Epic Skills Assessment Revenue Cycle and Billing 5

Question 1

In Epic, the 'Collections' workqueue typically contains accounts that:

Accepted Answer

Have outstanding patient balances after payer adjudication

Answer

Collections workqueues surface patient-responsible balances that remain after insurance payments and adjustments have been posted.

Question 2

A 'timely filing' denial occurs when:

Accepted Answer

The claim was submitted after the payer's deadline for submission

Answer

Payers enforce timely filing limits; claims submitted after the deadline are denied regardless of clinical validity.

Question 3

Which Epic module is specifically designed to manage professional billing (physician billing) as opposed to hospital billing?

Accepted Answer

Resolute Professional Billing

Answer

Resolute Professional Billing in Epic handles charge entry, claim submission, and payment posting for physician and outpatient professional services.

Question 4

In Epic, what does the 'Coordination of Benefits (COB)' process determine?

Accepted Answer

The order in which multiple payers are responsible for a patient's charges

Answer

COB establishes which payer pays first (primary), second (secondary), etc., preventing duplicate payment for the same service.

Question 5

When a payer sends an 835 transaction file to Epic, it contains:

Accepted Answer

Electronic remittance advice with payment and claim adjudication details

Answer

The 835 is the HIPAA standard for Electronic Remittance Advice (ERA), detailing payer payments, adjustments, and denial reasons.

Epic Skills Assessment Practice Test