EPIC COG230 Revenue Data Model
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1. Accounts Receivable Outstanding money we
expect to receive in the fu-
ture
2. Three Transaction Types: Charges
Payments
Adjustments
3. Charges occur as a result of: Performing services
4. Payments are a result of: Receiving money
5. What are adjustments? Anything that changes AR
(Credit Adjustments or
Debit Adjustments)
6. An example of a credit adjustment is: Contractual write-offs
7. An example of a debit adjustment is: A refund
8. Debits _______ AR Increase (Charges and
Debit Adjustments)
9. Credits ________ AR Decrease (Payments and
Credit Adjustments)
10. What is the function of a Hospital Account (HAR)? Collects transactions re-
lated to an encounter
and centralizes encoun-
ters, transactions, insur-
ance, etc.
11. Insurance coverage, is a unique combination of what
3 things?
, EPIC COG230 Revenue Data Model
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Payer
Plan
Subscriber
12. What is an insurance payer? The insurance company
13. What is an insurance plan? The set of benefits a pa-
tient receives
14. What is an insurance subsriber? The policy holder
15. What is a guarantor? The person ultimately re-
sponsible for payment.
This could be the patient
or someone else (ie. the
subscriber)
16. Who is the insurance member? The member is who the
insurance coverage is for.
For example, if a sub-
scriber has children. The
children are members of
the subscriber's plan.
17. If a patient has multiple coverages, the order in which Filing Order
they are billed is called the:
18. True or False True
Every Hospital Account must be connected to a guar-
antor
19. True or False True
Every PB Transaction must be connected to a guaran-
tor
, EPIC COG230 Revenue Data Model
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20. What are the two hospital applications used to track 1. Resolute Professional
billing? Billing
2. Resolute Hospital
Billing
21. What services do Professional Billing cover? Services performed by
clinicians in inpatient or
outpatient settings
22. What services do Hospital Billing cover? Services and supplies re-
lated to hospital encoun-
ters, including: medica-
tions, lab charges, imag-
ing, room and bed
charges and more.
23. True or False True
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
24. PB transactions are stored in the ___ master file ETR
25. HB transactions are stored in the ___ master file HTR
26. Which system did EPIC have early on in its' develop- Professional Billing
ment, Professional or Hospital Billing?
27. What is the purpose of a Single Billing Office (SBO)? SBO is a billing mode that
combines HB and PB bal-
ances into a single guar-
antor statement. Thus,
creating simpler state-
Study online at https://quizlet.com/_8mdyb0
1. Accounts Receivable Outstanding money we
expect to receive in the fu-
ture
2. Three Transaction Types: Charges
Payments
Adjustments
3. Charges occur as a result of: Performing services
4. Payments are a result of: Receiving money
5. What are adjustments? Anything that changes AR
(Credit Adjustments or
Debit Adjustments)
6. An example of a credit adjustment is: Contractual write-offs
7. An example of a debit adjustment is: A refund
8. Debits _______ AR Increase (Charges and
Debit Adjustments)
9. Credits ________ AR Decrease (Payments and
Credit Adjustments)
10. What is the function of a Hospital Account (HAR)? Collects transactions re-
lated to an encounter
and centralizes encoun-
ters, transactions, insur-
ance, etc.
11. Insurance coverage, is a unique combination of what
3 things?
, EPIC COG230 Revenue Data Model
Study online at https://quizlet.com/_8mdyb0
Payer
Plan
Subscriber
12. What is an insurance payer? The insurance company
13. What is an insurance plan? The set of benefits a pa-
tient receives
14. What is an insurance subsriber? The policy holder
15. What is a guarantor? The person ultimately re-
sponsible for payment.
This could be the patient
or someone else (ie. the
subscriber)
16. Who is the insurance member? The member is who the
insurance coverage is for.
For example, if a sub-
scriber has children. The
children are members of
the subscriber's plan.
17. If a patient has multiple coverages, the order in which Filing Order
they are billed is called the:
18. True or False True
Every Hospital Account must be connected to a guar-
antor
19. True or False True
Every PB Transaction must be connected to a guaran-
tor
, EPIC COG230 Revenue Data Model
Study online at https://quizlet.com/_8mdyb0
20. What are the two hospital applications used to track 1. Resolute Professional
billing? Billing
2. Resolute Hospital
Billing
21. What services do Professional Billing cover? Services performed by
clinicians in inpatient or
outpatient settings
22. What services do Hospital Billing cover? Services and supplies re-
lated to hospital encoun-
ters, including: medica-
tions, lab charges, imag-
ing, room and bed
charges and more.
23. True or False True
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
24. PB transactions are stored in the ___ master file ETR
25. HB transactions are stored in the ___ master file HTR
26. Which system did EPIC have early on in its' develop- Professional Billing
ment, Professional or Hospital Billing?
27. What is the purpose of a Single Billing Office (SBO)? SBO is a billing mode that
combines HB and PB bal-
ances into a single guar-
antor statement. Thus,
creating simpler state-
