Transactions: Professional Billing

Question 1

In PB, what is the fundamental unit of AR and drives the majority of reporting?

Answer 1

The transaction.

Aug. 2021, 3.3

Question 2

Is matching unique to PB?

Answer 2

Yes.

Aug. 2021, 3.3

Question 3

What allows payments from guarantors and insurance companies to be connected to the providers who performed the services?

Answer 3

Matching

Aug. 2021, 3.3

Question 4

Why is it good practice to check the documentation about a Clarity column before you decide to use it in a report?

Answer 4

Clarity column names don’t always fully explain what they contain.

Don’t assume that you know what a column does.

(Aug. 2021, 3.5-6)

Question 5

What does the ETR master file use to track changes to transactions?

Answer 5

Details, not contacts, track the events that modify transactions.

(Aug. 2021, 3.7)

Question 6

What does the “TDL” in CLARITY_TDL_TRAN stand for?

Answer 6

TDL = transaction detail line

Aug. 2021, 3.7

Question 7

What do detail types tell?

Answer 7

The full story of what happens to PB transactions.

Aug. 2021, 3.7

Question 8

What do new PB posts refer to in Chronicles?

Answer 8

New ETR records (will always have new transaction IDs)

Aug. 2021, 3.7

Question 9

What do detail types represent?

Answer 9

As new rows are added to the table, they represent either:

1. Newly posted transactions
2. Modifications and actions taken on previously posted transactions

(Aug. 2021, 3.7)

Question 10

What do details types 10 and up (10s - 60s) represent?

Answer 10

A modification or an action.

Aug. 2021, 3.8

Question 11

What detail types inherit values from its original posting?

Answer 11

Detail types 10 and up (10s - 60s)

Aug. 2021, 3.8

Question 12

List the detail types for original posts?

Answer 12

Detail types 1-6

1. New Charge
2. New Payment
3. New Debit Adjustment
4. New Credit Adjustment
5. Payment Reversal
6. Credit Adjustment Reversal

(Aug. 2021, 3.8)

Question 13

Define voids.

Answer 13

Undo transactions.

Voids:
• are not new transactions
• will inherit transaction IDs from the transaction they modify

(Aug. 2021, 3.8)

Question 14

List the detail types for voids?

Answer 14

10s
• 10 - Void Charge
• 11 - Void Payment
• 12 - Void Debit Adjustment
• 13 - Void Credit Adjustment

(Aug. 2021, 3.8)

Question 15

When can debit transactions be voided?

Answer 15

At any time.

(Debit transaction = charge)

(Aug. 2021, 3.9)

Question 16

When can credit transactions be voided?

Answer 16

On the same day the credit was posted.

Aug. 2021, 3.9

Question 17

When can credit transactions be reversed?

Answer 17

Any day after the day the transaction was posted.

This creates a new (debit adjustment) transaction that cancels the first.

(Credit transaction = payment)

(Aug. 2021, 3.9)

Question 18

What are detail types 5 and 6 a result of?

Answer 18

Reversals

5. Payment Reversal
6. Credit Adjustment Reversal

(Aug. 2021, 3.9)

Question 19

Are debit transactions ever reversed?

Answer 19

No

Aug. 2021, 3.9

Question 20

Define refunds.

Answer 20

Refunds are a return of money that was paid to the organization.

(Aug. 2021, 3.9)

Question 21

Are refunds credit adjustments?

Answer 21

No. Refunds are debit adjustments (detail type 3)

Aug. 2021, 3.9

Question 22

Which billing system uses matching?

Answer 22

Professional Billing

Aug. 2021, 3.9

Question 23

Define matching.

Answer 23

Matching is a process used in Professional Billing that connects a debit and a credit.

(Aug. 2021, 3.9)

Question 24

What two transactions can be matched to modify the balance?

Answer 24

1. Debit
2. Credit

(Aug. 2021, 3.9)

Question 25

How is matching information tracked?

Answer 25

Matching information is tracked using detail types (CLARITY_TDL_TRAN) (Aug. 2021, 3.9)

Question 26

What are the two ways to document payment reversals in Professional Billing?

Answer 26

1. Positive Payments 2. Debit Adjustments Epic recommends that your organization tracks payment reversals as positive payments. (Aug. 2021, 3.12)

Question 27

List the detail types for debit matching.

Answer 27

20. Charge -> Payment 21. Charge -> Credit Adjustment 22. Debit Adjustment -> Payment 23. Debit Adjustment -> Credit Adjustment (Aug. 2021, 3.11)

Question 28

List the detail types for credit matching.

Answer 28

30. Credit Adjustment -> Charge 31. Credit Adjustment -> Debit Adjustment 32. Payment -> Charge 33. Payment -> Debit Adjustment (Aug. 2021, 3.11)

Question 29

List the detail types for actions.

Answer 29

40. Change Payor 41. Transfer Responsibility 43. Resubmit 44. Claim Denied 45. Research (Aug. 2021, 3.12)

Question 30

List the detail types for collecting.

Answer 30

50. Claim 51. Bill (Aug. 2021, 3.12)

Question 31

Detail type 20s are _____ matching rows.

Answer 31

Debit. Meaning they show how the debits connect to their associated credits. (Aug. 2021, 3.16)

Question 32

What detail types represent a modification or action?

Answer 32

Detail types 10 and up (10s - 60s) | Aug. 2021, 3.7

Question 33

Detail type 30s are _____ matching rows.

Answer 33

Credit. Meaning they show how the credits connect to their associated debits. (Aug. 2021, 3.17)

Question 34

True or False: | When two transactions are matched, the information on each transaction is connected.

Answer 34

True | Aug. 2021, 3.17

Question 35

True or False: It is only when transactions are matched that we can answer the question "how much money were we paid for this type of service?" or "how much money did this provider earn our organization?"

Answer 35

True | Aug. 2021, 3.17

Question 36

When does bad debt occur?

Answer 36

When guarantors are unable or unwilling to pay and the organization has stopped trying to collect the balance. (Aug. 20021, 3.21)

Question 37

Is external AR similar to bad debt?

Answer 37

Yes, but may reflect other types of collections. | Aug. 2021, 3.21