RHB303

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Importing Records into Epic

1. Create/maintain record(s) in a spreadsheet. 2. Create a flat file of the information to be imported. 3. Place the file on the Epic server. 4. Import the flat file into Epic.

What is a cost center?

A BCC record used in revenue reporting.

System batch

A background process that tracks transactions over a given day. There is one for HB and a separate one for PB transactions, per service area. Each night an automated process closes the existing system batches and opens new ones for the new day. A self-pay balance must be part of a closed system batch for it to appear on a statement.

Self-pay discounts: Flat-rate discounts

A combination of rules and a percentage discount. They are configured in the Discount Rate Table. A rule determines which HARs qualify for the discount, and there is a defined discount rate for both insured and uninsured HARs.

A difference between which two values identifies a contractual variance?

A difference between the expected amount and the allowed amount.

What is an extract?

A flat file containing data pulled from Epic that will be uploaded into another system. The flat file will generate when the Batch Scheduler runs a Reporting Workbench report.

Expected Charges form

A form in the Revenue Guardian Check Editor where you can list all charges that should be present if the logic specified in the CER rule and the BPA criteria are met.

Multiple response items

A line count property can be used to return the value of the number of lines of data when creating a rule.

Federal Poverty Level Table (SST)

A list of family size and income, it is the maximum income for a family of that size to be considered in poverty by the federal government, determined by the U.S. Department of Health and Human Services. The system uses this table to calculate a percentage of FPL and it typically will be configured at the facility level.

Extract Format Definition (HGX)

A master file containing records for extract formats created using the Extract Format Editor in Hyperspace. Extract formats are used in conjunction with Reports (HGR) records, Reporting Workplace Template (HGT) records, and Report Info (HRX) records.

Patient Profile (WDF)

A profile includes settings that control how MyChart behaves. Each profile is a record in the Patient Access System Definitions (WDF) master file that contains settings that should be applied to a patient or a group of patients.

Self-pay discounts: Contract-based discounts

A rule determines which HARs qualify for the discount, and then the benefit plan and contract determine the discount.

Self-pay discounts: Income-based discounts

A rule is used to determine which HARs qualify for income-based discount calculations. A Federal Poverty Level Table is used to store FPL information and calculate a patient's percentage of FPL based on income and family size. A sliding scale table is then used to calculate a discount based on the percentage of FPL.

GL string

A series of numbers identifying the GL accounts assigned to transactions. The numbers reference many other parts of the system, such as base class, service area, collection status, and cost center.

Restrict Coverages to Guarantor field

A setting in Coverage Manager that makes sure actions are performed only if the coverage is on the guarantor account associated with the hospital account. If set to No, Coverage Manager also will review late coverage changes for coverages that are connected to the patient record as well.

Best Practice Advisory (LGL)

A tool in the Epic decision support system that typically serves as a reminder or warning to clinicians during their workflows. They are used in Revenue Guardian checks to identify information in the patient chart that indicates the need for certain changes.

Revenue Guardian Check (LGL)

A tool that allows organizations to check for expected charges on hospital accounts based on account- or encounter-level criteria. They find missing or incorrect charges due to workflow problems, not due to build problems. They leverage BPA functionality to access data from the patient's chart.

Patient Access Classifications (ECL)

Access classifications allow you to control which features MyChart patients have available to them. They are essentially security classes for MyChart patients and are even stored in the same file.

You want end users to jump to a specific activity within the Hospital Account activity each time they select an account within your workqueue. Which field do you populate to allow for this functionality?

Acct maint activity

For productivity reporting, you want to give more weight or importance to an activity. What can you configure to do this?

Activity Score

Before importing, the system identifies an error with your flat file. Which steps should be taken to fix the error?

Adjust the spreadsheet, create a new flat file, move the flat file over to the Epic server, and then scan the new flat file.

Your collections users are able to use an activity and you want to grant your customer service user access to the same activity. What can you configure to do this?

Allowed security classes

Owning area

Allows for reporting on DNBs by ownership and efficient workqueue build.

Consecutive account logic

Allows the system to automatically flag hospital accounts as potentially needing to be combined based on payer requirements. It must be defined in the payer record.

Locked Sort

Allows users to see all of the records in a workqueue, but the sort is already defined and can't be changed by the user. This ensures the most important records are worked first.

Workqueue Manager

Allows you to make all of the appropriate changes to your workqueues from within one workspace, instead of opening each workqueue individually. Examples of tasks include adding and removing rules from workqueues and adding and removing users from workqueues.

Hospital Systems Definition (HSD)

Also called the Hospital Billing Profile, the HSD is a record that contains configuration settings for Hospital Billing and applications that use the Hospital Billing framework (HB-specific). A single HSD record exists at the facility level and is automatically created and connected to the facility record.

Which character is used in an import spreadsheet to indicate you want to create a new record?

An asterisk (*)

Where should you set a Hospital Billing setting that you want to only apply to one service area at an organization?

At the service area-level HSD. HSD records can be attached at the Facility, Service Area, and Location Level.

System Action Queues (BWQ)

Automate processes that would otherwise need user interaction. There are three types: account, bucket, and guarantor. Each type of queue uses a different set of rules to identify matching records and has a different set of available actions to be performed.

Self-pay discounts

Automatic self-pay discounts for HB can be classified into five main categories: flat-rate discounts, income-based discounts, contract-based discounts, prepay discounts, and approval-based discounts.

Why should you not lock the note portion of a billing activity?

Because if a note is locked, staff will not be able to add any text to the standard text the note begins with.

Why is a system action queue like a workqueue?

Both use routing and workqueue rules.

DNB checks

Built using extension (LLP) records. Many are Epic-released records , so they can be used as-is. If a custom DNB check is needed, then a Foundation System rule-based DNB check extension can be duplicated to create a custom rule.

How are Epic's Foundation System HB denials workqueues organized?

By owning area and financial class (but owning area is better than financial class)

Rule (CER)

CER rules are logical expressions that identify records that meet (or do not meet) criteria you configure.

Federal Poverty Level (FPL)

Calculated as a family's income divided by the income threshold for a family of that size in the Federal Poverty Level Table, and then multiplied by 100 to get an FPL percentage.

DNB check extension

Can either hold the logic of the edit directly in the extension or be blank. If the extension holds the logic, then a rule is not required unless filtering is desired. If the extension is blank, then a rule is required.

What is built in the EAP master file?

Charge codes, adjustment codes, payment codes, and clinical procedures

What do transactions in Epic include?

Charges, payments, and adjustments. Every transaction in Epic is assigned a debit GL account and a credit GL account.

Transaction

Charges, payments, and adjustments. Transactions in Epic move through three main master files (EAP, HTT, and HTR) depending on where the transaction is in the system and what is happening to it.

Payer configuration in Epic

Configuration in Epic determines: is this variance large enough to warrant a user manually follow-up or should it be noted but the revenue cycle keep moving; an adjustment to the AR will be posted, but should it be based on the expected or allowed amount; and if there is any remaining balance, should it remain with the payer or should it move to the next responsible party.

What will the system use to apply self-pay discounts to HARs automatically?

Configuration in the Discount Rate Table in the HSD and the Prepay Discount form in the SSD.

Statement configuration: Timing

Configured in Billing Profile and Batch Scheduler, this decides when to process statements automatically, if it's a drop cycle or billing cycle, and if there's a recurring pattern (such as weekend or holiday actions).

Statement configuration: Balances

Configured in the Enterprise Billing Profile, this decides which guarantors get statements, which HARs appear on a statement, and if it is part of a closed System Batch.

Statement configuration: Statement format

Configured in the Statement Template Editor, this decides the statement layout, colors, and logo, as well as what information is included.

Enterprise Billing Profile (SSD)

Contains configuration settings that apply to enterprise features in the system. It is only service area-level, but contains settings that are shared between HB and PB.

Date properties

Dates in the past are always a smaller number than today's date. So an operator of < or <= should always be used. The value will be t - (# of days).

What actions can be defined in a billing activity?

Default, required, and locked

Max Days Apart

Defines a true number of days, meaning the value includes all number(s) of days less than the value specified.

Workqueue Rule

Defines the problem and why a follow up is necessary. If there are no workqueue rules, nothing will qualify for the workqueue. There is an 'OR' relationship between them, so a record only has to qualify for one workqueue rule.

Allowance discrepancy type

Determines if the variance should only apply to underpayments, overpayments, or either.

Coverage Manager

Determines the actions that can take place on HB HARs due to late coverage changes. Can only be set at the Facility or Service Area-Level HSDs.

What are a single credit and a single debit GL account assigned to?

Each transaction, because every charge, payment, and adjustment is assigned a GL credit account and a GL debit account.

How can you identify whether an extension is Epic-released or Foundation System?

Epic-released DNB Check extensions will have five digit IDs, while Foundation System extensions will have 10 digit IDS.

What is the purpose of estimate templates?

Estimate templates allow an end user or patient to choose a single estimate template and the correct charge codes are pulled into the estimate without any additional work on the user or patient's part.

Workflows

Every time a new DNB or Stop Bill is added to the system, there also needs to be a defined workflow to follow up on those issues. This often means creating an account workqueue or adding a new workqueue rule to an existing account workqueue.

Extension (LPP)

Extensions contain code that the system uses to do something. Epic releases many standard extensions that can be used to customize the system. It is generally recommended to create a custom copy of an existing extension whenever you need to use an extension.

True or False: A service area record and service area HSD are automatically linked.

False

True or False: There is a simple Undo Import option in case you make an error during importing.

False

True or False: You must use the same payment plan restrictions for payment plans set up in MyChart and Hyperspace.

False

True or False: While a workqueue is set to Single Item Mode, users should "Skip" all accounts that need to be followed up with later.

False. "Defer" should be used in this scenario. "Skip" is used in situations when the user isn't able to work with an account for reasons such as lack of information or conflict of interest.

True or False: To create an import spreadsheet, you should start from a blank spreadsheet.

False. Always create the spreadsheet using the system.

True or False: A DNB with a type of "error" can be overridden by a user.

False. An error must be addressed, while a warning can be bypassed by an end user.

True or False: CER rules are used to display custom messages to guarantors in HB/SBO.

False. BWR rules are needed.

True or False: HAR system actions are performed before bucket system action queues.

False. Bucket system actions are evaluated before HAR system actions.

True or False: Professional Billing settings are configured in the HSD record.

False. Hospital Billing settings are configured in the HSD record.

True or False: Estimate templates are automatically available in MyChart once they are released.

False. In order for an estimate template to be available to patients in MyChart, you must configure the Available in MyChart settings.

True or False: FPL information must be collected for a guarantor in order for that guarantor to receive a self-pay discount.

False. Not all self-pay discounts are given based on FPL information; some are flat rates and other discounts use rules in the HSD.

True or False: 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.

True or False: HB self-pay discounts can be automatically posted as soon as charges post to the hospital account.

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

True or False: The Expected Charges form of Revenue Guardian checks specify the charges that have errors you are looking for on a hospital account.

False. The Expected Charges form specifies the expected (good) charges you want to be on a hospital account.

True or False: If an extract column isn't aligned to meet the vendor's specifications, a new PAF column must be configured.

False. The Override section of the Setup tab or the Format Ext field should be used.

True or False: All users with HB security point 318 (MAY Perform Billing Activities) will be able to perform all account activities.

False. The allowed security classes field limits who can see and perform activities.

True or False: The new contact date for record updates are stored directly in the import spreadsheet.

False. The contact dates are set during the import process.

True or False: The order of the lines in the Coverage Manager table does not matter.

False. The table (because it is a table with a capital T) reads from the top down and the first row that matches the scenario is the action the system will take.

True or False: Patients can create estimates in MyChart without any configuration in their patient access class.

False. This feature needs to be added to their access class.

In which master file are prices associated with specific charge codes?

Fee schedule (FSC)

Field Dictionary (PAF)

Field records define columns used in extracts and Reporting Workbench reports.

Estimate Template (PET)

For common estimate requests, an estimate template provides a way to build the specifics of an estimate ahead of time, so that the end user chooses the single, understandably named estimate template, and the associated standard procedure codes pull into the estimate.

An account workqueue has three routing rules and four workqueue rules. For how many rules must the account qualify?

Four

Billing Activities

Groups of actions that can be used to complete workflows on hospital or guarantor accounts in HB. The default values and options are configured in the Activity Template (ATM) master file, while the activities themselves are built in Hyperspace.

Charges caught in HB Charge Review workqueues are which type of record?

HTT

What do HB Charge Review rules evaluate, and are tested with?

HTT records

When reading the variance threshold table in a payer record, each row evaluates true if the variance amount matches or is ?

Higher

Hospital Billing Workqueue (WQF)

Hospital Billing workqueues group similar work together based on the logic of Hospital Billing Rules (BWR). Workqueues identify items needing human intervention or review and route them to the correct group or users.

How does the system determine which GL pattern record to use for each hospital billing transaction?

Hospital transactions are compared to rules in the GL Settings form of the HSD. Which rule the transaction matches determines which GL pattern to use.

Minimum guarantor account balance to print statement

If a guarantor's balance across HARs is below this threshold, then they will not qualify for a statement.

Mark for Combining Options

If any hospital account meets the rules defined here, it will still be considered a consecutive account, but it will be excluded from any system automatic combining. This allows for scenarios that should never be automated and should always be placed into a workqueue for review.

Consecutive Account Filter Rules

If any hospital account meets the rules defined here, then that hospital account is excluded from consecutive account logic.

Where do you configure a Cycle 2 billing cycle to run on the first of the month?

In the Batch Scheduler

Where are Revenue Guardian Checks plugged in?

In the HSD

Where should a DNB check be marked as an error or a warning?

In the HSD

Where are Payment Plan restrictions configured?

In the Hospital Billing Profile (HSD)

When are Revenue Guardian checks evaluated?

Initiate Billing

When are hospital accounts evaluated against DNB checks?

Initiate Billing. Additionally, some may be configured to run at Discharge and each night through Min Days. If an account fails a DNB check, it does not get billed and a DNB error or warning flag is applied to the account.

How is Single Billing Office enabled?

It is set in the Enterprise Billing Profile and then linked to a service area.

Tags

Key search terms that can be used to find an estimate template. Once a tag is created, it can be attached to multiple estimate templates to make it easy for users to find relevant estimate templates.

A payer defines that for recurring visits, the hospital accounts should be billed monthly and always on the last day of the month. What value should go in the Length field to accomplish this?

L. By setting the value to L, the system will calculate the last date in that month dynamically.

Discount Rate Table

Located in the HSD, it holds configuration for determining discounts for eligible HB HARs. Discounts provided by the Discount Rate Table are automatically applied when a balance moves to the self-pay bucket.

GL account ID

Made up of eight characters. The first two characters will be the ID of the service area of the charge. The third character represents the charge's base class, with a 1 meaning inpatient and a 2 meaning outpatient and ED. The fourth through eighth characters are the ID of the cost center assigned to the charge.

Payment Plans

Make it more manageable for patients to pay their bills and make it more likely the organization will see full compensation. It is possible to set guardrails for guarantors setting up their own payment plans.

What are true of DNB checks?

Many DNB checks are included in the Foundation System, custom DNB checks can be created using rules, which DNB checks to run before Min Days can be configured, and a Stop Bill on an account will not prevent Initiate Billing unless the appropriate DNB check for Stop Bills is listed in the HSD.

DNB check 41404 (Stop Bill)

Needs to be listed in the DNB check field, or else accounts with stop bills could still successfully initiate billing and change to a Billed account status.

Hospital Account Activities

One of two forms in the HSD where you can build billing activities. Allows you to create or link billing activities with a context of Hospital Account.

Guarantor Activities

One of two forms in the HSD where you can build billing activities. Allows you to create or link billing activities with a context of guarantor.

Drop cycle

One of two ways to qualify a guarantor account for a statement. The guarantor is eligible for a statement as soon as a self-pay balance is due, then on a regular schedule until the guarantor account balance reaches zero. This is the primary statement cycle for most organizations.

Billing cycle

One of two ways to qualify a guarantor account for a statement. The guarantor is eligible for a statement based on an assigned, pre-determined schedule. They can be assigned based on: all guarantor accounts to a single billing cycle, an alpha-split, or a default billing cycle.

Self-pay discounts: Prepay discounts

One way to incentivize guarantors to make upfront payments. The configuration is found on the Discount form of the Enterprise Billing profile.

What status must a HAR have in order to make coverage changes?

Open or DNB. If a coverage change is on a patient with a HAR with a Billed status, then either a stop bill should be placed on the HAR, or the HAR will be worked from a denials workqueue once the payer response is received.

Single Item Mode

Operates much like Locked Sort, but a user is automatically assigned the highest priority record and can't see anything else in the workqueue.

Which records work together to control the way patients can use MyChart?

Patient Profiles and Patient Access Classifications

System action queue: Account (HAR)

Performs action on a single HAR. Can be for PB, HB, or Default.

System action queue: Guarantor

Performs action on a single guarantor account (EAR).

System action queue: Bucket

Performs action on a single liability bucket on an HB HAR. PB HARs do not have liability buckets.

What is the most specific level for configuring variance thresholds?

Plan

What types of workflows should be completed by a system action queue?

Policy driven workflows that do not require user discretion. System action queues are best used to perform actions when the same criteria always produce the same results.

Revenue general ledger pattern

Produces a GL account ID and is used to assign a Credit GL account.

What determines the order in which system action queues are evaluated during HB nightly processing?

Queue priority. The types of system action queues are evaluated in a specific order, from most to least specific. Bucket system action queues are evaluated first, followed by account, and then guarantor system action queues.

HB GL Patterns (BGL)

Records associated with the rules in the HSD to generate general ledger account numbers for hospital transactions.

Some fields in an account activity, such as "Score" or "Can result in payment?", affect what?

Reporting

Why are extracts common and necessary for hospital billing?

Resolute doesn't provide certain models, like General Ledger; Resolute does not generate refund checks; some organizations use a third-party system to perform a given workflow, such as collections or contracts; and organizations often are required to submit information to government programs for regulatory purposes.

The functionality for displaying custom messages on the Account Details page for Hospital Billing Office SBO pages results in the usage of ?

Rule Maintenance rules (BWR)

What are used to determine which HARs qualify for flat-rate discounts?

Rules

What should you do to an import file before importing it, in order to catch any errors?

Scan it

HSD-1 is automatically linked to the facility record, but what level hospital billing profile can be linked to use the rule of specificity?

Service area-level

You would like the workqueue to be sorted first based on days in workqueue and then based on account balance. Users still need to have the flexibility to sort by account name in certain circumstances. Which option should you configure for this workqueue?

Set Default Sort Order

Feature

Similar to security points, a feature is access to a single piece of functionality in MyChart. Examples include viewing test results and seeing alerts.

Sliding Scale Table (SST)

Sliding scale tables determine discount rates and minimum fees for patients with different income levels (calculated as percentages of the federal poverty level).

In the Enterprise Billing Profile (SSD), which form should be used to determine the accounts that will qualify for a statement run?

Statement Processing form

Fee Schedule Group (BFG)

Tell the system which fee schedule to use in which scenario. Fee schedules need to be plugged in to fee schedule groups in order for the prices in the fee schedule to be applied to any hospital billing charges.

Epic-released Extension (LPP) + Rule (CER)

The Extension Record defines the problem, and is used when a standard-released DNB check matches the edit checking needed but you want to limit which hospital accounts are evaluated.

Epic-released Extension (LPP)

The Extension Record defines the problem, and is used when a standard-released DNB check matches the edit checking needed with no modifications necessary.

Extract build tools

The Extract Format Editor determines what information is extracted, Reporting Workbench determines which records qualify for the extract and where the file goes, and the Batch Scheduler determines when the extract occurs.

Self-pay discounts: Approval-based discounts

The Financial Assistance module allows organizations to offer discounts that require that patients be approved by a financial counselor before the discount in applied to a self-pay balance.

General Ledger

The GL is the sum of all financial activity and the definitive source of financial information for the organization. Every transaction is assigned a credit and debit GL account.

Where does a billing activity need to be listed in order for users to find it?

The HSD

Overriding PAF column formatting

The Overrides section and the Format Ext field, to plug in an extension.

Charge Code (EAP)

The Procedure (EAP) master file contains all non-medication orders, including equipment orders, diet orders, nursing orders, level of service codes, lab orders, and in-office procedures. It also includes procedure records used to document charges, payments, and adjustments.

Shell Extension (custom copy or Foundation System LPP) + Rule (CER)

The Rule Record (CER) defines the problem. Used when a custom edit check is needed that is not already handled by any of the standard or Foundation System extensions.

What is the key advantage of Revenue Guardian Checks?

The advantage is that they can look to the patient's chart and clinical data.

What are used to determine from which master files the extract can pull information?

The base and additional databases

What best describes Drop Cycle statement processing?

The guarantor is eligible for a statement as soon as self-pay liability exists for charges that are part of a closed system batch.

Payer (EPM)

The payer master file is shared by multiple Epic applications; in HB, records created in the payer master file represent insurance companies. Payer records contain demographics, information about filing and processing claims, payer requirements, settings related to expected reimbursement, and more.

Access and Ownership

The section of the workqueue settings that determines who can access a workqueue, as well as the user primarily responsible for the workqueue content.

Rule of Specifity

The system will use the most specific setting available. If a setting is not found at the most specific level, it will continue looking up until a setting is found.

Defining statement cycles

There are two different methods for qualifying a guarantor account for a statement: billing cycle and drop cycle.

Enterprise statements

These are required with SBO. The statements are at the guarantor level, and include self-pay balances from both HB and PB. The benefits of this are saving time and money, since there is a streamlined process.

Day properties

These properties reference a specific date in the past and count forward. An operator of > or >= should always be used, and the value will be # of days.

Shell DNB checks

These should always use a rule to define only a subset of accounts to hold for a specific reason. If no rule is entered, all HARs will qualify for the DNB check.

Tables with a capital T

These tables evaluate from the top down. This means that any exceptions to the default need to be higher in the table than the default option.

What are the Hospital Billing Profiles and Enterprise Billing Profiles connected to in Text?

They are both connected to the service area record.

Where are defaults set for payment plans?

They are set on the Payment Plan form in the HSD.

For organizations using Single Billing Office, where are statements set up?

They are set up in the Enterprise Billing Profile.

For whom can payment plan restrictions be configured?

They can be configured for both guarantors and end-users.

In an import spreadsheet, for what can the gray rows be used?

They can be used to read item help text and category list options.

What is true about routing rules?

They can improve system performance, they are an initial filter, and they are used to further divide a workflow, such as by financial class or last name.

Where are DNB checks plugged in?

They plug into the Hospital System Definitions (HSD).

Guarantor account statuses not to bill

This list is used to suppress statements based on certain guarantor-level flags.

Useful properties for insurance follow‐up and denials rules: First Active Bucket No Response

This property is useful when building no response workqueues. This property is flexible based on the payer's expected turnaround time, but defaults to 45 days since a claim was sent.

Useful properties for insurance follow‐up and denials rules: First Active Bucket Outstanding

This property tree branch will exclude buckets that haven't had a claim sent or aren't active. Choosing this property over First Active Bucket makes more sense in the context of Insurance follow-up. It will only find the first bucket when there are multiple outstanding insurance buckets.

Useful properties for insurance follow‐up and denials rules: First Bucket with an Open Denial

This property tree branch will only include HARs with open denials. Choosing this property is more efficient for system evaluation in the context of Denials workqueues. It will only find the first bucket with a denial when there are multiple active buckets with denials.

Less useful properties for insurance follow-up and denials rules: First Active Bucket

This property will include active insurance buckets, including those without sent claims.

Less useful properties for insurance follow-up and denials rules: Insurance Buckets

This property will not exclude any types or statuses of insurance buckets. This makes it an expensive, more system-intensive property, because the system has many insurance buckets and it is difficult to process all of them when evaluating a rule.

Statement and detail bill printing - Smarttext

This screen in the Enterprise Billing profile determines which statement and detail bill forms to send to different guarantor types.

Drop cycle type

This setting determines how frequently a guarantor will receive their statement when they are on a drop cycle setting.

Minimum days between two statements

This should always be one day less than the drop cycle interval. This is because if both are configured to be the same number of days, the statement won't generate until after the full interval has passed.

Statement cycle type by guarantor type

This table determines if a guarantor is billing or drop cycle and overrides the default.

Transactions: HTT (Hospital Temporary Transaction)

Transaction records are in this master file as charges and adjustments when the transaction is in a workqueue, and as payments when the transaction is in an unposted batch.

Transactions: EAP (Procedure Record)

Transaction records are in this master file as charges, payment, and adjustment codes prior to being generated for a specific HAR.

Transactions: HTR (Hospital Transaction Record)

Transactions records are in this file when charges, payments, and adjustments post to the HAR.

True or False: Adjustments due to prepay discounts can be applied automatically.

True

True or False: All Revenue Guardian Checks should be configured to trigger a DNB check.

True

True or False: Billing activities can have default values configured for their actions.

True

True or False: Coverage Manager can add a stop bill to an HB HAR when there is a coverage change for the guarantor connected to that account.

True

True or False: Extract formats can be either fixed-width or delimited.

True

True or False: If a minimum balance is defined in a sliding scale table row, then the minimum balance will be billed to the guarantor even if the discount amount would otherwise cause the balance to fall below what is listed as the minimum balance.

True

True or False: In Single Billing Office, an Enterprise statement will always be a guarantor-level statement.

True

True or False: In order to post a charge to a hospital account there must be a charge code (EAP) record built for that service.

True

True or False: It is possible to add multiple users to multiple workqueues at one time.

True

True or False: It is possible to build a rule from within a workqueue.

True

True or False: It is possible to lock users from making changes to the default settings.

True

True or False: Some HSD settings are configured in Hyperspace and some are configured in Text.

True

True or False: System action queues use rules to identify which records (HARs, Buckets, or Guarantor Accounts) to take action on.

True

True or False: The facility EAF record and facility HSD record are automatically linked.

True

True or False: The number of Min Days can vary based on organizationally-defined restrictions.

True

True or False: You can lock an individual action within an activity to prevent the end user from changing the configuration.

True

True or False: You can only use existing charges when creating/updating a fee schedule import.

True

True or False: Extracts are different than imports/exports.

True. An export entails getting information out of Epic, changing it, and then importing it back into Epic. An extract entails getting information out of Epic and then giving it to someone else.

General Ledger transactions assignments

Two steps: the GL Settings form in the HSD identifies transactions using a rule. When a transaction qualifies, then a specified GL pattern is used to assign a debit and credit account to the transaction. 2. GL patterns define which series of numbers are combined to form the ID of the GL accounts.

Send a hospital account detail bill

Use this field to determine whether by default guarantors will receive a detail bill prior to their statement.

Fee Schedules (FSC)

Used to associate prices, or billed amounts, with charge codes. They are a large table that lists individual charge codes and their associated price. A single EAP record can be created for a charge code, then the price of the charge can vary based on location, department, or other criteria using different fee schedules.

Routing Rule

Used to perform an initial filter for a workqueue and helps break up the workload among many workqueues. There is an 'AND' relationship between each one, so a record must meet all of them.

Action Setup tab

Used to select the actions that should be automatically performed. Actions are performed in the order listed, because actions performed first can affect what happens when a lower action is attempted.

Default statement cycle type

When not otherwise overridden, this field determines whether guarantors are drop cycle or billing cycle.

What is true about Charge Reveiw Workqueues?

Workqueue rules can be configured as either errors or warnings, and warnings can be overridden.


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