EPIC COG230 Revenue Data Model Newest 2025 Actual
Exam Complete Questions And Well Defined
Answers(Verified Answers)|Already Graded A+
An example of a credit adjustment is: - CORRECT ANSWER-Contractual write-offs
An example of a debit adjustment is: - CORRECT ANSWER-A refund
Debits _______ AR - CORRECT ANSWER-Increase (Charges and Debit Adjustments)
Credits ________ AR - CORRECT ANSWER-Decrease (Payments and Credit
Adjustments)
What is the function of a Hospital Account (HAR)? - CORRECT ANSWER-Collects
transactions related to an encounter and centralizes encounters, transactions,
insurance, etc.
Insurance coverage, is a unique combination of what 3 things? - CORRECT ANSWER-
Payer
Plan
Subscriber
,What is an insurance payer? - CORRECT ANSWER-The insurance company
What is an insurance plan? - CORRECT ANSWER-The set of benefits a patient receives
What is an insurance subsriber? - CORRECT ANSWER-The policy holder
Accounts Receivable - CORRECT ANSWER-Outstanding money we expect to receive in
the future
Three Transaction Types: - CORRECT ANSWER-Charges
Payments
Adjustments
Charges occur as a result of: - CORRECT ANSWER-Performing services
Payments are a result of: - CORRECT ANSWER-Receiving money
What are adjustments? - CORRECT ANSWER-Anything that changes AR (Credit
Adjustments or Debit Adjustments)
What is a guarantor? - CORRECT ANSWER-The person ultimately responsible for
payment. This could be the patient or someone else (ie. the subscriber)
,Who is the insurance member? - CORRECT 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:
- CORRECT ANSWER-Filing Order
True or False
Every Hospital Account must be connected to a guarantor - CORRECT ANSWER-True
True or False
Every PB Transaction must be connected to a guarantor - CORRECT ANSWER-True
What are the two hospital applications used to track billing? - CORRECT ANSWER-1.
Resolute Professional Billing
2. Resolute Hospital Billing
What services do Professional Billing cover? - CORRECT ANSWER-Services performed
by clinicians in inpatient or outpatient settings
What services do Hospital Billing cover? - CORRECT 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 - CORRECT
ANSWER-True
PB transactions are stored in the ___ master file - CORRECT ANSWER-ETR
HB transactions are stored in the ___ master file - CORRECT ANSWER-HTR
Which system did EPIC have early on in its' development, Professional or Hospital
Billing? - CORRECT ANSWER-Professional Billing
What is the purpose of a Single Billing Office (SBO)? - CORRECT 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
Which transactions occurred? - CORRECT ANSWER-One charge, two payments, one
credit adjustment
Exam Complete Questions And Well Defined
Answers(Verified Answers)|Already Graded A+
An example of a credit adjustment is: - CORRECT ANSWER-Contractual write-offs
An example of a debit adjustment is: - CORRECT ANSWER-A refund
Debits _______ AR - CORRECT ANSWER-Increase (Charges and Debit Adjustments)
Credits ________ AR - CORRECT ANSWER-Decrease (Payments and Credit
Adjustments)
What is the function of a Hospital Account (HAR)? - CORRECT ANSWER-Collects
transactions related to an encounter and centralizes encounters, transactions,
insurance, etc.
Insurance coverage, is a unique combination of what 3 things? - CORRECT ANSWER-
Payer
Plan
Subscriber
,What is an insurance payer? - CORRECT ANSWER-The insurance company
What is an insurance plan? - CORRECT ANSWER-The set of benefits a patient receives
What is an insurance subsriber? - CORRECT ANSWER-The policy holder
Accounts Receivable - CORRECT ANSWER-Outstanding money we expect to receive in
the future
Three Transaction Types: - CORRECT ANSWER-Charges
Payments
Adjustments
Charges occur as a result of: - CORRECT ANSWER-Performing services
Payments are a result of: - CORRECT ANSWER-Receiving money
What are adjustments? - CORRECT ANSWER-Anything that changes AR (Credit
Adjustments or Debit Adjustments)
What is a guarantor? - CORRECT ANSWER-The person ultimately responsible for
payment. This could be the patient or someone else (ie. the subscriber)
,Who is the insurance member? - CORRECT 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:
- CORRECT ANSWER-Filing Order
True or False
Every Hospital Account must be connected to a guarantor - CORRECT ANSWER-True
True or False
Every PB Transaction must be connected to a guarantor - CORRECT ANSWER-True
What are the two hospital applications used to track billing? - CORRECT ANSWER-1.
Resolute Professional Billing
2. Resolute Hospital Billing
What services do Professional Billing cover? - CORRECT ANSWER-Services performed
by clinicians in inpatient or outpatient settings
What services do Hospital Billing cover? - CORRECT 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 - CORRECT
ANSWER-True
PB transactions are stored in the ___ master file - CORRECT ANSWER-ETR
HB transactions are stored in the ___ master file - CORRECT ANSWER-HTR
Which system did EPIC have early on in its' development, Professional or Hospital
Billing? - CORRECT ANSWER-Professional Billing
What is the purpose of a Single Billing Office (SBO)? - CORRECT 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
Which transactions occurred? - CORRECT ANSWER-One charge, two payments, one
credit adjustment
