Epic RHB390 Practice Exam

These questions are part of the practice quiz. Start practicing

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