiple Response Values screen.
9. Enter "No" in the !ALL QUEUED CONTRACTS value.
10. In the CONTRACT ID mnemonic, enter " Payer Reimbursement
Contract".
11. Enter "2" into the !Charge Date Type value.
12. Enter "1" into the Only Re‐Calculate Expected Amounts field.
13. SHIFT + F7 to leave your job.
14. PAGE UP back to the Batch Scheduler Main Menu.
15. Choose Batch Enter/Edit.
answers
1. What is the import spec used to import Fee Schedules in Chronicles?
Choose ONLY one:
A. Fee Schedule, 100
B. FSC,1300
C. FSC, 200
D. FSG, 1200 Ans✓✓✓ B. FSC,1300
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 Ans✓✓✓ D. Not Allowed Amount
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 Ans✓✓✓ C. Billed Amount
Allowed amount Ans✓✓✓ The maximum amount an insurer will pay for
any given service.
Actual collectable amount on the EOB from a payer.
Anesthesia billing Ans✓✓✓ Anesthesia billing uses many variables when
assigning a price to a charge. In order to correctly assign prices, there is
required fee schedule, procedure, and anesthesia pricing record setup.
Anesthesia billing also uses a conversion factor. The conversion factor is
the dollar amount per unit that the system multiplies by the quantity of
the procedure when pricing anesthesia charges.
Batch Scheduler Ans✓✓✓ a tool that automates many tasks in the system
(like claims and statement processing)
Benefits/challenges of reimbursement contracts Ans✓✓✓ 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
Billed amount Ans✓✓✓ total amount charged for a service
The price of a charge sent out on the claim to the payer
Build a line the MPPR table
EXAMPLE: Payer adheres to CMS's standards in regards to Multiple
Cardiovascular Procedures. Because the technical component has fewer
overhead fees, you will be reimbursed less for the second charge.
Ans✓✓✓ 1. In Classic, make sure you're on the Further Reductions tab of
your contract
2. In the CMS MPPR Rule field, enter "Cardiovascular Rule".
3. In the Technical Component % Reimbursement field enter, "75".
4. Save your contract.
Component Ans✓✓✓ Group common records together
Used to define services/procedures in contracts
Can be reused
, Component group Ans✓✓✓ Used to combine components to further
define services
Configure the Batch Scheduler
EXAMPLE: You need to configure the Batch Scheduler to run and re‐
evaluate all of the charges you posted earlier. Ans✓✓✓ 1. Navigate to the
Professional Billing Programmer Menu in Text
2. From the Professional Billing Programmer Menu in Text, go to Other
System Modules > Batch Scheduler > Job Enter/Edit. 3. At the Job
prompt, enter " 1404 Job".
4. At the Would you like to create a new Job? field, enter "Yes".
5. Click ENTER to allow the system to assign the job an ID.
6. Click ENTER to accept the name.
7. In the Template to use: field, enter template "1404" and press ENTER
twice to accept that template.
8. PAGE DOWN to the Single and Multiple Response Values screen.
9. Enter "No" in the !ALL QUEUED CONTRACTS value.
10. In the CONTRACT ID mnemonic, enter " Payer Reimbursement
Contract".
11. Enter "2" into the !Charge Date Type value.
12. Enter "1" into the Only Re‐Calculate Expected Amounts field.
13. SHIFT + F7 to leave your job.
14. PAGE UP back to the Batch Scheduler Main Menu.
15. Choose Batch Enter/Edit.
