Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/83

Click to flip

83 Cards in this Set

  • Front
  • Back

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

True

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

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

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

True

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

Department

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

Revenue Location

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?

False: Service area is more specific than facility.

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

True

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

False

Where is Single Billing Office enabled?

Enterprise Billing Profile

T or F: Statements are sent per hospital account

False: Statements are sent per Guarantor

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

Single Billing Office and Enterprise Insurance Payment Posting.

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

Users and Security Matrix

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

False

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

False

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

True

Which of the following can be shared amongst multiple users?


Application Security Class


User Role


Template


Shared security class

Which security record primarily controls access to functionality?

Security Class

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

User Role

Which security record contains the user's password?

User record

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

True

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

False

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

Chargeable

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


Account Base Class


Payor

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

True

Which record determines WHEN a fee schedule is used?

Fee Schedule Group record

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

$300 (55*5+25)

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

Search precedence in the system definition profile.

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

Tx Inquiry

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

False: They are added to the HSD via Hyperspace

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

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

Which of the following are true of DNB checks:


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.

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

True

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

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

Which component of criteria represents a field in Epic?

Property

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


Within Rule Maintenance


Within the WQ itself.

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

True

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


And


Or


Custom

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

Column configuration

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

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

Which of the following are true about routing rules?


Can improve system performance.


An initial filter.


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

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

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

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

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

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


BPA Criteria


CER Rules


Expected charges.

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

False: They are built in Rule Editor.

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

True

Which of the following are true about Charge Review WQs?


WQ rules can be configured as either errors or warnings.


Warnings can be overridden.

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

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

T or F: A payor represents one insurance company?

True

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

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

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

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

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

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

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


False.

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?

True.

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

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

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

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

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

True: All statements in SBO are guarantor level.

What best describes Drop Cycle statement processing?

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

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

True.

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

False.

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

True.

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

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

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

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

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

True.

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

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

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

False: Post types are completely configurable.

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

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

What is Distribution Method?

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

Which of the following are types of system action queues?


Bucket


Account


Guarantor

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


True.

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?

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.

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

False: Buckets are evaluated before hospital accounts.

What is the role of the Batch Scheduler in extracts?

Determines when the extract should occur.

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

False: It's determined in Reporting Workbench.

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

True.

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

True.

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

True.

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


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.

T or F: Access to Nova is security restricted?

True.

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


Application.


Type.

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

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

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

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

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

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

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

True.