Exam (elaborations)
RPB102 STUDY SET #2 QUESTIONS AND ANSWERS
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RPB102 STUDY SET #2 QUESTIONS AND ANSWERS
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RPB102 STUDY SET#2 QUESTIONS
AND ANSWERS
What is the difference between a patient record and a guarantor record? - Answers -A
patient record represents the person recieving care.
It contains the demographic information for the patient and the patient's chart.
The guarantor record represents the person responsible for the charges. It contains the
name of the guarantor and the address where the bill will be sent.
Tue or False:
Hospital accounts contain the information about the person ultimately responsible for
the charges incurred during the visit. - Answers -False. The HAR is the hub for a visit
that allpws a user to see information stored elsewhere. The Guarantor Account record
stores the information about a person or entity ultimatley responsinble for remaining
balances for a visit. Serving as a hub the HAR allows the user to see the guarantor and
guarantor information without having to look up the guarantor separately. The
guarantor's information, however, is not stored in the HAR.
Which record contains information about A patient's insurance benefits? - Answers -
Coverage
True or False:
A PB HAR is always created manually by a user in a regiatration workflow. - Answers -
False. PB HARS are created automatically by the system whenever an encounter gets
a PB filing order.
Guarantor Record - Answers -The guarantor record stores contact information for the
person who ultimately pays the bill. The responsible party or guarantor may be the
patient, guardian, or employer.
,Guarantor Account - Answers -Information about the person responsible for the self-pay
portion of the visit.
Charge Review Workqueue - Answers -Review charge sessions for issues while
charges are still temporary
Delete (a charge session) - Answers -Completely removes the charge session from the
system, not just from the supervisor's workqueue. Even though the session is deleted, a
record of that deletion is stored in the system. You cannot undo a deletion.
Force Resubmit - Answers -Another security controlled button in the supervisor's
workqueue, this button lets the supervisor force the charge session to post, regardless
of its errors.
True or False:
You can add new procedures when you access a charges session from charge review. -
Answers -True
List the steps to resolving duplicate charges - Answers -Research if the session is a
duplicate
Transfer the session to a supervisor
Supervisor deletes the session
What does the Transfer function do to the charge session? - Answers -Removes
sessions from this workqueue and sends it to a designated workqueue.
Why might you use Force Resubmit? - Answers -Timely filing- denial and fix is better
than no payment
Build requires fixing- waiting for build team to make changes.
Where are the charges located that are ready and waiting to process for claims? -
Answers -The claims queue
What tool in the system automates processes? - Answers -Batch Scheduler
Creating claims is a mostly (manual/automatic) process - Answers -Automatic
Claims Queue - Answers -This queue holds all of the transactions that are available to
go out on a claim
If a posted charge has an insurance balance due and is set up to go out on a claim, the
system automatically adds the charge to this queue.
Claim Run - Answers -The first step in the claims process includes transactions from the
claims queue. The system creates claims during this step by grouping together
transactions with the same encounter information.
, CDF (Claim Definition File) - Answers -The system's internal claims scrubber which
checks for errors and can format a claim according to payer-specific requirements.
Batch Scheduler - Answers -A tool that automates many tasks in the system (like claims
and statements processing).
What Epic record defines all of the possible errors a claim could have? - Answers -CDF
(Claim Definition File)
Who corrects user errors? Where are these errors corrected? - Answers -End users
correct them in Hyperspace
Who corrects master file errors? Where are these errors corrected? - Answers -
Application cooridinators or IT staff correct them outside of Hyperspace.
How can you access the step-by-step instructions for how to fix a claim error? -
Answers -Click on the error link in the claim edit assistant
What does the Refresh button in the Companion do? - Answers -Tests claim errors
against the CDF in real-time
Claim Edit Workqueue Assistant - Answers -A tool that helps you fix the errors on the
claim
Claim Edit Workqueue Companion - Answers -A window that gives you instructions
about how to correct claim errors.
Claim Edit Workqueue - Answers -To view and correct claims with errors before sending
to payers.
User Erros - Answers -Can be fixed by an end user in Hyperspace
Master File Errors - Answers -Must be corrected in the build by an application
coordinator or IT person.
How do you prioritize your workqueue to work the claims with the oldest service dates
first? - Answers -Click the SVC Date column heading
Where can you view the past activities performed on claims? - Answers -Activity History
in the Assistant; Follow-Up Activities section in the workqueue information display
After calling a payer about an outstanding claim, you want to document the
conversation so that others researching the balance see a record of your work.
Which activity or activities would you add? - Answers -Call Payer and Notes
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