RPB102: EPIC
RESOLUTE
PROFESSIONAL BILLING
FUNDAMENTALS
Patient Filing Order - Answers -Every coverage the patient has ever had whether or not
it's still effective
Prelude - Answers -Enterprise Registration. Hold the basic patient, guarantor account
and coverage data
Cadence - Answers -Scheduling. Schedule and check in visits. Collect visit specific
data.
Resolute Professional Billing - Answers -Billing for professional services. UB and CMS
claim forms available.
Single Billing Office - Answers -Using an integrated set of tools to send a statement
both hospital and professional self-pay balances and follow-up on those balances.
Requires the use of an encounter-specific account called a hospital account (HAR) in
both HB and PB.
HAR - Answers -Hospital Account Record. Encounter-specific account.
Retroadjudication - Answers -review and resolution of changes made to an existing
visit's filing order. Triggered when an update to a patient's filing order creates a new
proposed visit filing order.
Visit Filing Order - Answers -Which coverages to send a claim & in what order
- Filing order saved per visit
- Finalized when a visit is checked in
- Claims sent based on visit filing order
A patient can have *** guarantor accounts - Answers -Multiple
Accident related guarantor account types - Answers -work comp or third party liability
Encounter form number - Answers -Created when a visit is checked in
Contact Serial Number (CSN) - Answers -Created when the appointment is scheduled
When are POS payments posted to the account? - Answers -Immediately
In the foundation system, which of the following payment types can be partially refunded
using the Patient Refund module?
Check
Cash
Credit Card - Answers -Cash & Credit Card
True or False: In the foundation system, the front desk user can use the patient refund
module to issue a refund? - Answers -False
True or False: When adding a secondary coverage after a primary has already paid,
you should undo billing to bring the HAR back to DNB status. - Answers -False
If a coverage is not effective for any past encounters but you want to record it for future
use, which option in Registration should you use to add the coverage? Choose only
ONE answer.
A. Coverage Info form
B. Add coverage link
C. Guarantor Demographic link
D. Add the coverage in Hospital Account Maintenance, not Registration - Answers -B
Where in Account Maintenance can you view information about self-pay and insurance
balances, as well as any payments or adjustments made for all HARs beloning to the
same guarantor? Choose only ONE answer.
A. Account Summary
B. Account Contact
C. Liability Buckets
D. Guarantor Summary - Answers –D
True or False: When creating a coverage record in the system, you must choose the
correct Payer and Group Number listed on the subscriber's insurance card. - Answers -
False: Payer and Plan
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