RPB102 Epic Resolute Professional Billing
Fundamentals Updated!!
What does the patient account number on the CMS 1500 claim form equal? -
ANSWER>>Invoice number
NRP (Next Responsible Party) Action - ANSWER>>moves the remaining balance to the
next party in the visit's filing order
NAA (WO) (Not Allowed Adjustment) - ANSWER>>writes off the amount over the allowed
amount.
New Detail - ANSWER>>use to post to a new invoice from the same check
New Check - ANSWER>>use this when you are ready to post from another payer check
Where does the system pull in the allowed amount during Insurance Payment Posting -
ANSWER>>Reimbursement Contracts
If the allowed amount differs on the EOB than what appears on the Insurance Payment
Posting form, do you change it? - ANSWER>>Yes
If an invoice does not appear on the EOB, how do you search for it in PB Insurance
Payment Posting? Select ONLY ONE of the following answers.
A. Perform a Claim Status Request activity
B. Enter ".c" in the Invoice field to search for it by claim date
C. Enter ".ICN" in the Invoice field to search for it by internal control number
D. Type ".p" in the Invoice field to search for it by patient - ANSWER>>D
, True or False: An allowed amount will always appear automatically on an insurance
posting line. - ANSWER>>False. One will only appear if that charge code is included in
a reimbursement contract
What step in payment posting sends payments to guarantor accounts? Choose only
ONE answer.
A. Closing the batch
B. Confirming the batch
C. Opening the batch
D. Processing the batch - ANSWER>>D
True or False: A batch must balance before you can successfully process it. -
ANSWER>>True
What are follow-up workqueues? - ANSWER>>1. a list of outstanding claims that need
follow-up
2. A list of claims that have been denied
If a claim cannot be resubmitted to the payer for payment, which activity can you use to
pass the balance on to the guarantor? - ANSWER>>NRP: Denial
After you perform the NRP activity, what must you do to take the claim off of your
workqueue? - ANSWER>>Nothing, it is completed automatically by the system
What is charge correct? - ANSWER>>Voids a charge and allows the user to edit it
before reposting
When do you use charge correct? - ANSWER>>To correct a charge after it has been
posted
Fundamentals Updated!!
What does the patient account number on the CMS 1500 claim form equal? -
ANSWER>>Invoice number
NRP (Next Responsible Party) Action - ANSWER>>moves the remaining balance to the
next party in the visit's filing order
NAA (WO) (Not Allowed Adjustment) - ANSWER>>writes off the amount over the allowed
amount.
New Detail - ANSWER>>use to post to a new invoice from the same check
New Check - ANSWER>>use this when you are ready to post from another payer check
Where does the system pull in the allowed amount during Insurance Payment Posting -
ANSWER>>Reimbursement Contracts
If the allowed amount differs on the EOB than what appears on the Insurance Payment
Posting form, do you change it? - ANSWER>>Yes
If an invoice does not appear on the EOB, how do you search for it in PB Insurance
Payment Posting? Select ONLY ONE of the following answers.
A. Perform a Claim Status Request activity
B. Enter ".c" in the Invoice field to search for it by claim date
C. Enter ".ICN" in the Invoice field to search for it by internal control number
D. Type ".p" in the Invoice field to search for it by patient - ANSWER>>D
, True or False: An allowed amount will always appear automatically on an insurance
posting line. - ANSWER>>False. One will only appear if that charge code is included in
a reimbursement contract
What step in payment posting sends payments to guarantor accounts? Choose only
ONE answer.
A. Closing the batch
B. Confirming the batch
C. Opening the batch
D. Processing the batch - ANSWER>>D
True or False: A batch must balance before you can successfully process it. -
ANSWER>>True
What are follow-up workqueues? - ANSWER>>1. a list of outstanding claims that need
follow-up
2. A list of claims that have been denied
If a claim cannot be resubmitted to the payer for payment, which activity can you use to
pass the balance on to the guarantor? - ANSWER>>NRP: Denial
After you perform the NRP activity, what must you do to take the claim off of your
workqueue? - ANSWER>>Nothing, it is completed automatically by the system
What is charge correct? - ANSWER>>Voids a charge and allows the user to edit it
before reposting
When do you use charge correct? - ANSWER>>To correct a charge after it has been
posted
