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Epic Access Data Model COG220 > Registration > Flashcards

Registration Flashcards

1
Q

In Clarity, what field should be used to identify the patient?

A

I EPT .1

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2
Q

In Caboodle, what field should be used to define relationships with patients?

A

Surrogate or Durable Key

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3
Q

What master file stores patient insurance information?

A

CVG

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4
Q

What master file stores information about the guarantor?

A

EAR

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5
Q

What is a Payer?

A

A payer is an insurance company.

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6
Q

What is a plan?

A

A plan is a set of benefits that the insurance company offers.

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7
Q

What is a subscriber?

A

The subscriber on a coverage is the person in whose name the insurance is issued.

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8
Q

Which Clarity database object greatly simplifies coverage reports?

A

V_COVERAGE_PAYOR_PLAN

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9
Q

What is a member on a coverage?

A

Members are the set of patients who would use a coverage and are stored as EPT records.

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10
Q

In which database object(s) would you find member‐level effective dates?

A

EligibilityEventFact, COVERAGE_MEMBER_LIST

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11
Q

What is the Caboodle Table and Column name for the current patient MRN?

A

PatientDim.PrimaryMrn

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12
Q

What is the Caboodle Table and Column name for the patient name?

A

PatientDim.Name

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13
Q

What is the Caboodle Table and Column name for the guarantor name?

A

GuarantorDim.Name

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14
Q

What is the Caboodle Table and Column name for the primary payer name?

A

CoverageDim.PayorName

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15
Q

What is the Caboodle Table and Column name for the Secondary Payer Name?

A

CoverageDim.PayorName

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16
Q

What Clarity column stores the patient’s name?

A

PATIENT.PAT_NAME

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17
Q

What Caboodle column stores the patient’s name?

A

PatientDim.Name

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18
Q

Generally, which field in Caboodle should be used to join or group patients?

A

PatientDim.DurableKey

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19
Q

What is the granularity of the Caboodle DBO, PatientDim?

A

One row per patient per date range

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20
Q

What is the granularity of the Clarity DBO, PATIENT?

A

One row per patient

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21
Q

What is the granularity of the Caboodle DBO, GuarantorDim?

A

One row per guarantor account per date range

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22
Q

What is the granularity of the Clarity DBO ACCOUNT?

A

One row per guarantor account

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23
Q

In which database object(s) would you find member‐level effective dates?

A

EligibilityEventFact, COVERAGE_MEMBER_LIST

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24
Q

What would it mean if MEMBER_EFF_FROM_DATE stored the beginning of last month but MEMBER_EFF_TO_DATE was null?

A

The coverage is currently active for the member.

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25
Q

What is the granularity of the Clarity DBO, ACCT_COVERAGE?

A

One row per CVG attached to an EAR or one row per coverage attached to a guarantor.

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26
Q

What is the granularity of the Clarity DBO, PAT_ACCT_CVG?

A

One row per EAR attached to an EPT or one guarantor account attached to a patient.

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27
Q

What is the granularity of the Caboodle DBO, EncounterFact?

A

One row per patient encounter

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28
Q

What is the granularity of the Clarity DBO, PAT_ENC?

A

One row per patient encounter

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29
Q

What is the granularity of the Clarity DBO, PAT_ENC_HSP?

A

One row per hospital encounter

30
Q

Which master file contains hospital accounts?

A

HAR

31
Q

What is the granularity of the Caboodle DBO, BillingAccountFact?

A

One row per HAR, regardless of how it is generated

32
Q

What is the granularity of the Clarity DBO, HSP_ACCOUNT?

A

One row per HAR, not including VFO HARs

33
Q

What is the granularity of the Clarity DBO, ARPB_VISITS?

A

One row per PB Visit HAR

34
Q

What Caboodle table establishes the relationship between encounters and HARs?

A

BillingAccountEncounterMappingFact

35
Q

True or False: Assuming an encounter has a HAR (which is guaranteed in Epic 2018 and after), I EPT 2205 and I HAR 110 will store the same value.

A

True. The one exceptions is with Related HARs.

36
Q

What is a claim?

A

A bill for payment for the services provided to the patient.

37
Q

What is the filing order?

A

The order in which claims will be sent to payers.

38
Q

How many coverages will a patient have for an encounter?

A

Zero to many.

39
Q

What is the primary coverage?

A

The first coverage to receive the bill.

40
Q

What financial class does a visit have if no coverage will pay for the services of the encounter?

A

Self-pay

41
Q

Which table in Caboodle stores the first five coverages?

A

BillingAccountFact

42
Q

True or False: In Clarity, HSP_ACCOUNT and ARPB_VISITS both only store the primary coverage.

A

True

43
Q

What DBO in Clarity stores all the coverages for a hospital account?

A

HSP_ACCT_CVG_LIST

44
Q

How is filing order denoted in Clarity?

A

Using the LINE column

45
Q

What Clarity table should be used for the filing order for all HARs?

A

HSP_ACCT_CVG_LIST

46
Q

What is the granularity of the Clarity DBO, VERIFICATION?

A

One row per VRX (verification) record

47
Q

What is the granularity of the Clarity DBO, VERIF_STATUS_HX?

A

One row per change to a VRX record’s status

48
Q

What Clarity table should be used if you need to know the verification status of a record at some point in the past?

A

VERIF_STATUS_HX

49
Q

If you need to find the verification status of a record at some point in the past, what two things do you need to look at?

A
  1. The history table’s listed status at that time

2. Check that the status had not expired by that time

50
Q

When will an encounter appear in ECHKIN_STEP_INFO?

A

When a patient uses eCheck for an encounter.

51
Q

Which master file’s tables should you avoid in registration history?

A

HNO

52
Q

True or False: A patient’s MRN is guaranteed to be unique across all patients on the same instance of Epic.

A

False

53
Q 
A given coverage record represents the unique combination of which of the following? Choose ALL
answers that apply.
A. Payer
B. Plan
C. Subscriber
D. Patient
E. Member
F. Guarantor
A

a, b, c

54
Q

Which of the following join conditions would connect each hospital account to its guarantor’s current information and exclude historical information? Choose just ONE of the following.
A. BillingAccountFact.GuarantorKey = GuarantorDim.GuarantorKey
B. BillingAccountFact.GuarantorDurableKey = GuarantorDim.DurableKey
C. BillingAccountFact.GuarantorKey = GuarantorDim.DurableKey
D. BillingAccountFact.GuarantorDurableKey = GuarantorDim.DurableKey AND
GuarantorDim.IsCurrent = 1

A

d

55
Q

How many patient encounters may be associated with a guarantor record? Choose only ONE answer.
A. Always zero
B. Always one
C. Either zero or one
D. Any number of encounters, including zero

A

d

56
Q

Which of the following scenarios would create a HAR? Choose ALL answers that apply.
A. A visit in a service area with SBO ﴾and not VFO﴿ that is billed through Resolute Hospital Billing
B. A visit in a service area with SBO ﴾and not VFO﴿ that is billed through Resolute Professional Billing
C. A visit in a service area with VFO ﴾and not SBO﴿ that is billed through Resolute Hospital Billing
D. A visit in a service area with VFO ﴾and not SBO﴿ that is billed through Resolute Professional Billing
E. A visit in a service area with both SBO and VFO that is billed through Resolute Hospital Billing
F. A visit in a service area with both SBO and VFO that is billed through Resolute Professional Billing
G. A visit in a service area with neither SBO nor VFO that is billed through Resolute Hospital Billing

A

a, b, c, d, e, f, g

57
Q

What does VERIFICATION.VERIF_STATUS_C represent? Choose just ONE of the following.
A. The current status of a verification record
B. The first status of a verification record
C. Every status a verification record has had
D. The status of the eCheck‐In progress

A

a

58
Q

A user changed the status of a VRX record about a guarantor. That was not the final change to the VRX record’s status. Which of the following would VERIFICATION store? Choose only ONE answer.
A. The ID of the user who made the change
B. When the change occurred
C. The status that resulted from the change
D. The ID of the guarantor who was verified

A

d

59
Q

A patient’s address had two lines, and a user edited the address to instead have three lines. Assuming this is captured in Registration History, how many rows represent this edit in REG_HX_ADDR_CHNG_NEW? Choose just ONE of the following.

A. 0
B. 1
C. 2
D. 3

A

d

60
Q

For what reporting purpose can you use ACCT_GUAR_PAT_INFO?

A

Listing every patient associated with each guarantor record.

61
Q

What value does I EAR 250 store?

A

I EPT .1

62
Q

True/False: Member effective coverage dates may differ from the effective dates of the coverage overall.

A

True

63
Q

True/False: EligibilityEventFact is designed strictly for managed care coverages.

A

True

64
Q

What does VFO stand for?

A

Visit Filing Order

65
Q

What does SBO stand for?

A

Single Billing Office

66
Q

True/False: Resolute Professional Billing uses HARs to capture more than just registration data?

A

False

67
Q

True/False: Every HAR must have one and only one guarantor.

A

True

68
Q

If a patient uses eCheck-In for an encounter, will the encounter appear in ECHKIN_STEP_INFO?

A

Yes, but only then.

69
Q

What metric can be used to quantify how much eCheck-In reduces the time the front desk staff spend on encounters that use eCheck-In?

A

MYC Average Time Saved by eCheck-In

70
Q

What master file stores the payer records?

A

EPM

71
Q

Can EligiblityEventFact be use to report on indemnity coverage?

A

No. It is strictly for managed care coverages.

Epic Access Data Model COG220 (7 decks)

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