Jump to a section: Epic Applications · Revenue Cycle & Billing · Master Data & Identifiers · Program & Governance
Epic Applications
Resolute Hospital Billing (HB)
Epic's module for institutional (hospital-side) claims: charge review, claim edits, billing, and follow-up for facility encounters.
Resolute Professional Billing (PB)
Epic's module for professional (physician-side) billing: charge capture, coding edits, and claims for provider services.
Prelude
Epic's registration module. Governs patient identity, demographics, and the master patient index that every downstream billing record depends on.
Cadence
Epic's scheduling module. Appointment and resource scheduling feed directly into registration, eligibility, and downstream charge capture.
Grand Central
Epic's ADT (admission, discharge, transfer) and patient-tracking module, the backbone of inpatient movement and bed management.
HIM (Health Information Management)
The Epic module and operational function governing medical records, coding, chart completion, and release of information.
Tapestry
Epic's payer/managed-care module, used for health plan administration, claims adjudication, and provider network management on the payer side.
Community Connect
Epic's model for extending a health system's Epic instance to affiliated or community-based practices, unifying the EHR across a broader network under one build.
Reporting Workbench
Epic's self-service reporting tool. A common source of post-go-live optimization work when reports don't yet answer the questions leadership is asking.
Cogito
Epic's enterprise data warehouse and analytics platform, used for cross-application reporting beyond what Reporting Workbench alone supports.
Epic Refuel
Epic's formal program for resetting and stabilizing an underperforming build, used when an existing implementation needs structured remediation rather than a full rebuild.
Revenue Cycle & Billing
Charge capture
The process of recording billable services and translating clinical activity into charges. A common source of revenue leakage when charges are missed, delayed, or misrouted.
Denial management
The operational discipline of identifying, categorizing, and resolving payer claim denials, ideally by fixing the upstream cause, not just resubmitting the claim.
Eligibility verification
Confirming a patient's insurance coverage and benefits before or at the point of service, typically via an automated 270/271 transaction.
Clearinghouse
A third-party intermediary that routes electronic claims, eligibility checks, and remittance between providers and payers. A single point of failure if there's no tested backup pathway.
EDI (Electronic Data Interchange)
The standardized electronic transaction formats (eligibility, claims, remittance) that HIPAA-covered entities use to exchange revenue cycle data.
A/R days (Accounts Receivable days)
A core revenue cycle metric measuring the average time it takes to collect payment after a service is billed. A key indicator of both billing accuracy and collections efficiency.
HETS 270/271
CMS's HIPAA Eligibility Transaction System, the backbone of real-time Medicare eligibility verification.
Master Data & Identifiers
Master data
The authoritative, governed reference data (facility, provider, payer, patient) that every downstream system and report depends on for accuracy.
NPI (National Provider Identifier)
The standard identifier used across HIPAA administrative and financial transactions to uniquely identify a healthcare provider.
Taxonomy code
A code classifying a provider's specialty, used in NPI applications and Medicare enrollment. A provider may hold several, with one marked primary.
Place of service (POS) code
A CMS code indicating where a service was rendered, directly affecting how a claim is priced and adjudicated.
ICD-10
The current diagnosis coding standard used on claims; mismatches against current code sets are a common, often-overlooked source of denials.
Program & Governance
RAID log
A governance tool tracking Risks, Assumptions, Issues, and Decisions across a program; core to the disciplined executive reporting a recovery or PMO engagement relies on.
PMO (Program/Project Management Office)
The governance function responsible for decision rights, reporting cadence, and cross-workstream coordination on a program.
C2C (Corp-to-Corp)
A subcontracting arrangement where a consultant works under a prime vendor's contract rather than directly with the end client.
Go-live / cutover
The point at which a system transitions from build/testing into live production use, the moment all prior readiness work gets tested against reality.
Definitions are provided for general reference and reflect common industry usage. They are not certification claims or official Epic Systems Corporation documentation. See individual service pages for how The Pendulum Group applies these concepts in delivery.