A+ Graded Paper
RPB390 Epic Final Exam | A+ Answers &
Certification Content
Questions and Mark scheme
Version: Final 1.1
,Write‐off code - ✔✔This field determines which adjustment procedure will be used when the system automatically
performs a write‐off
If both the Auto write‐off and When to apply fields are left blank, the system will write‐off the difference only when the
insurance payment is posted.
Timely filing - ✔✔the requirement that claims must be submitted to payers within a specific number of days from the
date of service
A workqueue column referencing the filing window or appeal window values can be used to help prioritize the records
which need to be worked first. Data elements like timely filing or expected allowed amounts can also be used to drive
the score column which users use to sort their work.
Reimbursement Contract precedence - ✔✔If a charge meets the 'applies to' requirements of multiple reimbursement
contracts, your organization can configure which single reimbursement contract should be applied. The reimbursement
contract precedence defines which attributes of a charge session are of the highest priority when determining which
contract should be used.
You must either enter all ten in an order of precedence that works for your organization or leave this setting blank. If left
blank, the order is: provider, network, plan, payer, financial class, department, department specialty, location, service
area, and tax ID.
Configure the General Settings tab of a reimbursement contract
EXAMPLE: Contract negotiations just ended and you've been given the details for Payer contract. The contract will be
available beginning on January 1st of this year. - ✔✔1. Confirm you are logged into Classic as your 7014## user into "
Family Medicine" department.
2. Epic search for "PB reimbursement contract maintenance"
3. Select New Contract.
4. Enter " Payer Reimbursement Contract" and click Accept. 5. Enter a contact date of January 1st of this year.
6. Make the contract active.
7. Leave the Termination date field blank.
8. In the Description field, enter, "This is the reimbursement contract for Payer that is active for ."
9. In the Auto write‐off code field, enter "3000."
, 10. In the When to apply field, enter "Both Claims and Charge Entry".
11. In the Calculate reimbursement based on claims processing date instead of service date field, enter "No".
12. In the Allow reimbursement amount to exceed billed amount field, enter "No".
13. In the Classify variances as avoidable adjustments for collection ratio metrics, confirm "No" defaulted into that field.
Configure which adjustment codes should be used and when they should be applied - ✔✔If Both Claims and Charge
Entry is selected, the adjustment posted during claims processing offsets the difference between the reimbursement
amount calculated at charge entry and the reimbursement amount calculated during claims processing.
If Claims Only is selected, the adjustment is posted when claims are accepted.
If Charge Entry Only is selected, the adjustment is posted when charges are posted.
If both the Auto write‐off and When to apply fields are left blank, the system will write‐off the difference only when the
insurance payment is posted.
Deciding when to apply the write‐off is an organizational decision. Netting down the AR earlier in the revenue cycle can
be beneficial to your finance team. This is also important when self‐classifying in Financial Pulse. You're able to compare
your metrics against other metrics of organizations who write off at the same time you do.
Determine timely filing windows at the contract level
EXAMPLE: Payer only allows 120 days for timely filing for the primary claim. Your payer allows 180 days from the service
date or 60 days since the last payment for both replacement claims and appeal claims. Your organization uses the days
until timely filing column in workqueues to help users prioritize their work. - ✔✔1. Navigate to the Timely Filing tab of
your reimbursement contract.
2. In the Days from service date field of the primary claim section, enter "120".
3. In the Days from service date field of the Replacement Claim section, enter "180". In the Days from last payment field,
enter "60".
4. In the Days from service date field of the Appeal Claim section, enter "180". In the Days from last payment field, enter
"60".
If both the Days from service date and Days from last payment settings are configured, the system will use the greater
possible date for each claim
Configure when a contract should apply a charge session
EXAMPLE: Charge sessions associated with Payer will qualify for your reimbursement contract. - ✔✔1. Select the Applies
To tab.
RPB390 Epic Final Exam | A+ Answers &
Certification Content
Questions and Mark scheme
Version: Final 1.1
,Write‐off code - ✔✔This field determines which adjustment procedure will be used when the system automatically
performs a write‐off
If both the Auto write‐off and When to apply fields are left blank, the system will write‐off the difference only when the
insurance payment is posted.
Timely filing - ✔✔the requirement that claims must be submitted to payers within a specific number of days from the
date of service
A workqueue column referencing the filing window or appeal window values can be used to help prioritize the records
which need to be worked first. Data elements like timely filing or expected allowed amounts can also be used to drive
the score column which users use to sort their work.
Reimbursement Contract precedence - ✔✔If a charge meets the 'applies to' requirements of multiple reimbursement
contracts, your organization can configure which single reimbursement contract should be applied. The reimbursement
contract precedence defines which attributes of a charge session are of the highest priority when determining which
contract should be used.
You must either enter all ten in an order of precedence that works for your organization or leave this setting blank. If left
blank, the order is: provider, network, plan, payer, financial class, department, department specialty, location, service
area, and tax ID.
Configure the General Settings tab of a reimbursement contract
EXAMPLE: Contract negotiations just ended and you've been given the details for Payer contract. The contract will be
available beginning on January 1st of this year. - ✔✔1. Confirm you are logged into Classic as your 7014## user into "
Family Medicine" department.
2. Epic search for "PB reimbursement contract maintenance"
3. Select New Contract.
4. Enter " Payer Reimbursement Contract" and click Accept. 5. Enter a contact date of January 1st of this year.
6. Make the contract active.
7. Leave the Termination date field blank.
8. In the Description field, enter, "This is the reimbursement contract for Payer that is active for ."
9. In the Auto write‐off code field, enter "3000."
, 10. In the When to apply field, enter "Both Claims and Charge Entry".
11. In the Calculate reimbursement based on claims processing date instead of service date field, enter "No".
12. In the Allow reimbursement amount to exceed billed amount field, enter "No".
13. In the Classify variances as avoidable adjustments for collection ratio metrics, confirm "No" defaulted into that field.
Configure which adjustment codes should be used and when they should be applied - ✔✔If Both Claims and Charge
Entry is selected, the adjustment posted during claims processing offsets the difference between the reimbursement
amount calculated at charge entry and the reimbursement amount calculated during claims processing.
If Claims Only is selected, the adjustment is posted when claims are accepted.
If Charge Entry Only is selected, the adjustment is posted when charges are posted.
If both the Auto write‐off and When to apply fields are left blank, the system will write‐off the difference only when the
insurance payment is posted.
Deciding when to apply the write‐off is an organizational decision. Netting down the AR earlier in the revenue cycle can
be beneficial to your finance team. This is also important when self‐classifying in Financial Pulse. You're able to compare
your metrics against other metrics of organizations who write off at the same time you do.
Determine timely filing windows at the contract level
EXAMPLE: Payer only allows 120 days for timely filing for the primary claim. Your payer allows 180 days from the service
date or 60 days since the last payment for both replacement claims and appeal claims. Your organization uses the days
until timely filing column in workqueues to help users prioritize their work. - ✔✔1. Navigate to the Timely Filing tab of
your reimbursement contract.
2. In the Days from service date field of the primary claim section, enter "120".
3. In the Days from service date field of the Replacement Claim section, enter "180". In the Days from last payment field,
enter "60".
4. In the Days from service date field of the Appeal Claim section, enter "180". In the Days from last payment field, enter
"60".
If both the Days from service date and Days from last payment settings are configured, the system will use the greater
possible date for each claim
Configure when a contract should apply a charge session
EXAMPLE: Charge sessions associated with Payer will qualify for your reimbursement contract. - ✔✔1. Select the Applies
To tab.
