Exam (elaborations)
RPB102: RESOLUTE PROFESSIONAL BILLING FUNDAMENTALS
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RPB102: RESOLUTE PROFESSIONAL BILLING FUNDAMENTALS
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RPB102: RESOLUTE PROFESSIONAL BILLINGFUNDAMENTALS
What is the difference between a patient record and a guarantor record? - Answers-A
patient record represents the person receiving 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.
True or False:
A hospital account contains the information about the person ultimately responsible for
the charges incurred during a visit. - Answers-False. The Hospital Account (HAR) is the
hub for a visit that allows a user to see information stored
elsewhere. The Guarantor Account record stores the information about a person or
entity ultimately
responsible 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 registration 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.
Hospital Account - Answers-Displays information about the charges, payments, and
adjustments for that visit. It also shows which coverage is used for a particular visit, as
well as information
about any claims that are sent out.
Coverage Record - Answers-A coverage record (at minimum) is the unique combination
of a payor, plan, and subscriber.
,Patient Record - Answers-Patient-specific information, like the patient's address, phone
numbers, employment, PCP, and medical information are all stored in the patient
record.
When checking in a patient, why might you click the Enterprise Pmt button? - Answers-
In order to collect a copay, pre-payment or previous balance payment at the front desk.
What status does the appointment change to once it has been checked in? - Answers-
Arrived
Copay - Answers-The flat fee that a patient pays, usually at the time services are
rendered
Check In - Answers-The Department Appointments Report (or DAR) is a list of
scheduled appointments and is commonly used to check a patient in when he arrives.
True or False:
When you schedule a walk-in appointment, the system automatically selects the first
available time slot for the physician. - Answers-True
You are updating a patient's registration information. That patient hands you her new
insurance card. You look for the insurance in the system but can't find it. What should
you do?
A) Select a coverage that has the closest name to what you have on the insurance card.
B) Do not enter her insurance information.
C) Select a generic coverage and enter information from the card.
D) Call somebody who has more security than you to do the search. - Answers-C)
Select a generic coverage and enter information from the card.
Walk In Appointment - Answers-The Walk-In functionality is used to schedule an
appointment for patients in the next available time slot. This workflow combines
scheduling and check-in.
Generic Coverage - Answers-When you attempt to add coverage to a patient, you might
not find the patient's insurance if it isn't
already built in the system.
True or False:
It is possible to refund payments collected at the front desk the same day they are
collected. - Answers-True.
Refund a POS Payment - Answers-You can refund patient payments at the point of
service. If you cannot physically refund the payment (for example, because your cash
drawer is closed), you can process a refund request from the same workflow.
, Note: That it is not possible to return part of a credit card payment or check, so the
refund is all or nothing. If a cash payment is paying for a copay as well as additional
balances, a partial refund is available.
What is the purpose of the cash drawer in the system? - Answers-To reconcile the
physical money you collected with the money that you posted in the system.
What must you do when the cash drawer is out of balance? - Answers-First, try to
balance the cash drawer by re-counting and re-entering the contents of your physical
money. If it
still does not balance, contact a supervisor and enter a reason why the drawer is not
balanced.
What do you do with a cash drawer before you go home? - Answers-Count the contents
Verify the money in the drawer matches the money posted in the system
Print a report about the money that was collected and reconciled
Turn in the money and the printed report to your supervisor
Clicking which button automatically matches
the money you recorded from your cash drawer with the money posted in the system? -
Answers-Select All
True or False:
Each charge entry batch contains only one charge entry session. - Answers-False.
Each charge entry batch can contain an unlimited number of charge entry sessions.
True or False:
Each charge entry batch only contains information for one patient's charges. - Answers-
False. The batch can contain charges for an unlimited number of different patients.
True or False:
One charge ticket is the equivalent of one charge entry session. - Answers-True.
Name two conventions for entering a diagnosis code in the Code field on the Charge
Entry form. - Answers-Enter the ICD code or the name and description of the diagnosis.
On the procedure line, what purpose does the Diagnosis field serve? - Answers-The
entry in this field associates the charges with the appropriate diagnosis from the
Diagnoses table.
What is the purposes of processing your batch? - Answers-Processing the batch posts
the charges and make them available for billing.
Charge Ticket - Answers-When the patient's visit is checked in in Cadence, an
encounter form number is generated as a method of tracking the visit.
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