Cash Management
Creates 2 types of records: Cash control groups and cash records. Tracks how much of a deposited payment has been posted in Resolute.Benefits include:simpler reconciliation between bank deposits and payment in EpicIncreased payment posting efficiency and accuracy.
Cash control group
Cash control group represents several deposited checks(cash records) grouped together for posting purposes, usually based on deposit date.Cash control groups are representations of a bank deposit. Matching a cash control group to a payment posting batch allows for the reconciliation of posted payments to the money in the bank. Multiple checks and multiple payers can be combined into one cash control group. Best created automatically from the system.
Cash record
Represents one deposited check.
What is the purpose of a cash control group?
Matching a cash control group to a payment posting batch allows for the reconciliation of posted payments to the money in the bank
Does confirming a as control group post the payments into Epic?
No. Payments aren't posted thru the cash control group creation process.
Does confirming a control group post the payments into Epic?
No. Payments aren't posted thru the cash control group creation process.
Payment posting batch control amount
Is the total amount of money that you expect to post in a batch.
routing code
descries the type of payment that will be posted and determines the routing number the system will assign
deposit data field
holds the date the money was deposited in the bank
A cash record
represents one deposited check
A cash control group
represents several checks grouped together, for posting purposes
ref date field
the date associated with an individual payment
payment posting batch
is a holding tank for payment information
total control mount
total dollar amount of all checks in a batch
(T/F) cash management tracks how much of a deposited payment has been posted in resolute
True
(T/F) multiple checks can be combined into one cash control group
True
(T/F) Confirming a cash control group posts the payments into epic
False
(T/F) Cash control groups must be created manually in epic
False
How do you prioritize your WQ to work the claims with oldest service dates first?
Click the Service Date column heading.
Where can you view the past activities performed on claims?
Activity History in the AssistantFollow Up Activities section in the WQ information Display
Outstanding claim
Claims might not get a timely response, requiring insurance follow-up staff to contact the payor todetermine the status of the claim.
Outstanding claim
Otherclaims might not get a timely response, requiring insurance follow-up staff to contact the payor todetermine the status of the claim.
Follow Up WQ Assistant
The Assistant provides further information about the charges on the invoice, and can be accessedby double clicking on a line from a follow-up workqueue.
Resubmit claim
Found in the follow up activity field at the bottom of the screen. Allows you to resubmit claim if payer did not receive original claim.
Active Tab
Claim is active in WQ to follow up on.
User Deferred Tab
Moves the claim from the Active WQ to a deferred WQ for a specified amount of time. For example, payer needed more time to process. Can setup a max time to prevent user abuse.
How can you identify the currently responsible payer from the Assistant?
Highlighted in yellow in the follow up WQ assistant
The Assistant
Provides further info about the charges on the invoice and can be accessed by double clicking on a line from a follow up WQ
Activity history Section
Can be helpful when troubleshooting a follow up record. This section outlines which activities were performed, by who and when.
The icon next to the payers name (looks like 3 circles connected) .
indicates that there is an available link. If there are specific payer websites for eligibility queries, claim status requests, referral authorizations or other tasks, you can access it directly in hyperspace. from the follow up assistant by clicking the link
Where can you find the payer contact info for a claim your WQ?
Insurance coverage section of the assistant
Which activity do you perform when the payer did not receive the claim and you need to send them a new claim
resubmit claim
What do you do to summarize all of the actions taken while working on a claim
click the add note checkbos
Which activity do you preform when you can't work the claim right now so it shouldn't be on your active tab
defer
What factors will your org use when calculating the "score" column?
amt outstanding, age, number of denials rec'd, payer, denial type, other
what is the consequence of deferring a claim
defer moves the claim off of your active tab (work list)
why would you defer a claim
if yuou were prevented from working on a calim for a certain perio of time due to waitin gin a insurnce company
Claim Edit WQ Companion
Its the box with the step by step instructions displayed for the end user about how to fix the claim and these are customizable.
Claim Edit Tab
Professional claim edit WQs-showing all the WQs (when on the WQ List open the claim edit tab to get to the Pro Fee claim edit WQs)
What Epic Record defines all of the possible errors a claim could have?
CDF Claim Definition File
Who corrects user errors?
End users correct user errors.
Where are end users errors corrected?
End user errors are corrected in Hyperspace
Who corrects master file errors? Where are these errors corrected?
Application coordinators or IT staff correct master file errors. Master file errors are corrected outside of Hyperspace.
How can you access the step by step instructions for how to fix a claim error?
Step by step instructions by Clicking on the error link in the claim edit assistant.
What does the Refresh button in the Companion do?
The refresh button in the companion tests claim errors against the CDF (edit checks against the claim) in real time. The system automatically resubmits the claim.
What is the purpose of a claim edit WQ
To correct claims with errors before sending to the payers
CDF (Claim Definition File)
during the claims process, claims are checked by the CDF
Claims Edit WQs
Claims with errors appear in claim edit WQs for correction. An end user is only responsible for fixing errors assigned to the.
Claims Edit WQs
Claims with errors appear in claim edit WQs for correction. An end user is only responsible for fixing errors assigned to them.
User errors
User errors can be fixed by an end user in hyperspace (usually the lower numbers)
Master file errors
Must be corrected in the build by an application coordinator or IT person (usually the higher numbers)
What does a user need to do after fixing a claim?
Nothing, the system automatically resubmits the claim.
Fix claim errors
Once fixed, make sure that the resolved claim has left the WQ before processing claims to create a clean version of the claim.
Force resubmit the Claim
This button is security controlled. Force resubmit sends the claim back to the claims queue and the next time it is pulled into a claim run the error checking for that claim will be skipped (even if the claim still has errors) and the claim placed in a clean run. Useful for testing and for sending claims before they become timely (so you have more time to fix)
Edit Values Button
This button is security controlled and will appear when editing an individual invoice in a claim edit WQ. Allows you to edit specific pieces of data on the claim, while leaving the source data in the system unchanged.
what is the purpose of a claim edit workqueue
to correct claims with errors before sending to payers
which window gives you instructions about how to correct claim errors
claim edit/error (WQ companion)
which button in the companion lets you run the CDF edit checks on the claim in real time
refresh
Claims Queue
Charges that are ready and waiting to process for claims are located in the Claims Queue. A list of all the charges available to go out on a claim.
Batch Scheduler
Batch scheduler is the tool in the system that automates processes like claims and statement processing.
Creating claims should be mostly an automated process.
True
Claims Run
The first step in the claims process is creating a claim run form the charges listed in the claims queue. The systems groups together transactions with the same encounter information. A single claim run can contain both paper and electronic claims. Claim runs mare Accepted to mark the claims in the run as Accepted, which indicates they have been generated and sent successfully.
Claims Run
The first step in the claims process is creating a claim run from the charges listed in the claims queue. The systems groups together transactions with the same encounter information. A single claim run can contain both paper and electronic claims. Claim runs mare Accepted to mark the claims in the run as Accepted, which indicates they have been generated and sent successfully.
Invoice Number
An invoice number is printed in the Patient's account number box of the CMW1500 for tracking purposes.
Invoice Number
An invoice number is printed in the Patient's account number box of the CMS1500 box 26 for tracking purposes.
Claims Reconciliation
Claims reconciliation is a process which loads the file, sent by a clearinghouse or payer into Epic and automatically accepts all claims the file indicates are clean. It requires additional configuration and communication with your clearinghouse and or payers.
Charges to appear on a claim
For Charges to appear on a claim, the charge must be assigned an insurance coverage, have an insurance balance and be in the claims queue.
Accepted Invoice Status
the invoice is available for insurance payment posting and is or has been in a followup WQ.Look in the summary tab for the invoice, in the WQ section to see if it currently in a f/up WQ
Processed Invoice Status
The invoice is still in a claim run that has not been accepted. It is not yet available for use in other PB workflows. Summary-Claims Reconciliation Info
Errored Invoice Status
The invoice has errors and is caught in a claim edit WQ. It is not yet available for use in other PB workflows.Summary-WQs
Voided Invoice Status
The invoice was created but the charges on the invoice were voided. It is not available for use in other PB workflows and never will be.Sent to payer, payer denied, void & repost Look in history. (on your/ counted ACTIVE AR)
Rejected Invoice Status
The invoice was created but was then rejected due to: invoice was in a rejected claim run, errored into a claim edit WQ and was resubmitted, this invoice errored into a claim edit WQ
Closed Invoice Status
The invoice was created, acdcepted and then the responsibility for the payer listed on the invoice was completed.Summary-payhments & credit adjustments-related invoices tab.
Closed Invoice Status
The invoice was created, accepted and then the responsibility for the payer listed on the invoice was completed.Summary-payhments & credit adjustments-related invoices tab.
Posted the charges but why are there no invoices on the Invoices view?
You haven't processed claims yetUsually done overnight but if you want to see sooner you need to process manually
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claim definition file (CDF)
internal claim scrubber checks for insurance related errors and formats the claim. if a claims fails a check it will then appear on a edit WQ for corrections
invoices
only populate PB follow up WQ and will become available to a user in insurance payments posting once the invoice has a status of accepted
history tab
allows you to determine source of a s rejected claim
What is the difference between a warning and error?
Warnings can be ignored but errors must be fixed.
What does the Transfer button in a charge review workqueue do?
Moves a charge session from the current workqueue to another charge review workqueue.
What does this workqueue icon (stack of papers) represent?,
The charge session is in multiple charge review workqueues.
True or False? Users review charges in charge review workqueues after the system has posted the charges to the account.
False. Users review charges before the system posts them to the account, while the charge are still considered temporary and editable.
When should a user resubmit a charge session?
When the user thinks all the issues are corrected.
Why are duplicate charge sessions sent to a supervisor?
The DELETE button is security controlled.Not all users have access to delete charges.
Charge review workqueue
Before charges can post, they go through a series of edit checks within PB called charge review WQ.
Delete (a charge session)
Security access controlled. Goes to Supervisors for deletion.
Force resubmit
Force resubmitting a charge session forces the session to post regardless of its errors in any of the charge review WQs it's in. The force resubmit button lets the supervisor force the charge session to post for all charge review WQs. it's in without critical errors. Examples: timely filing, build requires fixing-waiting for build team to make changes. Need posted charges for testing later in the Rev Cycle.
Pre AR
Manual Charge EntryPB Charge Entry (Claims scrubber here too)HB Error CheckingHB Charge Review WQ
Active AR
Send ClaimPosted to PB HARPosted to HB HAR
Charge Router Review WQ
Charges that originate from Epic Clinical apps, interfaces, or manually entered from Charge Router Charge Entry are reviewed by charge router review WQ & PB Charge Review WQ before posting.
PB Charge Review WQ
Charges originating from PB Charge Entry are reviewed only by PB Charge Review WQ's before posting.PB Critical and PB coding-specific checks.
What happens when charge session passes all the edit checks?
Charge are posted to the account and become permanent transactions.
What happens when charge session fails an edit check?
It is sent to a WQ and does not yet post to the account.
Temporary transactions
While charges are in charge review, they are temporary transactions and easy to edit or correct.
Score Assignment
Every charge session is assigned a score that your end-users will use to determine which records are the highest priority.
Resubmit
Resubmit will trigger the charge session to leave the WQ and charge review WQ rules re-evaluate the charge session. If all of the charge session issues are corrected, the charges post to the account. Once resubmitted and posted, the charge session should fall off the WQ.
The Router Error Pool
Also contains a list of charge sessions that need to be reviewed. Not a WQ that contains rules to pull in charge sessions, instead charge sessions appear here when there are Charge Router critical errors.
How are PB Charge review WQs divided up?
PB Charge review WQs are divided up by type (coding, registration, admin, etc), location and/or bill area.
How are users sharing the work within a WQ?
Users can use filters within a WQ to only show the charge sessions they are responsible for within the WQ.
Session History
Displays activities performed on the charge session.
Charge Sessions originating from Clinical Activity
Charge Sessions originating from Clinical Activity are automatically generated as providers place orders, perform procedures and enter results. The system sends these charges from the clinical app thru the Charge Router and into the assigned billing system.
Encounter report
The clinical chart for this patient. Click encounter report (arrow on the right side of the charge session-PB Sidebar, to review the clinical details from the visit.
Do changes in the charge session update the clinical chart?
No, not if a charge session is from a clinical source.
If you want the chart and account to match, where should the charge update be made?
The chart should be updated in the clinical application.
SmartPhrase
standard language (phrase) created so charge review staff can always send a consistent message to clinicians via In Basket message. Use F2 to move to the *** when using .pbcoding
In Basket messaging
When sending coding clarification back to provider in basket, Do not use the resubmit button in the charge session review comment window, instead click accept.
Clinical Encounter Changes/Updates
Changing the encounter sends an update message to the charge router.
Deleting charge sessions
The deleting of charge sessions is security controlled and typically not available to most end users. The end user Transfers the duplicate charge to supervisor for deletion. Completely removes the charge session from the system not just the supe WQ but a record of that deletion is stored in the system. You cannot undo a deletion.
Delete button on the activity toolbar
Supervisor uses delete button on the activity toolbar to delete a duplicate charge session (charge ticket),
Critical errors, such as missing billing provider, will have to be resolved before charges can post even using Force Resubmit.
This is true.
Which buttons (in this workflow) are security controlled?
Force resubmit and delete
PB Charge Review WQ in Single item mode
The WQs with single item mode enabled will present only one charge session at a time to the user. The WQ temporarily assigns the next highest priority charge session so no cherry picking can happen.
Locked sort WQ
Locked sort displays all the charge sessions in the WQ to a user but the charge sessions are locked in a pre-defined sort but is less restrictive than single item mode.
if a charge session is from a clinical source do chargers in the charge session update to clinical chart
no
if you want the chart and account to match where should the charge update be made
clinical chart application
why might you use force resubmit
timely filling, build fix, testing
How can you update a dashboard to see current information for all components at once?
Dashboard>Dashboard menu>Refresh Dashboard
Which of the following are types of components?
Report Listing andTable
Graph and table components pull their data from
Reporting Workbench reports
True/False. Users can set their own default dashboard by reordering their favorites.
True. the first dashboard in the Favorite Dashboards list is that user's default dashboard.
Dashboard
A reporting workspace intended for a specific audience and holds components. p4.15 (see tableDashboards are created using an application called Radar. An activity that pulls data from multiple sources into one centralized location for a group of end users. For example, your dashboard displays top charge review WQs and errors, shows Reporting Workbench favorites, Clarity reports, links to documents, Websites, hyperspace activities and more. The dashboard you see in your home workspace tab is your default dashboard. You can jump from this dashboard to other dashboards by using the My Dashboards activity. Dashboard is the overall screen and is very customizable. p4.4
Component
A unit of content on a dashboard. Units of content that compose a dashboard. p4.15 (see table) Components are units of content that compose a dashboard. Dashboards present info from multiple components in one location instead of multiple activities. Components make up a dashboard. p4.4Hover over any of the components sections to the right pops up 3 dots horizontal which provide options, about, show table etc for trending, etc
Analytics Catalog
Shows reporting content that you can access and matches your search terms. You can narrow down your search results using the filters on the left side of your screen. You can filter by content you have already favorted, the content type, report tags or personalized content. p4.14 Allows you to access add'l dashboards and favorite them so you can view them any time you sign in. p4.11
Default Dashboard
The dashboard you see in your home workspace tab is your default dashboard. Redirector dashboard. All Radar dashboards have components. p 4.5
Types of Dashboards and Components
Dashboard display different types of info for different purposes. Regardless of the purpose, All Radar dashboards have components.. p4.5
Redirector Dashboard
allows you to easily access multiple dashboards grouped together. p4.5
Learning Home Dashboards
contains links to resources such as websites or user guides (tip sheets/job aides/time savers, etc). A learning home dashboard gives users info at their fingertips so they can do their jobs effectively. p4.5learning home dashboards that you make for your staff to put tip sheets in their learning home dashboards p 4.3
Components - different types
Different types of component records available in Radar. All Radar dashboards have components. Some of the most common:linkreport listinggraphtable p4.5
Link component
displays a list of links to Hyperspace activities, reports, networked folders and files and URLs outside of Hyperspace. p4.5
Report Listing component
displays links to all of a user's essential reports with the added ability to run and edit Reporting Workbench reports. p4.5
Graph component
displays a visual summary of data in the form of a bar graph, line graph or pie graph. These components can use Reporting Workbench reports or code templates as a source. p4.5
Table component
displays a table of summary info from a Reporting Workbench report. The rows and cells in these components can change color as metrics pass pre-defined thresholds. It's possible to link to other activities from these components. p4.5
Refresh
you should periodically run and refresh the dashboard to see current info. Components that display dynamic data can be updated throughout the day by clicking the Refresh button at the top of the component. The buttons controlling a component stay hidden until you mouse over them. Other components that show static data, such as links to activities in Hyperspace, cannot be refreshed. p4.6
Selecting Run Reports
will run the reports that will populate your graph and table components. p.4.6
Actions Menu (the 3 dots vertical)
Rather than run and refresh each component individually, in the upper right corner of the dashboard there is a menu that has options to run or refresh all report components at once. p.4.6
Reporting Workbench Report
A configurable report built from a template that pulls real-time or nearly real-time data from your system. p4.15 table
Crystal Report
A specialized report that pulls data from Clarity to show comprehensive data. p4.15 table
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ARCR Program
Groundwork Phase 0Direction Setting Phase 1Build & Adoption Phase 2Testing Phase 3Training Phase 4Post-Live Phase 5Created because operational engagement is the key driver to a successful implementation.ARCR leads will get an orientation in system knowledge, key workflows and reporting. Able to help staff use the system effectively, maximize workflow efficiency, interpret reports to identify potential bottlenecks in the rev cycle and understand how to adjust the system to manage these bottlenecks. P1.5
Parallel Revenue Cycle Testing
PRCT involves taking claims from your current system and replicating them in Epic as an end=to-end process to test your Epic build. Helps you feel confident that your Epic build is complete and correct.Needs to cover all significant areas of your org's business. Need to represent the full scope of your business. Provide a foundation for a solid rev cycle go-live. p1.7Involves 3 types of testing:Parallel Rev Cycle TestingIntegrated TestingWorkflow Walkthrough p1.8
Operational workbook
Used throughout an implementation to provide a roadmap of the install specifically for ARCR leads; calling out the key tasks, milestones and responsibilities. ARCR leads use the workbooks to make sure that they complete all of the steps that lead to a successful go=live and strong future operational performance.
Operational workbooks are used as an overview of the implementation process
2 operational workbooks:ARCR Operational WorkbookRole Specific (Ins AR F/up) Operational WorkbookThese are the roadmaps to the ARCR Program and install as a whole.ARCR Operational Workbook describes the overall ARCR process, milestones ,goals all the ARCR leads are involved in.
Responsibilities of Readiness leads
Groundwork Phase 0Direction Setting Phase 1Build & Adoption Phase 2Testing Phase 3Training Phase 4Post-Live Phase 5
Operational Summit
opportunity to review the top risks across the rev cycle with operational leadership.. The owners present their mitigation plans for top risks. Present refined plans again at the Operational Readiness Review, the final review before go-live. p1.8
Operational Readiness Review
Serves as a final checkpoint to help ensure that operational, project and fin'l leadership understand:Revenue Cycle and clinical milestones and expectations.Key metrics and success factors.Risks and mitigation plans.Meeting occurs about 45-60 days before go-live p1.9
Go-Live
Busy time helping other staff in the system, escalate problems and work with the project team to fix them, monitor key metrics and report on your area to project leadership.Assist at go-liveLead go-live meetingsParticipate in post-live training sessionsParticipate in the Revenue Mgmt Workshop p1.10
Post-Live and Beyond
The ARCR program ends with go-live but you'll continue to be a super user and advocate for your area.Optimize the SystemAttend XGM or UGM at Epic (collaborate with Epic community for success with Epic)
Does System build and configuration end after go-live?
No, continue to look for opportunities to improve the system. p1.11
Clinical and Financial Programs
help you easily adopt proven initiative at your org. Replicate the success of others. p1.11
Expert Group Meetings (XGM) & Users' Group Meeting (UGM)
Annual opportunities for orgs that use Epic to share info, learn about new features and grow relations within the Epic Community. p1.11
why was the ARCR program created
because operational engagement is the key driver to successful implementation
True/False. Filters need to be re=applied to WQs every time a user logs in.
False
How does a user find a subset of records in a WQ that qualifies for certain characteristics?
Filter
Which icon would a user select to customize the activities shown in the Hyperspace toolbar?
Wrench
Filter
A set of rules for determining which records will be displayed. p6.7
View
Mode in which the presentation appears on the screen. End users can drag & move columns to a new location in the WQ. To change which columns display, select the Columns option from the Column Actions link (or right click on a column header) and decide which columns to see from a predetermined list. p6.9
Customize the hyperspace toolbarFilter which transactions display in Inquiry
click wrench in the upper right corner of hyperspace next to the log out button etc p 6.4
Customize columns in Inquiry
Similar to hyperspace toolbar, the info that displays in Inquiry is also customizable. End users can modify which columns display when viewing transactions as well as which filter are available in the filter pane. It's also possible to lock the detail pane on the bottom of the screen. p 6.6
Set a WQ filter
When there are many records to sift thru in a WQ, you can use the Filter button to narrow your view or to find records that match specific criteria. Filters are also useful if multiple end users are sharing one WQ. End users are often given the ability to set their own simple filters. The project team will be responsible for creating rules for more complex filters. p6.7
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What is the purpose of the cash drawer in the system?
To reconcile the physical money you collected with the money that you posted in the system.
What must you do when the cash drawer is out of balance?
First, try to balance the cash drawer by re-counting and re-entering the contents of your physical money. If itstill does not balance, contact a supervisor and enter a reason why the drawer is not balanced.
Clicking which button allows you to easily compare thetotal recorded cash to the money posted in thesystem?
Select All
What button do you click to confirm whether the money from your physical drawer matches what you posted in the system?
Select all
True or False The Cash Drawer is used to track the collection of payments made by cash or check and will not display payments collected via credit card.
False
Using the Deposit Tool, what is the order/process
Confirm individual deposits amts are accurate compared to cash drawer closing reports.Calculate a grand total dollar amt for all the collected deposits.Enter the deposit number and the deposit date.Click Generate Deposit.
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True/False. Every visit affected by a retroactive coverage change is sent to WQ for review?
False. The system can automatically retroadjudicate visits or automatically reject retroadjudication for visits. When the system automatically accepts or rejects the coverage change, the visit does not get routed to a WQ.
What happens to the visit filing order when you reject retro for a visit, either automatically in the profile or manually from a WQ?
The visit retains the original filing order
What happens to the visit filing order when you accept retroadjudication for a visit, either automatically in the profile or manually from a WQ?
The visit is retroadjudicated, updating the filing order for the visit. If the primary coverage changed then the charges from that visit will also be voided and reposted.
Visit Filing Order
Visit filing order refers to the order in which claims are sent for a particular visit. Each visit stores a filing order specific to that visit. Claims are sent based on filing order of the visit. The filing order is finalized when the visit is checked in.
Retroadjudication (examples that could create p 5.5)
Is the review and resolution of changes made to an existing visit's filing order. System retroadjudication is triggered when an update to a patient's filing order creates a new proposed visit filing order. p5.5
Visit FO Review/Retroadjudication Profile
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ACCEPT Filing Order Change
will alter the visit's filing order and if the primary coverage changes the charges will be reposted. If the primary coverage remains the same, the visit's filing order will be updated but the charges will not be voided and reposted. p5.8
REJECT Filing Order Change
will leave the visit's filing order and the charges in their original state. p5,8
Manual Review
see page 5.6-5.7
Edit the filing order for a visit from acct maintenance
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Explore various ways of researching filing order changes
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Accept and Reject visits from a Retro Review WQ
Remember that accepting the filing order change for a visit will only repost the charges if the primary coverage changes. Accepting changes to 2ndary/tertiary coverage's will add those coverage's to the visit's filing order but it does not change the party currently responsible. p5.8-5.9
How does security affect what users can do with the filing order for a visit?
Manual retroadjudication occurs when a user with security directly edits a visit's filing order. p5.5
Automatic retro processes
the system will auto retro primary changes only. The visit is retroadjudicated, updating the filing order for the visit. If the primary coverage changed then the charges from that visit will also be voided and reposted. p5.4
Manual retro processes
Does not go thru system processing. Instead it goes to Retro Review WQ and person lays eyes on it and does the change manually p5.6
All professional visits get a defined filing order
True from (e-learning test)
What is the definition of retroadjudication?
It is the system or a user evaluating whether changes in registration should apply to past visits. (e-learning test)
What best describes which visits have the filing order reviewed by the system for a potential retroadjudication?
Only visits affected by retroactive coverage changes. (e-learning test)
Encounter Filing Order Adjustment Logic (FOAL)
Prelude can use rules to determine the appropriate filing order, referred to as FOAL or filing order adjustment logic. It determines which coverage's from the patient's will be used and in what order they will appear.FOAL is commonly based on dept and provider characteristics such as dept or provider specialty. FOAL is configured in the Reg/Grand Central System. p5.3
Patient Filing Order Diagram
page 5.4
Reposting Charges Due to Visit Filing Order Changes
When a visit's proposed filing order change is ACCEPTED (either automatically or manually by a user) the visit's filing order is updated.If the primary coverage for a visit is changed by an update, then the system will automatically repost the charges from the visit to reassign them to the proper liability. This will only happen when the PRIMARY coverage changes; never for any other level of the filing order. p5.5
Benefits of Retroadjudication
Reduction of denialsFaster reimbursementIdentification of filing order changes and automation of void/repost saves user time. p5.6
Retroadjudication is for pro fee visits only.
Similar considerations can be made forHB charges using Coverage Manager, a tool in Resolute HB. p5.6
Under Functions is Actions
In PB, an Action is something that deals with remaining liability (ie. transfers to another party) p5.9
What is an action?
Transfer of Liability (see p5.11 for questions & answers)
The following are benefits of using reimbursement contracts.
Facilitates reportingAuto-populates allowed amounts in payment posting.Underpayments can be routed to WQs for follow up.
True/False. Reimbursement contracts are required.
False
What options can be chosen for when contracts can write-off the difference?
Only Charge EntryOnly Claims ProcessingBoth Charge Entry and Claims ProcessingCan also choose to route underpymts and overpymts to f/up WQs p4.3
Reimbursement contracts
Compare the payments you expect to receive to what you actually collect for every procedure associated with a particular payer. Reimb contracts do NOT affect the pricing of a procedure. p4.3
Allowed Amount
Actual collectable amount on the EOB from a payer. p4.4
Underpayment
Underpayments or overpayments can be routed to a F/up WQthe amts that you were reimbursed by a payer with the amt you were entitled to be reimbursed according to your reimbursement contracts in effect at the time
Expected vs. Actual Allowed Amts and Reimbursement Report
Difference between what contract says and what payer paid.the amts that you were reimbursed by a payer with the amt you were entitled to be reimbursed according to your reimbursement contracts in effect at the time
Reimbursements by Payer and Plan for All Charges Report
Helpful in negotiations with select payers.
Reimbursement Contract Underpayment Report
is an application report run real-time out of hyperspace.It compares the amts that you were reimbursed by a payer with the amt you were entitled to be reimbursed according to your reimbursement contracts in effect at the time. p4.7path:epic>reports>professional billing reports>reimbursement contract reports>underpayment report
Find the allowed amount in Charge Entry
...
Find the allowed amt for a charge after it has been posted to the guarantor account
...
Billed amount
The price of a charge sent out on the claim to the payer. p4.4
Expected reimbursement amount
the amount built in your reimbursement contract that you expect to collect p4.4
Not allowed amount
The difference between the allowed amt and billed amt that will be written off. p4.4
Terminology scenarios
page 4.4-4.5
Underpayment queues
are a holding place for f/up records that have not been paid according to what you would expect from the payer. p4.6
How can you access Help text about a component?
Options Menu (3 dots)>about
How can you run a report from a Report listing component?
Click on the 3 dots vertical, actions button, select run report. Also 'ready to run'
True or False: Components can contain links to jump you to other Hyperspace activities.
True
How do you access trending graphs in table components?
Click on the number you would like to see trending data for in the component.
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Reporting Workbench Reports
Very configurable reports that can display more complex data sets than Application reports.You can access application reports not already on your dashboard from Epic>Reports>My Reports p3.5
Application Reports
Used to view short term up to the minute data.End users run these reports mainly in Hyperspace on small amts of data at their convenience.You can access application reports not already on your dashboard from Epic>Reports>Professional Billing Reports p3.5
Clarity Reports
Long term trending reports. This data is pulled from your reporting server. These reports are often run & populate components of your dashboard.You cannot configure these reports.Clarity reports are built and run by your reporting team. p3.5
Access My Reports activity
Epic>Reports>My Reports>Library tab (on left column) p3.7You can also use the search bar (Chart Search) in the upper right to search for "My Reports
View a list of follow up records in a WQ
Epic>Reports>My Reports>Library tab (on left column) Click one of the WQs for the detail records.
View a graph summarizing data about WQs from a component
Click on one of the blue numbers on the right. The one you click on will show a graph. You can change the timeframe by clicking on one of the buttons, ie 7 day, 14 day, etc
Dashboards
An activity that pulls data from multiple sources into one centralized location for a group of end users.Are workspaces in Eipic that summarize large amts of data using visual aids such as tables & graphs. p3.4
PB Ins F/Up Supervisor Dashboard
contains the key reports and metrics specific to the Ins F/Up supervisor p3.3
PB Overview Dashboard
contains high level AR metricshistorical and projected accounting datainformation about pending charges and adjustments p3.3
PB Ins F/Up Learning Home Dashboard
contains links to training materials such as guides and efficiency tips for ins f/up staff p3.3
Component
Units of content that compose a dashboard.Dashboards present information from multiple components in one location. p3.4
View a Reporting Workbench or Application Report
Reporting workbench: epic>reports>my reports>Library p3.5
Ready to Run (status)
the report settings are configured but the report need to be run to view the results. p3.5
Ready to View (status)
the report has run; you can view the results. p3.5
Template
unconfigured versions of a report that a new report can be built from. p3.7
Reports
save configuration of a template p3.7
Access Reporting Workbench explore add'l reports avail
Epic>Reports>My Reports>Library tab (on left column) The 3 dots=Options then click 'about' (mouse needs to be in the WQ box to see the 3 dots)Information Dialog box after clicking 'about' This component shows the ten follow-up workqueues that contain the highest dollar amounts. Click the workqueue name to open each workqueue. Click the values in the Invoice count, Amount, and Avg WQ age columns to open a trending graph for each value. p3.7
How can you access HELP TEXT about a component
Options Menu>About (Options Menu=3 little dots ...) p3.9
How can you run a report from a Report listing component?
Click on the report p3.9
True/False: Components can contain links to jump you to other Hyperspace activities.
True. p3.9
How do you access TRENDING GRAPHS in table components
Click on the number you would like to see trending data for in the component p3.9
Follow Up Operational Workbook
Has Metric and Reports section for monitoring.
Follow Up WQ Payor Lag Time Report
Epic>Reports>PB Reports>F/Up WQ Payor Lag Time ReportSummary:Use to compare the lag time of different payorsLag starts when the claim run is accepted or activity is performed that has been indicated to start the lag time (defined in the report settings)Lag time stops when a payment is posted, a denial is posted, amount is written off or NRP'd.Places f/up records into aging buckets based on how long it took the payor to respond to claims.Configuration & Results: the systems looks at each f/up record that had a payer response, for those w/out a response the f/up is not included. A single f/up record can have responses from multiple payers and show multiple lag periods. A f/up record is created for each transaction on a claim so a single claim can result in multiple entries in the report.The info provided on this report is out of the org's control because it depends on how long it takes for payer to get back to us. p3.10
WQ History Report
Useful for both high level info & detailed analysis.Drilldown functionality which displays metrics for a single WQ.Report Sections: Summary-includes total $ amt & record counts for the tabs in all the WQs in the report.Details-includes $ amt & record amts for each WQUse the Change column to gauge the overall activity in a WQ or type of WQ.Explore why the volume in some WQs changed over a certain period while volume remained the same in other WQs.Identify WQs with the most records & dollar amts in the Removed columnReconsider human resource allocation.The most common instance of this report is always visible from the WQ tab-the 7 day history. p3.12
User Activity Summary Report
Epic>Reports>PB Reports>User Activity Summary Report>RunDesigned to monitor user productivity across workflow so they can see complete info about a user who works both f/up and retro review WQsCan assign a point value to more complex tasks so users who perform more complex tasks get a higher productivity than simple tasks.Provides a daily score for each user with details about all the activities performed that day. Report exportable for analysis. p3.13
User Activity Time Log Report
Epic>Reports>PB Reports>User Activity Time Log Report>RunProvides a chronological view of a user's activities in the system over the course of a single day.Pinpoint irregularities or difficulties that impacted user's productivity.Suprv. review the work of new staff membersSuprv typically access this from a link in the User Activity Summary report but can also be run separately p3.13Time log activities show a summary section about all activities performed as well as a detail section with links to different hyperspace activities. p3.14
Billing Scorecards
Billing productivity scorecards show suprv data about what their users accomplish in a given timeframe. Shows a list of f/up staff along with how many key activities they've performed. Click the user's name & pick which level of detail to review: the individual scorecard or detailed time log activity.Grouped by key metrics & add'l metrics. p3.14
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What is the purpose of creating a payment posting batch?
A batch is a holding tank in the system that retains payment information while you post multiple payments. It also stores the control amt which aids in confirming the accuracy of the payments entered.
How do you look up an invoice number in PB Insurance Payment Posting if it doesn't appear on the EOB?
Use .p to look it up by patient or .a to look it up by guarantor account.
If a payer sends payment for an invoice or patient that does not exist in the system, what should you do to still record the payment in Resolute?
If you can't find the invoice or the patient, post the payment undistributed to a clearing account. (If you can't find the invoice, but can find the patient in the system, consider posting by Patient and DOS or account and DOS.
True of False. An allowed amount will always appear automatically on an insurance posting line.
False. One will only appear if that charge code is included in a reimbursement contract.
What should you do when the system allowed amt is different from the allowed amt on the EOB?
Override the system amt by entering the amt from the EOB in the Allowed Field.
What step in payment posting sends payments to guarantor accts?
Processing the batch.
What should you enter in the Post field when posting a PB Denial?
Claim Denied
True of False. A batch must balance before you can process it.
Yes, a batch must balance before you can process it.
Payment Posting Batch
A holding tank for while posting multiple payments.
Control Amount
Is the total amount of money to be posted in the batch.
Explanation of Benefits (EOB)
Information from the payer explaining what is paid and how to match it to the charges. EOBs may also be referred to as remittance advice.
Invoice Number
Box 26 on the CMS 1500 claim form = the Epic invoice number in the system.
Patient's account number (from a CMS claim form)
...
Patient's account number (from a CMS claim form)
The Epic invoice number is placed in box 26 (Patien't acct number) on the CMS claim form.
Allowed amount
The maximum reimbursement amt (payer and guarantor)
Not allowed amount
Difference between billed and allowed amt (contractual adjustment)
Reimbursement contract
The system pulls in the allowed amount during ins payment posting from reimbursement contracts.
EOB codes
Specific actions tied to the EOB codes. The actions can transfer responsibility of a charge to the NRP, post write-offs, flag specific payments for further investigation.
Next Responsible Party (NRP)
moves the remaining balance to the next party in the visit filing order
Action
System deals with liability of any remaining balances after EOB/RA is posted. Examples of actions: NRP moves the remaining balance to the next responsible parry. NAA (not allowed amt) writes off the amt over the allowed amt. part
Next Responsible Party (NRP)
moves the remaining balance to the next party in the visit filing order
Denial
It's critical that you enter Claim Denied in the Post field rather than entering zero in the Paid field. Changing this field send the claim to an insurance follow up WQ so someone can research the denial.
Can you post HB & PB in the same workspace and in the same batch if needed.
Yes, you can post HB & PB in the same workspace and in the same batch if needed.
What are the 2 sources of info needed to post payments manually
The EOBIs in Epic's payment posting module (appropriate invoice within Epic)
Payment Posting: Finding the right charges
Post using invoice number from EOBLook up invoice using shortcutsPost without an invoice numberpost to clearing account
.P
you can search for the invoice using the patient name and the service date range of the charges. This creates a more manageable list of invoices allowing the user to be accurate.
In the invoice field enter .P
you can search for the invoice using the patient name and the service date range of the charges. This creates a more manageable list of invoices allowing the user to be accurate.
New Detail
means Epic invoice used to post a new invoice from the same check
New check
Use this when you are ready to post from another payer check.
NAA (not allowed adjustment)
writes off the amount over the allowed amt
What is an ICN
An ICN is a unique number that the payer assigns to track their payment activity for a specific claim. We include this number with the denial so our ins f/up team can follow up with the payor regarding the issue.
What if you forgot to post an entire check?
Click new check
What if you forgot to post one invoice?
Click the check level pencil and select 'add PB Detail (invoice)
What if you posted incorrect dollar amts to an invoice?
Click the detail-level pencil and select edit detail
What if you applied a payment to the wrong invoice?
click the detail level pencil and select Delete Detail
how can payments be posted
payments can be posted both manually and through electronic remittance
the total of all check In a batch is
paid control amount
the total of each individual check
check control amount
invoice number
the invoice number is associated with the liability bucket to which you will post the payment
billed
the amount that was sent out on the claim
allowed and not allowed
allowed and not allowed determined by contract with the payers
deductible, co insurance , copay
deductible, co insurance , copay payments are the patients responsibility based on their benefit plan
non covered
amount not covered by the insurance company
denied amount
amount denied by payer populated automatically based on reason codes entered from remittance advice and associated action in reason code table
ins w/o
insurance write off amount. can be automatically calculated by the system using standard remittance codes entered during payment posting
paid amount
amount paid based on insurance company to be allocated to the invoice
other adjusted
the amount of other adjustments for the invoice. you must include an adjustment code to complete the adjustment.
Balance Sheet
Balance Sheet
action
the system supplies certain defaults actions that will be taken on the amount not covered by the insurance. actions include not allowed, adjustments, next responsible party, claim denied, transfer to self pay , remark, and allowance discrepancy
P/A code check box.
To also carry over the payment type
from where does the system pull in the allowed amount during insurance payment posting
insurance contracts
Claim denials that should be reviewed are caught by the system and placed in which type of WQ?
Follow up
If a claim must be printed to paper right now, the (demand claim or resubmit claim) activity should be used.
Demand claim
If, in order to resubmit the claim successfully, information on the charge needs to be updated which function should be used?
Correct Function
If a denial cannot be corrected, say ins termed, how can you move the balance to the next payer or guarantor?
NRP (next responsible party)
resubmit claim
sends the claim back to the claims queue so it is available to go out the next time the system processes claims.
charge correct
Voids a charge and allows the user to edit it before reposting. Correct a charge after it has been posted. charge that needs to be updated, use charge correct function
demand claim
if you need to print a claim right now
The effect of charge correct
Voids a charge and allows the user to edit it before reposting. Correct a charge after it has been posted.
When a demand claims should be used.
When a claim needs to be printed right nowCreates a claim in real-timeOnly creates paper claimsbypasses error checking in the CDFremoves charges from claims queue
Follow Up WQ
A list of outstanding claims that need follow upA list of claims that have been denied
what can be viewed From Inquiry button,
you can view all the transactions on an account sorted by visits, invoices, and credits. Depending on how you access Inquiry, it might already be filtered to help you find the information you need.
after preforming the NRP activity, what do you need to do to remove the claim from your workque
Nothing if the claim falls off IF the claim dose not fall off automatically then REFRESH
Demand claims
real time ,paper claim only , skips error checks in CDF, removes charges from claims queue
Statements in a Single Billing Office are generated per HAR with a self-pay balance
False No, stmts are generated for guarantor accounts (a listing of all HARs with a self-pay balance)
Can the system be configured to automatically create statement runs?
True Yes, stmts can be automatically created.
Stmts in a single billing office can contain both professional charges and hospital charges.
True Yes, SBO stmts can contain both HB & PB charges.
What is a purpose of the Enterprise Statement Run Report?
Reconciliation tool to compare what Epic indicates was generated to what was actually generated.Reconciliation tool to compare what was sent to a print vendor and what the print vendor sends back in the receipt.Record of which guarantor accounts got a stmt and which guarantor accounts did not get a stmt, even though they qualified for the stmt run.
What happens when a statement run is accepted?
The guarantor accounts get stamped with a statement sent date.Each HAR included in those stmts has its self-pay follow up level incrementedThe stmt run is removed from Epic.
How do you Reprint stmts
...
How do you Reprint stmts
.Reprint Stmts or Detail Bills from an accepted stmt run using the Reprint SmartText Stmt/DB utility. This utily is particulary helpful when stmt files are corrupted or overridden on the web blob server. You can reprint individual stmts or a subset of stmts.go to Resolute HB Text>Administrator Menu>Utilities>Re-Print SmartText Stmt/DB.
SBO
Single Billing Office means combining self-pay processes. Goal of SBO is one combined stmt
Benefits of SBO
Guarantors receive 1 bill (per guarantor acct) contains both PB & HB balances.Staff can post a single guarantor payment toward both PB & HB self=pay balances. Efficient Pmt posting.Staff use same features & workflows when follow up on Self-pay balancessave on processing and postage costsGuarantor accts have one payment plan with one monthly amt and one due date
HARs (hospital acct records)
Store visit-specific information such as charges and the coverages valid for a particular visit.HARs are used as containers for charges in both HB & PB.
HB HAR (on the test)
HB HARs are created manually. Examples: pre-admission, admission & check-in for a visit in a hospital OP department.
PB HAR (on the test)
PN HARs are created automatically by the system when the filing order is confirmed, typically during checkin or admission.
PB HAR (on the test)
PB HARs are created automatically by the system when the filing order is confirmed, typically during checkin or admission.
once a statement run has been accepted where can you view the statement image
account maintenance
Detail Bill
An itemized list of charges for an HB HAR.
PB HAR
Professional transactions (Prof Inquiry)
HB HAR
Hospital transactions
Billing Indicator
HAR-levelcustom statusFlags a HARfor follow-upor as an FYI
Stop Bill
HAR-levelFlags a HAR for follow-up andhalts a HAR from progressingthrough the revenue cycle
Guarantor Account Status
Guarantor-level custom statusFlags a guarantor account forfollow-up or as an FYI
Prof Inquiry
View pro fee transactions and additional chargers on a PB HAR in the Prof Inquiry activity within Hosp Acct Maint.Each line listed in the Charges section of Prof Inquiry represents a pro fee charge on the PB HAR.
Viewing Guarantor Information
In Hosp Acct Maint, the Enterprise Summary activity displays a summary of info pertaining to the guarantor account including:Guarantor demographicsBalancesHARs attached to the guarantor accountA history of payments, adjustments and stmts
Which activity tab displays an overall picture of the guarantor account, including balances, payments and adjustments?
Guarantor Summary
What information is visible in Hosp tx inquiry?
Hospital chargeshospital paymentshospital adjustments
When you use an account activity, multiple actions might be performed on a HAR at once.
True
Account Activities can be performed on multiple HARs at the same time.
True
Which of the following methods of flagging something for further review is HAR based (meaning it affects only the HAR it's added to)?
Billing IndicatorStop BIll
A stop bill will stop all HARs for a given guarantor from appearing on a statement.
False. Stop bills are HAR based.
Demanding a Detail Bill will increase the self pay follow up level for a HAR
False
Detail Bills can only be sent for HB HARs.
False.
There are 2 versions of Account Maintenance
Guarantor Account MaintenanceHospital Account Maintenance
Guarantor Account Maintenance
useful for users who perform PB centric workflows and rarely if ever need to access HB Information
Hospital Account Maintenance
useful for users who perform SBO workflows or for HB centric workflows. It's recommended for customer service staff.Allows HB and PB self-pay follow up integration from one workspace.Allows users to perform PB & HB actions on transactions or HARs and view on HAR at a time.
How do you open all HARs linked to a guarantor account?
Enter patient's name in the Guarantor field.
Enterprise Guarantor Summary (Benefit)
easy access to all of a guarantor's HARs including the ability to select one or more HARs on which you can perform account activities.
Reviewing Pro Fee Transactions on a PB HAR
In the Prof Inquiry activity within Hosp Acct Maint
How are Hospital Charges grouped?
By Revenue Code (4 digit procedure groupers used on hospital claims (UB04)
Detail Pane
View add'l charge info by highlighting a transaction and viewing the detail pane.
Hospital Account Select Window
can select by:AccountPatientGuarantorInvoice/ReceiptTx ref/Auth #
Viewing Guarantor Information
IN Hosp Acct Maint, the Enterprise Guarantor Summary activity displays a summary of info pertaining to the Guarantor acct includingGuarantor demographicsBalancesHARs attached to the guarantor acctA history of payments, adjustments and stmtsBenefit of Enterprise Guarantor Summary is easy access to all of a guarantor's HARs including the ability to select one or more HARs on which you can perform acct activities.
Hosp Tx Inquiry
You can see all charges, payments and adjustments posted to an HB HAR in the Hosp Tx Inquiry activity in Hosp Acct Maint
Detail Bills are:
Itemized charge listing for a single HARAre not a request for paymentDo not increment the self pay follow up level of the HAR
Queue Detail Bill
Send the detail bill to a print queue to be build printed (often overnight)
which account maintenance module allows HB and PB self pay follow up integration from one workspace
hospital account maintenance
Which HB HAR statuses allow you to change the primary?
OpenDNB
When adding a secondary coverage after a primary has already paid, you should undo billing to bring the HAR back to DNB status.
False. Undo billing should NOT be performed when adding a non-primary coverage. Instead it should be added to the guarantor account and manually associated with any affected HARs.
If a coverage is not effective for any past encounters but you want to record it for future use, which option in Registration should you use to add the coverage?
Add coverage link
Retroadjudication
Can automatically add the new coverage to the PB HAR's filing order. If manual review is needed, the HAR can be routed to a WQ for evaluation.PB Process to add new coverage retro finding existing HARs that need a change.
Coverage Manager
Searching for HB HARs instead of PB HARs. is a Hospital Billing process. It can automatically update the coverage at the HAR level. Coverage Manager does not perform coverage changes on Billed HB HARs in the Foundation System.
Filing Order
System determines what order coverage(s) are billed.
Which records are impacted when adding a coverage using the Add Coverage link in Registration
Use to add at the guarantor level for future transactions.
Adding Ins Coverage's in Registration
Coverage can be added in 2 places.Coverage InfoAdd coverage
Coverage Info Link
Use to add coverage at the HB HAR level. The coverage is linked to the HB HAR, guarantor account and patient records.
Add Coverage Link
Use to add coverage at the guarantor account level for future use. The coverage is linked to the guarantor account and patient records.
What level to add if a new coverage doesn't impact existing encounters.
Add to the guarantor account level
At which level should you add a coverage record for future use?
Add coverage from the Guarantor section of the interactive face sheet
When coverage is added at the guarantor level in Registration, which records are impacted?
Patient & Guarantor so future services affected
3 steps manually adding Primary Coverage to an existing HB HAR
Undo billingAdd the coverage to the HARInitiate billing
Undo Billing
You can only change the primary coverage on a HAR when its status is Open or DNB. If the status is Billed or Closed you must first undo billing before you can change the filing order.
To add Secondary Coverage to an HB HAR or any coverage to a PB HAR following these steps.
Undo the transfer of money into the self pay bucket (HB only)-Undo Transfer to Self-Pay/NRPAdd the coverage to the guarantor acctAssociate the coverage with the HARs (HB & PB)Move the remaining balance to the correct payor (if 2ndary payer)DO NOT undo all billing when adding a secondary coverage.
Coverage Manager Logic
Logic in the background can automatically add a stop bill based on a coverage change. (HB HARS only)
A stop Bill
prevents the HAR from moving forward in the revenue cycle until it is removed. A stop bill can also drive the HAR to a WQ for review.
where can you see, access, or document billing changes made by other users or the system.
Account notes
if there has been no response from a payer there are three steps to add a primary coverage manually to a HAR
1.undo billing2.add coverage to the HAR3. initiate billing
True/False. Clarity reports run off of real time data.
False
You configure what info user will see in a report in which tab of the Report Settings Window?
Display tab
True/False. A user with the appropriate security can create a new application report query.
True
Application reports
Can be embedded into a workflow, found in a menu of application-specific reports, OR selected from the reports menu under Epic button>Reports. Standard canned Reports; runs in hyperspace, typically uses real time data, security controlled. p3.6
Reporting Workbench Report
A configurable report built from a template that pulls real-time or nearly real-time data from your system. p4.15 a standardized operational reporting tool that can provide a similar look and feel to reports across applications. Access from a few places in hyperspace; from my reports tab or Library tab. p3.7
Reporting workbench template
All reporting workbook workbench reports are built from templates. A report template is a flexible foundation for building reports. To build a report from a template you select from the available criteria and specify which values you want to search. p3.9 Defines what data a particular report searches and what data it returns
My Reports
My reports activity has 2 tabs: My Reports and Library. on my reports tab can access your favorite reports & view report results. End users can run My Reports. Allows you to quickly access your most important and frequently run reports. Click the star icon next to a report's name in the Library to add it to your Favorites. Can organize into folders for easy find. p3.7
Report Library
On the Library Tab you can search for any report or template that you have access to. The library can hold other documents such as tip sheets. To find a new report to add to your favorites, first find the report in the Library by entering a key word. If you can't find it you may not have access to the report. p3.8
Private Report
Depending on your security you may be able to save the report as public or private. You and the Administrator have access to a Private Report. p3.12
Public Report
Depending on your security you may be able to save the report as public or private. Everyone who can access the base report has access to a Public Report. p3.12
Report Settings
Report settings window controls what the report will do. Each tab controls a different aspect of the report. p 3.10
Access application and Reporting Workbench reports
Access from a few places in hyperspace; from my reports tab or Library tab. p3.7
Save a report
When you save a report you will be prompted for an expiration date. If you have saved results about ready to expire, can save for longer time or delete them (notified by My Reports) p3.8
Add a report to your Favorites
Click the star icon next to a report's name in the Library to add it to your Favorites. After you add a report to your Favorites you have the following options: Run the reportOpen & edit the report settings window for the reportRemove the report from you favoritesYou can organize your Favorite reports into folders to make your report easier to find later. p 3.7
View report results
After clicking Run, the report results will appear. Several options to alter your view of the results such as filtering and sorting. If you forget what search criteria you specified you can review the Search Summary by selecting Options>Show Search Summary. p3.13
Access records from report results
The DETAILS TAB lists individual results that matched on your report criteria. You can act on a specific report result by selecting that row and clicking any of the buttons on your activity tool bar. p3.13
Choose what info to display
SELECTED COLUMNS are ones that you will see in the Results Viewer after you run the report and Columns you CAN use in your report see graph p3.11-12Columns you WILL use in your AVAILABLE COLUMNS are defined at the template level and should meet most of you common needs. DETAILS TAB lists individual result that match on your report criteria. p3.13
Criteria Tab
A report's search is controlled by the Criteria Tab. Each criterion is one parameter that the report will use to determine what results should be returned. The Info Button displays more info about the criterion you have highlighted. p3.10
Display Tab
Allows you to control what info displays about the results of your search. see graph p3.11-12
Details Tab & Summary Tab
The DETAILS TAB lists individual results that matched on your report criteria. You can act on a specific report result by selecting that row and clicking any of the buttons on your activity tool bar. The SUMMARY TAB appears next to the Details tab if you defined a summary view, such as a bar graph or table, within the report settings. Creates charts, bar graphs, tables. p3.13
General Tabs
Save our own copy; GIVE YOUR REPORT A NAME P 3.17
Different ways to report on info in Epic. In reporting content design sessions you will:
review key metricsExamine Epic's recommended essential report for go-livediscuss any changes or additions that you think are neededidentify additional needs not met by these Foundation System reports and metricsIdentify operational owners for each report who an verify that the report meets the business need p3.3
Key performance indicators (KPIs)
A key metric identified by Epic community members as important for measuring their orgs financial health and quality of care over time. P3.4
Report on and track KPIs
before and after go-live. during phase 2 of install you will review and validate KPIs and other metrics P3.4
KPI examples for Access and Rev Cycle
Inpatient daystransfer ratesclaim acceptance ratebad debtAR daysp3.4
Operational Reports
data sets used as part of a workflow, built right into the workflow so users don't think of them as reports.Reports when you want to follow the performance of users in the short term. Operational reports share the following characteristics:time-sensitiverelatively smalleasily accessibleactionable Come in 2 varieties:Application reports and Reporting Workbench reports p3.5
Analytical Reports
Trending reports that help you determine the overall health of your org and make long term decisionsAnalytical reports share the following characteristics:ComprehensiveSummarizedStandardizedp3.5-3.6
Operational
Application ReportsReporting Workbench ReportsSlicerDicerimportant diagram p3.5
Analytical
Clarity (database)Caboodle (other data, claims data, legacy dataimportant diagram p3.5
Clarity Reports
Specifically designed to meet the reporting requirements of large healthcare orgs. the process extracts data from your production system to an independent, dedicated reporting repository. Running reports doesn't effect production response time. p3.6
Valid Until Time
When report is finished, status column displays 'Ready to view' with an expiration time. Unable to re-run the report until the Valid until time has been reached. After that time the data is considered obsolete or expired and will fall off the list. The exception-it will let you rerun if report configuration made. p3.8
Saved Results
After running a report you have an option to save the results. When you save the results, they appear in the saved Results section for later access. You will be prompted to enter an expiration date. p3.8
Templates versus Reports
All reporting workbench reports are built from templates. A report template is a flexible foundation for building reports. To build a report from a template you select from the available criteria and specify which values you want to search. p3.9
Report Repository
Search here or Library for reports you're interested in. If you can't find the report you need in the Library it could be because you don't have the security to access it. search the Report Repository on the UserWeb to see all of the reports available to Epic users. p3.9
Radar Dashboards
Are the home for most user's reporting needs. Many Epic users see a Radar dashboard immediately upon logging into Epic on their home workspace. p 3.9
Configuring Application Reports
Configuring application reports are very SIMPLE to configure but with less flexibility than Reporting Workbench Reports. The criteria are setup to guide users to make the query more specific. p3.9
Configuring Reporting Workbench Reports
NOT AS EASY to configure as application report configuration but you can create your own report from a template. p3.9
The WQ Monitoring Report Template
can be used to configure reports that generate a list of WQs with characteristics such as:WQ typeowning areastarting amtending amtprimary user supervisoraverage WQ daysservice areathis is not an exhaustive list but some of the common creitera a manager may want to search by. P3.13
Owning Areas
Chose one area or multiple areas that make sense for your role from the list in the owning area field.See chart on p 3.16
Different ways to use the criteria to specify which WQ you want included in your results such as
Primary UserReport GroupersSupervisorSpecified WQsWQ Typep 3.15
You can use the populations you create in SlicerDicer to demonstrate meaningful use.
False
dashboard
an activity that pulls data from multiple sources into one centralized location for a group of end users
component
units of content that composes a dashboard
redirector/dashboard
groups other dashboards together (makes it easier for commonly used dashboards)
play/ run reports
allow you to see data in a work que if not present when you first open your dashboard/WQ
what does the about button tell you (located in options)
help text and tells you WQ that need attention for + 14 days
what does the WQ by primary user tell you
1. accts that have nit been worked in 14 + days 2. user name/ assigned to the acct3. dollar amount