Epic RHB390 Practice Exam

These questions are part of the practice quiz. Start practicing

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