Epic RHB390 Practice Exam

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• Which Epic feature is used to track whether patient education was delivered and understood?
• Extensions (lpp) have contacts.
• In Epic, which statement correctly describes a contractual variance?
• A contract with inpatient bed charges that are reimbursed per diem requires what action to ensure no other inpatient charges are reimbursed?
• Which Epic client interface is commonly used to access Epic on desktops?
• If you modify a component, you should expect that change to affect all contracts and applications where that component is used.
• What do Selection Extensions define?
• Which Epic feature allows standardized phrases to be quickly inserted into notes via a shortcut?
• Which Epic function organizes discharge instructions and follow-up tasks for the patient?
• You can only plug one locale record in per contract for inpatient.
• A COMPONENT is defined as which of the following?
• Each contract used for Hospital Billing Expected Reimbursement Calculation must have unique criteria, but one claim can match the eligibility requirements of multiple contracts.
• Which Epic function standardizes incoming lab results to internal test definitions?
• The Re-evaluate expected reimbursement option from the bucket action button is a real-time process.
• What Epic function helps clinicians quickly review a patient’s recent labs and trends over time?
• What does Submit for Re-eval option allow in Contract Maintenance?
• The actions selected under Submit for Re-eval in Contract Maintenance occur when?
• One claim can match the eligibility requirements of multiple contracts.
• Which statement is true about all liability buckets creation?
• Which interface is optimized for desktop use by clinicians for patient lookup and navigation?
• Which Epic tool helps prevent duplicate patient charts and standardize patient data?
• Which option is not listed as a reevaluation action?
• Which Epic component provides patient education materials and discharge instructions?
• What security configuration in Epic combines access control with auditing to log data access?
• What information does the Payment Classification Definition (PCD) record define?
• What defines contract modeling as it is performed in Epic?
• Which Epic alert system provides real-time decision support at the point of care to help clinicians choose care options?
• A COMPONENT GROUP is defined as which of the following?
• In an inpatient contract that uses per diem unless total charges exceed $200,000, which stop-loss design would you add?
• You should use the Claim Pricing Code table when you adjudicate the entire claim based on a characteristic, regardless of individual charges.
• Which principle should guide the ordering of contract lines to ensure accurate claim adjudication?
• Initiate Billing is the point in the Revenue Cycle when we attempt to bill the HAR. Which option best reflects this?
• Which Epic area consolidates patient-related tasks, alerts, and messages for clinicians to action?
• Which Epic component delivers patient education materials and discharge instructions to patients?
• In the Jenny case, Acme owes $1,305.50; payment arrives as $1,200. The $1,200 is best described as which of the following?
• Follow-up Record is generated under what conditions?
• Which Epic feature enables reusable documentation blocks within templates?
• Second-dollar stop-loss pricing scenarios vary among organizations. Which statement best describes them?
• Which Epic CDS feature guards against prescribing errors by evaluating doses and interactions?
• Pmt Classification field references the field of the same name in plan, payer, or HSD records to know which rate to apply.
• The Payment Mechanism determines reimbursement for services based on which of the following?
• True or False: Extensions (lpp) have contacts.
• Min Days refers to which of the following?
• How many levels will you need to build in the kidney transplant reimbursement model?
• Locale records have contacts.
• Allowed Amount: Which statement best defines the Allowed Amount?
• Which Epic function manages patient appointment scheduling and clinic capacity?
• Which statement best describes the data comparison performed during contract modeling?
• In contract evaluation, when a stopping condition triggers, what happens to subsequent lines?
• In the kidney transplant example, what is the per diem amount for Level 3?
• Follow-up Records: When a remittance is received from a payer, how are underpayments, overpayments, and denials handled?
• Which stop-loss term describes pricing a claim using a different mechanism when the charges exceed a threshold?
• True or False: One PCM record is needed for each APC grouping.
• In Epic, what is the term for grouping all services during a patient encounter to support billing and care?
• What action finalizes a clinician's documentation in Epic to make it official?
• What is the effect of selecting 'Report Mode' in reevaluation actions?
• In the kidney transplant example, what is the per diem rate for Level 4?
• True or False: In general, inpatient contract lines should be ordered before outpatient contract lines.
• Which part of a contract line defines the service?
• What is the most efficient approach when renewing a contract with New Horizons where only a few terms change?
• What Epic tool merges multiple patient records into a single master file?
• In the context of reevaluation actions, which option represents making no changes?
• The ability to override expected reimbursement for a claim is security controlled, so only certain users have access.
• NRP stands for which term?
• Which of the following is an example of a Selection Extension?
• When a follow-up record is complete, what should you do?
• Medicare contract build requires the use of the Claim Policies tab.
• Write-Off Payer option directs posting of a write-off in which manner?
• POC stands for which term?
• In Epic, which function supports referrals and cross-clinic scheduling?
• Which Epic view shows a patient’s data in time-based rows for rapid data review?
• Which statement is true about the global case rate and stopping conditions?
• Full NRP action does what?
• What term describes temporary elevated access in an emergency in Epic?
• When a contract searches a claim, which line is compared first?
• Under what condition does Submit for Re-eval automatically reverse and re-post adjustments?
• Which Epic module is used for comprehensive clinical documentation of patient encounters and supports templates and macros?
• If implants might be exclusion procedures and non-exclusion procedures are reimbursed at 70% after $100,000, what must you add to the contract line?
• Medicare OPPS will be able to store Locale information at the Payer, Plan, or Location level.
• True or False: You can only model contract changes against claims from the past month.
• Suppression of a write-off results in what outcome?
• When importing records into Epic you should download the standard import spreadsheets from Galaxy first.
• Follow-up Records: Which description accurately reflects their function?
• Locale information for Medicare OPPS can be stored at Payer, Plan, or Location level.
• Which component is used by data analysts for reporting rather than real-time workflows?
• Which Epic feature would typically be audited to track who accessed patient data and what actions they performed?
• Which Epic reporting option is used to build dashboards from multiple data sources?
• True or False: If a stopping condition has been triggered before it, a global case rate will always be used.
• What Epic component handles computerized physician order entry and standardizes orders?
• Which environment is typically used to preview configuration changes in a non-production setting within Epic?
• Term for the amount allowed by the payer for a service?
• Which statement best describes the SUP environment?
• Where is the standard DRG rate stored?
• True or False: Making a copy of a contract for modeling will copy the contract record as well as all records inside that contract (like components and fee schedules).
• Identify the Epic data warehouse designed for advanced reporting and analytics.
• Term Date is the date after which this contract will never be used.
• Which of the following is NOT a bucket status?
• If a claim line remains unpriced after the first contract line, what is the next step?
• Which statement best describes the ability to search multiple criteria on a contract line?
• When using the Submit for Re-eval option in Contract Maintenance, when do any selected actions occur?
• Which environment is described as a test environment that closely simulates PRD?
• Which Epic module would you use to review a patient’s trend data for labs and imaging over time?
• What is the purpose of a stopping condition in a contract line?
• Follow-up records can be reopened after closure. Which statement best describes this capability?
• Which Epic capability uses population health data to identify patients overdue for screenings for outreach?
• True or False: A follow-up record can be deleted after the issue has been resolved.
• The total write-off is broken into two components. Which two components are described?
• Which element directly controls the set of charges that will be eligible for reimbursement within a contract line?
• Amber case: With Allowed $1,300; Paid $1,250; patient responsibility $50; contract expected amount $1,400. What is the contractual variance?
• Which Epic feature provides reusable text blocks that can be inserted into notes via shortcuts?
• What is the primary purpose of buckets in the revenue cycle?
• Which statement best defines a COMPONENT?
• Which process allows temporary access during emergencies without permanent elevation in Epic?
• Which statement about the Write-Off Payer option is true?
• Applies To tab determines when contract will be used and can restrict use by Location or specify payers and plans.
• After the Term Date, the contract will never be used.
• True or False: Each contract record (NCC) can only reference one locale record (LCL) for Medicare IPPS calculations.
• What term describes a controlled emergency access mechanism in Epic that expires after use?
• Which statement is true about the relationship between contract changes and claims data?
• Which Epic tool is used for ad hoc reporting directly from live data?
• Local and national factors for Medicare are stored in which record?
• Which Epic module supports inpatient medication administration and MAR data?
• No NRP (None) describes which behavior?
• What is the Epic inbox-style area for managing tasks, alerts, and in-basket items?
• Which Epic capability enables electronic prescriptions to pharmacies?
• If write-off is suppressed, there would be no posted write-off.
• The Claim Policies tab of the contract is evaluated before the Service Components tab.
• Which patient portal provides secure messaging, appointment requests, and result viewing?
• Locale Records store both local and national factors for expected reimbursement calculations.
• True or False: Selection extensions are used in conjunction with components (and component groups) to determine what a contract line searches for on a claim.
• What Epic alert system provides guidance at the point of care to influence clinical decisions?
• When using Submit for Re-eval, the selected actions occur at what time?
• Which statement about Follow-up Record is true?
• PCM mapping: One PCM stores all APC mapping; each APC will need a PCD.
• ENVIRONMENT is described as which of the following?
• What CDS feature in Epic helps prevent unsafe med orders by checking doses and interactions?
• If the first contract line does not match the first claim line, what happens to that claim line?
• Which process would you perform to ensure the most current medication and allergy information is accurately reflected when a patient is admitted or transferred?
• A contract term states that implant charges are reimbursed at 90% only if the total amount of charges for implants exceeds $2,000. Otherwise implants are not reimbursed. Which extension is needed?
• When is the primary insurance bucket created?
• Which statement best describes the payment mechanism?
• What environment is typically used to test Epic configurations before production deployment?
• Which Epic feature helps automatically populate note content from structured data fields?
• When adjudicating an entire claim using the Claim Pricing Code table, decisions are based on a single characteristic of the claim.
• Which Epic feature groups related orders into a single, reusable set for care pathways?
• What is the function of the Pmt Classification field?
• In a contract, how should terms be ordered?
• Which Hospital Account status indicates billing has been completed and the account is no longer active?
• What is the DATA CURIER tool used for?
• True or False: You can edit Epic released extensions.
• What holds the hospital charges for a hospital-based encounter?
• The term 'Implant charges over $2,000' determines which claims and which services on that claim are reimbursed (but does not define how they are reimbursed). This is which extension?
• Which step creates the insurance bucket from which a claim can be demanded?
• Which security measure is commonly used for Epic access to mitigate credential theft?
• Which Epic tool is used to place and standardize orders into a single batch that can be reused across patients?
• In an underpayment scenario with Billed Amount $5,000; Expected Amount $4,000; Allowed $3,000; Posted Write-Off $2,000, which write-off option is being used?
• Which Epic feature helps ensure that each patient has a unique chart and supports standardized patient identifiers?
• You need an extension that will compare the calculated expected reimbursement amount to the billed amount and then use the lesser value as the expected reimbursement. Which extension type is this?
• Which Epic component tracks and measures patient education delivery and understanding?
• What is the purpose of adding a stopping condition to the last per diem line?
• Which Epic customization allows inserting a standardized data block into multiple templates quickly?
• Which term corresponds to an environment described as a series of software programs used by contract builders?
• What Epic component supports population health and care gap management for a patient cohort?
• If a claim matches the extension on the Claim Pricing Code Table, the contract will search every line on the Service Components tab regardless of Type.
• If you copy a contract for modeling, which is true?
• Which Epic tool supports inserting commonly used documentation elements across notes with a single action?
• In Setup Per Diem Pricing, which field is set to the per diem pricing method?
• What Epic feature enables real-time data exchange with external labs and hospitals?
• In Epic, where do clinicians view patient results over time, including labs and imaging?
• Which Epic data store is optimized for large-scale analytics separate from transactional systems?
• When are Pre-billed and Self-pay buckets created?
• Claim Date: The date on the claim or hospital account you want to reference for contract dates (e.g., claim start date or discharge date).
• Where Used button: Components and component groups can be used in multiple contracts and multiple Epic applications. A change to a component will affect every place that component is used. Always reference the Where Used button before making changes.
• How many buckets will you need to build?
• Which Epic component serves as the primary data warehouse for reporting and analytics?
• In Epic, you can import records by starting with a blank spreadsheet because column and row configuration does not matter.
• APC grouping (based on HCPCS code) can be defined directly in Epic.
• What security model does Epic implement to grant users minimum access based on role?
• Write-Off Expected posting according to which source?
• What is the primary role of the Master Patient Index (MPI) in Epic?
• One benefit of exporting records is that the resulting spreadsheet matches the format and data of the records that currently exist in your system.
• Which of the following is true about the POC environment?
• When does a contract stop searching the claim?
• True or False: When ordering contract lines, the more specific lines should go first.
• Which statement describes No NRP action?
• What process tracks every service in a patient encounter for accurate billing and charge capture?
• What part of a contract line defines the service?
• What does a HAR store?
• What does a stopping condition do in contract pricing?
• Non-primary insurance buckets are created after an NRP action performed on the previous insurance bucket. Which option describes this action?
• What is Epic's data warehouse primarily used for advanced reporting and analytics?
• Which feature enables the reuse of documentation blocks inside templates?
• Accelerated NRP action does which?
• Which of the following is NOT a Hospital Account Status?
• Which environment is the production final live environment where end users perform their work?
• Post Write-off concept: Which statement is true?
• Which patient portal is commonly used for patient communication and appointment management?
• Which set of items correctly lists the possible reevaluation actions?
• When configuring contractual write-offs, which two items must be considered?
• Which Epic process maps external lab results to internal test definitions?
• Claim level reimbursement is a single payment for the claim based on characteristics of the claim.
• When are Insurance Buckets created?
• Which statement best defines a COMPONENT GROUP?
• Which statement correctly describes the Expected Amount?
• Contractual variance is caused by which difference?
• Which Epic list captures a patient's active diagnoses and problems?
• Write-Off Expected posting: Write-Off Expected posts the write-off according to which rule?
• Which environment is described as a test environment configured to closely simulate PRD?
• Given two contract lines, outpatient imaging at $300 and inpatient per diems at $1500, which line should be placed first in the contract?
• What is the process for removing duplicate patient records within Epic's system?
• What is the purpose of Pricing Extensions?
• The RESOLUTE HOSPITAL BILLING CONTRACT TRACKER is primarily which type of tool?
• Which Epic capability allows reviewing a patient’s data across external facilities in real-time?
• What Epic feature enforces that required fields must be filled before saving?
• Which Epic feature enables outreach to patients based on population health data, such as overdue screenings?
• The standard rate for a weighted DRG reimbursement calculation is stored in a fee schedule.
• Which Epic function helps create and reuse standard blocks of documentation across notes?
• Suppress Write-off: Which outcome occurs?
• Contract modeling in Epic compares changes to the contract or price data against which data?
• Which option represents performing changes during a reevaluation?
• True: NCC contract referencing locale records.
• Write-Off Expected: Which description matches its posting behavior?
• In the kidney transplant example, what is the limit for Level 2?
• NRP stands for what?
• Which buckets are created automatically when HAR is created?
• After evaluating the first line, what does the contract do next with the claim lines?
• To override service-line reimbursement, you access the Claims Policy Tab of the contract and enter an extension and type into the Claim Pricing Code Table.
• Which Epic module manages medications, including MAR and inpatient administration?
• Which Epic feature supports secure patient messaging and appointment reminders via MyChart?
• What is the combination of security model and auditing used to control and log data access in Epic?
• When a payer updates terms, what is the correct action?
• What does a CONTRACT CONTACT specify, and what action is taken when payer terms update?
• If the first contract line matches the first claim line, what happens to that claim line?
• A contract term that applies only for inpatient claims requires which type of extension?
• What Epic feature logs user actions for security and compliance auditing?
• Which option best explains why you should place lines that are more specific before lines that are more general?
• True or False: Contracts are used to track changes to a contract over time.
• Which bucket status indicates work is ongoing and not yet paid?
• Which process ensures accurate medication information during transitions by reconciling meds and allergies?
• Which Epic capability enables data sharing with external health systems via interoperability networks?