11830715
Beschreibung
Quiz von letty reyes, aktualisiert more than 1 year ago
|
Erstellt von letty reyes
vor fast 7 Jahre
|
|
Frage 1
Frage
CMS IS SHORT FOR
Antworten
-
CENTERS FOR MEDICARE AND MEDICAID SERVICES
-
CENTERS FOR MEDICAID AND MEDICARE SERVICES
-
SERVICES FOR MEDI-MEDI SERVICES
-
CENTERS FOR MEDICARE SERVICES
Frage 2
Frage
MEDICAID IS ADMINISTERED BY
Antworten
-
CMS
-
TMHP
-
MCS
-
CNS
Frage 3
Frage
MEDICARE PART A IS FOR
Antworten
-
PROVIDER SERVICES
-
OUTPATIENT SERVICES
-
HOSPITAL SERVICDES
-
DME SERVICES
Frage 4
Frage
MEDICARE IS A ____________ PROGRAM
Antworten
-
STATE
-
LOCAL
-
FEDERAL
-
STATE/FEDERAL
Frage 5
Frage
OVER THE PERIOD OF _________ YEARS, DEPARTMENT OF HEALTH AND HUMAN SERVICES WILL DISTRIBUTE REPLACEMENT CARDS TO MEDICARE BENEFICIARIES
Antworten
-
6-4
-
7-8
-
4-8
-
3-4
Frage 6
Frage
IF A CARD SHOWS HMO, THEN THE PATIENT SIGNED UP AND IS COVERED BY A ____
Antworten
-
PRIVATE INSURANCE
-
PREFERRED PROVIDER ORGANIZATION
-
MANAGED CARE PLAN
-
TRADITIONAL FEE FOR SERVICE
Frage 7
Frage
THE LETTER C IDENTIFIES THAT THE INSURED IS THE
Antworten
-
WIDOW
-
SPOUSE
-
BENEFICIARY
-
DISABLED CHILD
Frage 8
Frage
A RAILROAD MEDICARE BENEFICIARY IDENTIFICATION NUMBER BEGINS WITH A
Antworten
-
NUMBER OR NUMBERS
-
LETTER OR LETTERS
-
POUND SIGN
-
SPECIAL CHARACTER
Frage 9
Frage
UNDER MEDICARE PART____, IF AN INDIVIDUAL RECEIVING SOCIAL SECURITY OR RAILROAD RETIREMENT BENEFITS DID NOT SIGN UP FOR MEDICARE AT THE TIME OF ELIGIBILITY, THEN THE INDIVIDUAL IS ELIGIBLE TO ENROLL IN MEDICARE 3 MONTHS BEFORE HIS OR HER BIRTHDAY
Antworten
-
A
-
B
-
C
-
D
Frage 10
Frage
ESRD IS SHORT FOR
Antworten
-
EVEN STAGE RENAL DISORDERS
-
END STATE RENAL DISEASE
-
END SPECIAL RENAL DISEASE
-
END STATES RENAL DISEASES
Frage 11
Frage
MEDICARE PART B HAS AN ANNUAL ______ THAT CONTINUES TO INCREASE BY THE SOCIAL SECURITY ADMINISTRATION
Antworten
-
COPAYMENT
-
PREAUTHORIZATION
-
CO-INSURANCE
-
PREMIUM
Frage 12
Frage
MEDICARE PART ___ IS COMMONLY REFERRED AS MEDICARE ADVANTAGE PLAN
Antworten
-
A
-
B
-
C
-
D
Frage 13
Frage
MEDICARE PART D IS FOR PRESCRIPTION COVERAGE AND MOST OF THE MEDICARE DRUG PLANS HAVE COVERAGE GAP KNOWN AS
Antworten
-
GAP
-
LAPSE IN COVERAGE
-
DONUT HOLE
-
FORMELY
Frage 14
Frage
MEDICAL INSURANCE FOR RAILROAD RETIREMENT BENEFITS PREMIUMS ARE AUTOMATICALLY DEDUCTED FROM
Antworten
-
EMPLOYER PAYCHECKS
-
MONTHLY CHECKS RECEIVED OF PEOPLE WHO RECEIVE RAILROAD RETIREMENT
-
FROM THE BENEFICIARY'S CHECKING ACCOUNT
-
THE BENEFICIARY'S SAVINGS ACCOUNT
Frage 15
Frage
MEDICARE SECONDARY PAYER (MSP) DEFINES MEDICARE TO BE
Antworten
-
PRIMARY PAYER
-
SECONDARY PAYER
-
PAYER OF LAST RESORT
-
TERTIARY PAYER
Frage 16
Frage
A ________ IS A LIST OF THE DRUGS THAT A PLAN COVERS
Antworten
-
FORMULARY
-
LIST OF APPROVED DRUGS
-
MEDICARE PRESCRIPTIONS DRUG COVERAGE
-
TIER ONE LIST
Frage 17
Frage
MEDICARE MAKES PAYMENTS DIRECTLY TO THE _______ ON A MONTHLY BASIS FOR MEDICARE ENROLLEES WHO USE THE HMO OPTION
Antworten
-
PATIENT
-
PROVIDER
-
HMO
-
PPO
Frage 18
Frage
MEDICARE ADVANTAGE PLANS (HMO'S OR PPO'S) HAVE AN OPEN ENROLLMENT PERIOD IN THE ________ OF EACH YEAR
Antworten
-
SPRING
-
FALL
-
SUMMER
-
WINTER
Frage 19
Frage
IF A MEDICARE PATIENT HAS SWITCHED OVER TO A MANAGED CARE PLAN AND WISHES TO DISENROLL, THE PATIENT MUST
Antworten
-
CALL THE 800 NUMBER ON THEIR MEDICARE CARD
-
CALL THEIR MANAGED CARE PLAN
-
NOTIFY THEIR MANAGED CARE PLAN IN WRITING OF DISENROLLING
-
NOTIFY MEDICARE IN WRITING OF DISENROLLMENT
Frage 20
Frage
THE FEDERAL FALSE CLAIMS AMENDMENT ACT OFFERS FINANCIAL INCENTIVES OF ___ TO ____ OF ANY JUDGEMENT TO INFORMANTS WHO REPORT PHYSICIANS SUSPECTED OF DEFRAUDING THE FEDERAL GOVERNMENT
Antworten
-
15% TO 25%
-
20% TO 25%
-
20%TO 50%
-
10% TO 15%
Frage 21
Frage
QUALITY IMPROVEMENT ORGANIZATION PROGRAM CONTRACTS WITH CMS TO REVIEW _____ REASONABLENESS, APPROPRIATENESS, AND COMPLETENESS AND ADEQUACY OF CARE GIVEN
Antworten
-
PROCEDURES
-
MEDICAL NECESSITY
-
QUI TAM ACTION
-
BILLIN
Frage 22
Frage
IN A PARTICIPATING PHYSICIAN AGREEMENT, A PHYSICIAN AGREES TO ACCEPT PAYMENT FROM MEDICARE WHICH IS _____ OF THE MEDICARE APPROVED CHARGES
Antworten
-
20%
-
80%
-
115%
-
85%
Frage 23
Frage
THE MEDICARE BENEFICIARY IS RESPONSIBLE FOR THE MONTHLY PREMIUM, ANNUAL DEDUCTIBLE AND ____ OF THE MEDICARE APPROVED CHARGES
Antworten
-
20%
-
80%
-
115%
-
85%
Frage 24
Frage
IF YOU EXPECT MEDICARE TO DEY PAYMENT (ENTIRELY OR IN PART) INSTRUCT THE PATIENT TO SIGN A
Antworten
-
CCN
-
CBS
-
CBN
-
ABN
Frage 25
Frage
MEDICARE PATIENTS WHO HAVE ADDITIONAL INSURANCE, MANY INSURANCE CARRIER GROUP PLANS AND MCO SENIOR PLANS REQUIRE
Antworten
-
PRECERTIFICATION
-
PREAUTHORIZATION
-
PREDETERMINATION
-
COPAYMENT
Frage 26
Frage
AS OF OCTOBER 1, 2009, PROVIDERS NOW HAVE _______ MONTHS FROM THE DATE OF SERVICE TO FILE AND SUBMIT MEDICARE PLANS
Antworten
-
12
-
15
-
24
-
6
Frage 27
Frage
ONE OF THE WAYS TO SUBMIT A CLAIM FOR A DECEASED PATIENT IS TO INSERT "_______" IN BLOCK 12 OF THE CMS 1500 CLAIM FORM WHERE THE PATIENT'S SIGNATURE IS NECESSARY
Antworten
-
A PATIENT AUTHORIZES PAYMENT FOR SERVICES
-
PATIENT IS DECEASED
-
PATIENT DIED ON (INSERT DATE)
-
PATIENT EXPIRED
Frage 28
Frage
MEDICARE'S VERSION OF SENDING A CHECK IS A DOCUMENT CALLED
Antworten
-
EXPLANATION OF EOB
-
EXPLANATION OF MEDICARE PAYMENTS
-
MEDICARE REMITTANCE ADVICE
-
EXPLANATION OF MEDICARE BENEFITS
Frage 29
Frage
THE DOCUMENT RECEIVED BY BENEFICIARY'S IN THE MAIL TO INDICATE HOW THEIR SERVICES WERE PAID IS CALLED
Antworten
-
EXPLANATION OF BENEFITS
-
BENEFICIARY EXPLANATION
-
MEDICARE SUMMARY NOTICE
-
MEDICARE REMITTANCE ADVICE
Frage 30
Frage
A __________ IS THE AMOUNT THAT MEDICARE PARTICIPATING PROVIDERS AGREE TO ACCEPT
Antworten
-
ALLOWED AMOUNT
-
REASONABLE FEE
-
ALLOWABLE FEE
-
REIMBURSEMENT FEE
Frage 31
Frage
_________ ESTABLISHED FEDERAL STANDARDS, QUALITY CONTROL, AND SAFETY MEASURES FOR ALL FREESTANDING LABORATORIES, INCLUDING PHYSICIAN OFFICE LABORATORIES
Antworten
-
CCI
-
COBRA
-
DCG
-
CLIA
Frage 32
Frage
THE PRIOR _______ NUMBER IS USED WHEN BILLING THE MEDICARE CARRIER AND IS ENTERED ON THE CMS-1500 CLAIM FORM
Antworten
-
CERTIFICATION
-
DETERMINATION
-
CLAIM
-
AUTHORIZATION
Möchten Sie mit GoConqr kostenlos Ihre eigenen Quiz erstellen? eigenen Mehr erfahren.