What is an encounter-level rule in EPIC Resolute?

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Multiple Choice

What is an encounter-level rule in EPIC Resolute?

An encounter-level rule applies to every charge tied to a single patient encounter, ensuring billing decisions are applied uniformly across that encounter. This means pricing, payer application, edits, and other billing logic are consistent for all services and items billed during that visit, rather than being handled item by item. This consistency helps prevent discrepancies where one charge is treated differently from another within the same encounter. It’s different from rules about posting payments, which govern how payments are recorded after adjudication, or scheduling, which deals with when visits occur. It also isn’t about automatically negotiating payer contracts, which is a separate area of contract management.

An encounter-level rule applies to every charge tied to a single patient encounter, ensuring billing decisions are applied uniformly across that encounter. This means pricing, payer application, edits, and other billing logic are consistent for all services and items billed during that visit, rather than being handled item by item. This consistency helps prevent discrepancies where one charge is treated differently from another within the same encounter.

It’s different from rules about posting payments, which govern how payments are recorded after adjudication, or scheduling, which deals with when visits occur. It also isn’t about automatically negotiating payer contracts, which is a separate area of contract management.

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