EPIC COG230 Revenue Data Model NEWEST 2025/2026 ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+||BRAND NEW!! , SUCCESS
GUARANTEED
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 sent to Diakeishaye's mother, Leslie, who sends in a check two days later
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+||BRAND NEW!! , SUCCESS
GUARANTEED
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 sent to Diakeishaye's mother, Leslie, who sends in a check two days later
