How to enter charges in epic

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Resolute

Hospital Billing

Epic 2017

RHB101

RHB101 Resolute Hospital

Billing Fundamentals

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Epic Systems Corporation

1979 Milky Way • Verona, WI 53593 • Voice: (608) 271 -9000 • Fax: (608) 271-7237

www.epic.com

documentation@epic.com

Last Revision: August 11, 2017

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RHB101 Resolute Hospital Billing

Fundamentals

Introduction: Hospital Billing Fundamentals ...................................... 1•3

Introduction to the Hospital Billing Revenue Cycle .......................... 2•3

Linking Records in Registration........................................................... 3•3

Scheduling and Checking In a Patient in an HOD ........................... 4•3

Entering Charges from a Fee Ticket ................................................... 5•3

Correcting and Reviewing Charge Errors .......................................... 6•3

Reporting on Revenue ........................................................................ 7•3

Correcting Prebilling Edits................................................................... 8•3

Combining Consecutive Accounts.................................................... 9•3

Sending Claims ................................................................................. 10•3

Correcting Claim Errors..................................................................... 11•3

Processing Late Charges .................................................................. 12•3

Following Up on Outstanding Claims ............................................... 13•3

Posting Basic Insurance Payments .................................................. 14•3

Managing Denials ............................................................................. 15•3

Resolving Underpayments................................................................ 16•3

Sending Guarantor Statements ........................................................ 17•3

Researching Balance and Statement Inquiries............................... 18•3

Accessing Accounts for Follow-up .................................................. 19•3

Updating Guarantor Information...................................................... 20•3

Updating Coverage Information ...................................................... 21•3

Posting Guarantor Payments ............................................................ 22•3

Managing Credit Balances .............................................................. 23•3

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Reviewing Adjustments ..................................................................... 24•3

Contacting Guarantors about Unpaid Balances............................. 25•3

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Introduction: Hospital Billing Fundamentals 1•1

RHB101 Resolute Hospital Billing Fundamentals Resolute Hospital Billing Epic 2017

Lesson 1: Introduction: Hospital Billing

Fundamentals Introduction.................................................................................................................... 1•3

Prerequisites and Assumptions ................................................................................... 1•3

How to Use This Training Companion......................................................................... 1•3

Certification ................................................................................................................... 1•5

Class Attendance ...................................................................................................... 1•5

Exams .......................................................................................................................... 1•5

Failed Exams............................................................................................................ 1•6

How to Study for Your Epic Exams .......................................................................... 1•6

Project......................................................................................................................... 1•7

Maintaining a Certification ........................................................................................ 1•7

Proficiency .................................................................................................................. 1•8

Contact Information .................................................................................................. 1•8

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1•2 Introduction: Hospital Billing Fundamentals

Resolute Hospital Billing Epic 2017 RHB101 Resolute Hospital Billing Fundamentals

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Introduction: Hospital Billing Fundamentals 1•3

RHB101 Resolute Hospital Billing Fundamentals Resolute Hospital Billing Epic 2017

Introduction: Hospital Billing Fundamentals

Introduction

Welcome to Resolute Hospital Billing Fundamentals! In this class we'll explore the hospital revenue

cycle and the end user features the software supports to address it.

We'll discuss account creation, charge entry, and the charge editing tools in the software. Next we'll

discuss claims processing and claim editing, followed by insurance payment posting. We'll also

touch on guarantor statement processing and guarantor payment posting. For balances that remain

after payment posting we'll address adjustment posting, and self-pay follow-up.

During the class, keep in mind that we'll primarily discuss end user functions, and not

administrative system configuration, which is covered in the Resolute Hospital Billing

Administration class.

Prerequisites and Assumptions

Before undertaking the course of study within this class, it is recommended that you complete pre-

requisite e-learning lessons. The list of lessons is found on the UserWeb Course Catalog.

How to Use This Training Companion

This training companion is intended as a tool for learning the material presented in class. Please use

it as a place for notes on the topics and additional details covered in class.

Recommendations for certification success:

 Practice in the system.

 Take thorough notes during class in your companion.

 Review your companion and lecture notes.

 Review questions at the end of each chapter.

Informative text boxes throughout the companion will draw your attention to content of particular

interest. Here are examples of types of text boxes you might encounter:

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1•4 Introduction: Hospital Billing Fundamentals

Resolute Hospital Billing Epic 2017 RHB101 Resolute Hospital Billing Fundamentals

Critical information for the setup or use of a particular feature. For example: a particular

feature is only available if application X is installed.

Setup information related to the current feature. This provides basic information about the

system build required to get a feature to work properly.

Extra information related to a given topic. You do not need to know this information for

certification.

Foundation System information or recommendations. You do not need to know this

information for certification.

The Foundation System is regularly updated and improved based on lessons learned

and customer feedback. Log in to the Foundation Hosted environment to see our current

setup.

Our documents include Epic's standard copyright statement. Do not remove it.

If you create new materials, include: "This material contains confidential and copyrighted

information of Epic Systems Corporation" whenever that document contains Epic's screen shots or

other content based on our materials. You should also consider adding your own copyright

statement.

Be sure not to post Epic-related e-learning or documentation on an unprotected website that can be

accessed by the general public. This includes both materials that Epic has written and that you have

written.

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Introduction: Hospital Billing Fundamentals 1•5

RHB101 Resolute Hospital Billing Fundamentals Resolute Hospital Billing Epic 2017

Certification

The requirements to achieve certification are listed below for the Resolute Hospital Billing

Administration and Single Billing Office Administration certifications. If you are attending HB

Fundamentals as a pre-req to another certification (such as Resolute Hospital Billing Claims

Administration) then please reference the certification requirements contained in those courses.

Class Attendance

To achieve certification you must attend class at Epic. Attending class at Epic allows you to

network and experience the culture of Epic, all while getting the most up to date and accurate

information about an application directly from an application trainer. You are required to attend:

 RHB101 Resolute Hospital Billing Fundamentals

 REV201 Shared Revenue Administration

 RHB302 Resolute Hospital Billing Administration

Class attendance never expires.

Exams

Certification requires the taking and passing of various exams as a demonstration of content

knowledge. There is one exam per class attended.

Exams:

 RHB101 Resolute Hospital Billing Fundamentals

 NOTE: Use caution when requesting your exam. The Resolute Hospital Billing

Fundamentals for Single Billing Office (RHB102) exam is NOT the correct exam.

 Minimum passing score required is 80%.

 REV201 Shared Revenue Administration

 NOTE: You do not need a proctor for this exam and the exam can be taken an unlimited

number of times without returning to class.

 Minimum passing score required is 80%.

 RHB302 Resolute Hospital Billing Administration

 NOTE: Use caution when requesting your exam. The Resolute Hospital Billing

Administration for Single Billing Office (RHB303) exam is NOT the correct exam.

 Minimum passing score required is 80%.

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1•6 Introduction: Hospital Billing Fundamentals

Resolute Hospital Billing Epic 2017 RHB101 Resolute Hospital Billing Fundamentals

All exams are formatted to be True/False or Multiple Choice questions only. You can see an

example of this format at the end of each chapter in this book (the Reviewing the Chapter - Review

Questions section). All questions are worth one (1), three (3), or five (5) points each unless

otherwise noted for that exam. The higher the point value the more challenging the question. Five

point questions are almost entirely scenario based questions, which require providing multiple

responses. Exams are proctored and have a two (2) hour time limit unless otherwise noted per

exam.

Score expiration

If you pass an exam the score is valid to be used toward achieving certification for a limited time. If

you do not finish your certification before the expiration date your exam score will no longer be

valid. For exam expiration dates, follow these steps:

1. Go to the User Web.

2. Click the Training Home link along the left-hand side in the Training section (scroll down if

necessary).

3. Expiration dates are along the right-hand side in the Important Dates Section.

Failed Exams

There are considerations on the number of times you can fail an exam. Please consider, and verify

your understanding of, these considerations before you take your first exam.

 All exam attempts you make are tracked by exam, regardless of version.

 After your third (3rd) fail on an exam you must return to Epic and retake the associated class

before you can make another attempt to pass that exam. This attendance is considered refresher

training.

 If you fail the same exam five (5) times you must return to Epic and retake the associated class

before you can make another attempt to pass that exam. This training is not considered

refresher training and will be charged to your organization.

 Every subsequent failing score beyond five (5) fails will require re-attendance at Epic for the

associated class before you can make another attempt to pass the exam.

 The limitations described above will be enforced into the future.

This limit is also documented in Epic's Training Guide - Epic Community Member and Epic's

Training Guide - Consultant on the UserWeb.

How to Study for Your Epic Exams

https://documentation.epic.com/Redirect.aspx?DocumentID=2904903&Version=Epic%202017

https://documentation.epic.com/Redirect.aspx?DocumentID=2904905&Version=Epic%202017

https://documentation.epic.com/Redirect.aspx?DocumentID=2904905&Version=Epic%202017

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Introduction: Hospital Billing Fundamentals 1•7

RHB101 Resolute Hospital Billing Fundamentals Resolute Hospital Billing Epic 2017

Whether you have recently taken exams or have not taken an exam in quite some time, you will

want to make sure that your study techniques will work for your long-term learning.

To that end, Epic training has developed a piece of documentation, How to Study for Your Epic

Exams that you can access through Galaxy or through the hyperlink.

Project

You are required to complete one project for the Resolute Hospital Billing Administration

certification. The project details will be introduced in your Administration class as the project

cannot be started until after that class.

Project Grading:

You will receive a score back within three business days of submitting as well as the high-level

areas where you missed points. You may resubmit your project for a higher score considering the