Term
| Are patients automatically given the same coverage when they become eligible for Medicare? |
|
Definition
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|
Term
| How many types of private supplemental policies for Medicare are there? |
|
Definition
Two.
service benefits
indemnity benefits |
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Term
| Can a physician bill a patient for any amount that is not covered or paid by Medicare if they accept assignment? |
|
Definition
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|
Term
| What are some reasons that a Medicaid claim can be rejected? |
|
Definition
incorrect coding
no signature
not itemized
no diagnosis |
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Term
| Does a physician have to accept assignment if the patient has Medi-Medi coverage? |
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Definition
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Term
What is Medicare part 'B' for and what is Medicare
part 'A' for? |
|
Definition
part A-inpatient
part B-outpatient |
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Term
|
Definition
| Centers for Medicare/Medicaid Services |
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|
Term
| If a physician does not participate with pars want is doing an elective surgery that costs more than $500 or more what needs to be done? |
|
Definition
| prepare financial statement showing probable amount they will pay out of pocket. |
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|
Term
What Medicaid program provides physical examinations and immunizations for children under 21?
|
|
Definition
|
|
Term
| What Medicaid program covers the costs of prenatal visits, delivery, and postpartum care for women? |
|
Definition
|
|
Term
| What does the letter 'A' refer to on a Medicare card? |
|
Definition
|
|
Term
| Does Medicaid have eligibility classifications and if so, what are they? |
|
Definition
|
|
Term
| Do all the states have the same Medicaid program, eligibility, requirements and benefits? |
|
Definition
|
|
Term
| What are some things that a physician may be charged with in Medicare and Medicaid fraud? |
|
Definition
bill more than once for same service
billing for services not rendered
billing for wrong complexity
fragmenting billed services |
|
|
Term
| What should you do in the event that you are unable to obtain a patients signature on a Medicare claim form? |
|
Definition
| Obtain a lifetime authorization signature |
|
|
Term
| What is covered my Medicare part A? |
|
Definition
hospice
in home care
inpatient care |
|
|
Term
| How is Medicare part B funded? |
|
Definition
|
|
Term
| Are Medicaid patients issued certificates stating that they have coverage? |
|
Definition
|
|
Term
| What type of services would require prior approval for Medicaid? |
|
Definition
durable medical equipment
home health care
hearing aides
inpatient hospital service |
|
|
Term
|
Definition
| pain relief, symptom management for terminally ill patients |
|
|
Term
| Does Medicare cover inpatient up to 90 days and skilled nursing up to 100 days? |
|
Definition
|
|
Term
| What are prospective payment system what are payments based on? |
|
Definition
| UCR charges (usual, customary, reasonable) |
|
|
Term
| When a patient has Medi-Medi coverage, which one is primary? |
|
Definition
|
|
Term
|
Definition
peer review organization
group of physicians that act as mediator between healthcare provider and Medicare |
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Term
|
Definition
|
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Term
|
Definition
| condition caused by disease |
|
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Term
|
Definition
| abnormal disease or disorder of the stomach |
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
|
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Term
|
Definition
|
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Term
|
Definition
|
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Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
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Term
|
Definition
|
|
Term
|
Definition
|
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Term
|
Definition
|
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Term
|
Definition
|
|
Term
|
Definition
|
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Term
|
Definition
|
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Term
|
Definition
| abnormal enlargement of the liver |
|
|
Term
|
Definition
| abnormal softening of the bones |
|
|
Term
|
Definition
| painful, difficult, abnormal |
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|
Term
|
Definition
|
|
Term
|
Definition
| Medicare supplemental insurance |
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