Rhb 313 Review Questions

Front 1

T or F: A patient who has been seen in multiple service areas should have multiple guarantor accounts in Epic

Back 1

True

Front 2

T or F: Master Files are used to track changes in data over time.

Back 2

False: Contacts are used to track changes to data over time

Front 3

T or F: The Address field in a patient's record is an example of an item

Back 3

True

Front 4

Which level of the facility structure represents a specialty within a clinic?

Back 4

Department

Front 5

Which level of the facility structure represents a hospital at your organization?

Back 5

Revenue Location

Front 6

T or F: If a setting is configured differently in the service area and facility records, the facility record's setting will override the service area record's setting?

Back 6

False: Service area is more specific than facility.

Front 7

T or F: The facility EAF record and facility HSD record are automatically linked?

Back 7

True

Front 8

T or F: A service area record and service area HSD are automatically linked?

Back 8

False

Front 9

Where is Single Billing Office enabled?

Back 9

Enterprise Billing Profile

Front 10

T or F: Statements are sent per hospital account

Back 10

False: Statements are sent per Guarantor

Front 11

Which of the following options are enabled directly on the Miscellaneous settings form of the Enterprise Billing Profile?

Back 11

Single Billing Office and Enterprise Insurance Payment Posting.

Front 12

What tool provides a description of all model users, as well as descriptions for all Hospital Billing security points?

Back 12

Users and Security Matrix

Front 13

T or F: You attach security points directly to a user record?

Back 13

False

Front 14

T or F: Only one security class can be associated with each user record?

Back 14

False

Front 15

T or F: Changes made to a linkable template will automatically apply to all linked users

Back 15

True

Front 16

Which of the following can be shared amongst multiple users?

Back 16

Application Security Class

User Role

Template

Shared security class

Front 17

Which security record primarily controls access to functionality?

Back 17

Security Class

Front 18

Which security record primarily controls the look and feel of Hyperspace?

Back 18

User Role

Front 19

Which security record contains the user's password?

Back 19

User record

Front 20

T or F: It is possible to build a charge record directly in Hyperspace?

Back 20

True

Front 21

T or F: The price of a charge is stored in the procedure master file?

Back 21

False

Front 22

The purpose of a billing relevant procedure record should be set to which of the following?

Back 22

Chargeable

Front 23

You are able to designate alternate Revenue Codes for a procedure for which of the following criteria?

Back 23

Account Base Class

Payor

Front 24

T or F: It is possible to build fee schedules in Hyperspace?

Back 24

True

Front 25

Which record determines WHEN a fee schedule is used?

Back 25

Fee Schedule Group record

Front 26

A suture charge has a base price of $25 and a unit price of $55. What will be the price for 5 sutures?

Back 26

$300 (55*5+25)

Front 27

What determines how Fee Schedule Groups are searched when a charge meets the criteria for more than one group?

Back 27

Search precedence in the system definition profile.

Front 28

Which activity tab in Account Maintenance lets you view charge transaction detail?

Back 28

Tx Inquiry

Front 29

T or F: DNB checks must be added to the HSD via text?

Back 29

False: They are added to the HSD via Hyperspace

Front 30

T or F: A DNB error can be overridden by a user?

Back 30

False. A warning can be bypassed by an end user. An error must be addressed.

Front 31

Which of the following are true of DNB checks:

Back 31

Many DNB checks are included in the Foundation System.

You can create custom DNB checks using rules.

You can configure when to run DNB checks.

Stop Bills on an account will not prevent initiate billing unless the appropriate DNB check for Stop Bills is listed in the HSD.

Front 32

T or F: Coverage Manager configurations determines how coverage changes are automatically reflected on a HAR?

Back 32

True

Front 33

T or F: You can set a max limit for tickler duration?

Back 33

True: This is done in the HSD under WQ and Tickler configuration.

Front 34

Which component of criteria represents a field in Epic?

Back 34

Property

Front 35

Through which two activities can you build a rule for a WQ?

Back 35

Within Rule Maintenance

Within the WQ itself.

Front 36

T or F: It is possible to configure the relationship between multiple criteria?

Back 36

True

Front 37

Which of the following are ways a rule logic can be configured?

Back 37

And

Or

Custom

Front 38

From which form within a WQ would you customize the way a WQ looks to end-users?

Back 38

Column configuration

Front 39

T or F: Accounts qualify for account WQs and charge review WQs in the same manner?

Back 39

False: Account WQs are populated during nightly processing or during a batch job, depending on configuration. Charge review WQs are updated in real time.

Front 40

Which of the following are true about routing rules?

Back 40

Can improve system performance.

An initial filter.

Used to further divide a workflow, such as by payor or last name.

Front 41

T or F: It is possible to build a rule from within a WQ?

Back 41

True: Either from within a WQ or in Rule Maintenance.

Front 42

An account WQ has 3 routing rules and 4 WQ rules. For how many rules must an account qualify?

Back 42

Four: The 3 routing rules must be met, and one of the WQ rules.

Front 43

Revenue Guardian checks can combine which of the following elements into a single check?

Back 43

BPA Criteria

CER Rules

Expected charges.

Front 44

T or F: CER rules are built into Rule Maintenance?

Back 44

False: They are built in Rule Editor.

Front 45

T or F: Charges in the charge review WQs do not count towards your organization's active AR?

Back 45

True

Front 46

Which of the following are true about Charge Review WQs?

Back 46

WQ rules can be configured as either errors or warnings.

Warnings can be overridden.

Front 47

T or F: Adjustment review WQs are only used to catch adjustments posted through the Adjustment Posting Module?

Back 47

False: the source might also be the Bucket Action button.

Front 48

T or F: A payor represents one insurance company?

Back 48

True

Front 49

T or F: A plan record can be associated with several payors?

Back 49

False: A plan can only be associated with one payor.

Front 50

Many settings are shared between the HSD, the payor, and the plan records. Which of these is the most specific?

Back 50

The plan is the most specific. The system will use the plan record.

Front 51

If a setting is configured at the HSD, payor and plan levels, which setting will the system use?

Back 51

Plan level. The system will use the most specific setting available.

Front 52

T or F: FPL information must be collected for a guarantor in order for that guarantor to receive a self-pay discount?

Back 52

False.

Front 53

T or F: If a minimum balance is defined in a sliding scale table row, then the minimum balance will be billed to the guarantor if the discount amount causes the balance to fall below what is listed as the minimum balance?

Back 53

True.

Front 54

T or F: HB Self-pay discounts are posted as soon as charges post to the hospital account.

Back 54

False: Self-pay discounts are posted when balance moves to the self-pay bucket.

Front 55

T or F: Self-pay discount build in the HSD applies to all HARs, including PB HARs?

Back 55

False: Only HB HARs are evaluated by the HSD configurations for self-pay discounts.

Front 56

T or F: In Single Billing Office, the enterprise statement will always be a guarantor level statement?

Back 56

True: All statements in SBO are guarantor level.

Front 57

What best describes Drop Cycle statement processing?

Back 57

Guarantor is eligible for a statement as soon as self-pay liability exists.

Front 58

T or F: It is possible to have the system automatically generate a detail bill first and 7 days later, generate a statement?

Back 58

True.

Front 59

T or F: When using SBO, it is optional to use Enterprise Statement Processing?

Back 59

False.

Front 60

T or F: The default HAR stores PB insurance payments as well as guarantor payments?

Back 60

True.

Front 61

T or F: The default HAR holds both HB and PB credit transactions?

Back 61

False: The default HAR holds credit transactions only in Resolute Professional Billing.

Front 62

Where can I view professional payments while in Hospital Account Maintenance for a PB HAR?

Back 62

Prof Tx Inquiry. You can view payments associated with charges on the Matching Tx Tab.

Front 63

T or F: There is a 1:1 ratio between a given guarantor account and a default HAR?

Back 63

True.

Front 64

When should you use the Oldest First post type instead of the Manual post type?

Back 64

When the guarantor doesn't specify which charges to apply the payment to.

Front 65

T or F: Previous balance post types cannot be configured; you must use the model system options?

Back 65

False: Post types are completely configurable.

Front 66

T or F: You can add or edit the list of the Post Type names that display to the end users?

Back 66

True: Post Type names are created/edited from a category list.

Front 67

What is Distribution Method?

Back 67

The logic that defines how a payment is split across multiple HARs.

Front 68

Which of the following are types of system action queues?

Back 68

Bucket

Account

Guarantor

Front 69

T or F: System action queues are based on rules?

Back 69

True.

Front 70

T or F: The order of the system action queues listed in Queue Priority does not matter as all system action queues are evaluated against each bucket/account/guarantor every time?

Back 70

False: One action may change the characteristics of an account which could cause it to qualify or not qualify for other actions based on the change.

Front 71

T or F: Hospital accounts are evaluated by system action queues before liability buckets?

Back 71

False: Buckets are evaluated before hospital accounts.

Front 72

What is the role of the Batch Scheduler in extracts?

Back 72

Determines when the extract should occur.

Front 73

T or F: The extract file path is determined in the Batch Scheduler?

Back 73

False: It's determined in Reporting Workbench.

Front 74

T or F: Extract Formats can be either fixed-width or delimited?

Back 74

True.

Front 75

T or F: Account activities can have default values configured for their actions?

Back 75

True.

Front 76

T or F: You can lock an individual action within an activity to prevent the end user from changing the configurations?

Back 76

True.

Front 77

Which of the following are possible reasons why you cannot perform a billing activity that you have created?

Back 77

Your security Class is not an authorized security class.

The activity is not plugged in to the HSD.

The activity does not make sense in the context you are trying to use it.

Front 78

T or F: Access to Nova is security restricted?

Back 78

True.

Front 79

Which of the following can you use to sort Galaxy search results?

Back 79

Application.

Type.

Front 80

How can you tell if the field with a selection list is a networked item or a category list?

Back 80

Open the selection list and look to the bottom: "records loaded" indicates a networked item, "categories loaded" indicates a category list.

Front 81

Why isn't it necessary to have "mar" as a synonym for a "Married" category list value?

Back 81

MAR: Your synonyms should not be the same as what you could completion match on the title yourself.

Front 82

T or F: You can delete a category value after it has been entered as a possible value in a category list?

Back 82

True, although you should not delete a category value after it has been in use.

Front 83

T or F: You cannot add values to a list that has the release range "All Categories"?

Back 83

True.