CENTERS FOR MEDICARE AND MEDICAID SERVICES

CENTERS FOR MEDICAID AND MEDICARE SERVICES

SERVICES FOR MEDI-MEDI SERVICES

MEDICARE BY LETTY

Question 1

Question

CMS IS SHORT FOR

Answer

CENTERS FOR MEDICARE AND MEDICAID SERVICES
CENTERS FOR MEDICAID AND MEDICARE SERVICES
SERVICES FOR MEDI-MEDI SERVICES
CENTERS FOR MEDICARE SERVICES

Question 2

Question

MEDICAID IS ADMINISTERED BY

Answer

CMS
TMHP
MCS
CNS

Question 3

Question

MEDICARE PART A IS FOR

Answer

PROVIDER SERVICES
OUTPATIENT SERVICES
HOSPITAL SERVICDES
DME SERVICES

Question 4

Question

MEDICARE IS A ____________ PROGRAM

Answer

STATE
LOCAL
FEDERAL
STATE/FEDERAL

Question 5

Question

OVER THE PERIOD OF _________ YEARS, DEPARTMENT OF HEALTH AND HUMAN SERVICES WILL DISTRIBUTE REPLACEMENT CARDS TO MEDICARE BENEFICIARIES

Answer

Question 6

Question

IF A CARD SHOWS HMO, THEN THE PATIENT SIGNED UP AND IS COVERED BY A ____

Answer

PRIVATE INSURANCE
PREFERRED PROVIDER ORGANIZATION
MANAGED CARE PLAN
TRADITIONAL FEE FOR SERVICE

Question 7

Question

THE LETTER C IDENTIFIES THAT THE INSURED IS THE

Answer

WIDOW
SPOUSE
BENEFICIARY
DISABLED CHILD

Question 8

Question

A RAILROAD MEDICARE BENEFICIARY IDENTIFICATION NUMBER BEGINS WITH A

Answer

NUMBER OR NUMBERS
LETTER OR LETTERS
POUND SIGN
SPECIAL CHARACTER

Question 9

Question

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

Answer

Question 10

Question

ESRD IS SHORT FOR

Answer

EVEN STAGE RENAL DISORDERS
END STATE RENAL DISEASE
END SPECIAL RENAL DISEASE
END STATES RENAL DISEASES

Question 11

Question

MEDICARE PART B HAS AN ANNUAL ______ THAT CONTINUES TO INCREASE BY THE SOCIAL SECURITY ADMINISTRATION

Answer

COPAYMENT
PREAUTHORIZATION
CO-INSURANCE
PREMIUM

Question 12

Question

MEDICARE PART ___ IS COMMONLY REFERRED AS MEDICARE ADVANTAGE PLAN

Answer

Question 13

Question

MEDICARE PART D IS FOR PRESCRIPTION COVERAGE AND MOST OF THE MEDICARE DRUG PLANS HAVE COVERAGE GAP KNOWN AS

Answer

GAP
LAPSE IN COVERAGE
DONUT HOLE
FORMELY

Question 14

Question

MEDICAL INSURANCE FOR RAILROAD RETIREMENT BENEFITS PREMIUMS ARE AUTOMATICALLY DEDUCTED FROM

Answer

EMPLOYER PAYCHECKS
MONTHLY CHECKS RECEIVED OF PEOPLE WHO RECEIVE RAILROAD RETIREMENT
FROM THE BENEFICIARY'S CHECKING ACCOUNT
THE BENEFICIARY'S SAVINGS ACCOUNT

Question 15

Question

MEDICARE SECONDARY PAYER (MSP) DEFINES MEDICARE TO BE

Answer

PRIMARY PAYER
SECONDARY PAYER
PAYER OF LAST RESORT
TERTIARY PAYER

Question 16

Question

A ________ IS A LIST OF THE DRUGS THAT A PLAN COVERS

Answer

FORMULARY
LIST OF APPROVED DRUGS
MEDICARE PRESCRIPTIONS DRUG COVERAGE
TIER ONE LIST

Question 17

Question

MEDICARE MAKES PAYMENTS DIRECTLY TO THE _______ ON A MONTHLY BASIS FOR MEDICARE ENROLLEES WHO USE THE HMO OPTION

Answer

PATIENT
PROVIDER
HMO
PPO

Question 18

Question

MEDICARE ADVANTAGE PLANS (HMO'S OR PPO'S) HAVE AN OPEN ENROLLMENT PERIOD IN THE ________ OF EACH YEAR

Answer

SPRING
FALL
SUMMER
WINTER

Question 19

Question

IF A MEDICARE PATIENT HAS SWITCHED OVER TO A MANAGED CARE PLAN AND WISHES TO DISENROLL, THE PATIENT MUST

Answer

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

Question 20

Question

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

Answer

15% TO 25%
20% TO 25%
20%TO 50%
10% TO 15%

Question 21

Question

QUALITY IMPROVEMENT ORGANIZATION PROGRAM CONTRACTS WITH CMS TO REVIEW _____ REASONABLENESS, APPROPRIATENESS, AND COMPLETENESS AND ADEQUACY OF CARE GIVEN

Answer

PROCEDURES
MEDICAL NECESSITY
QUI TAM ACTION
BILLIN

Question 22

Question

IN A PARTICIPATING PHYSICIAN AGREEMENT, A PHYSICIAN AGREES TO ACCEPT PAYMENT FROM MEDICARE WHICH IS _____ OF THE MEDICARE APPROVED CHARGES

Answer

20%
80%
115%
85%

Question 23

Question

THE MEDICARE BENEFICIARY IS RESPONSIBLE FOR THE MONTHLY PREMIUM, ANNUAL DEDUCTIBLE AND ____ OF THE MEDICARE APPROVED CHARGES

Answer

20%
80%
115%
85%

Question 24

Question

IF YOU EXPECT MEDICARE TO DEY PAYMENT (ENTIRELY OR IN PART) INSTRUCT THE PATIENT TO SIGN A

Answer

Question 25

Question

MEDICARE PATIENTS WHO HAVE ADDITIONAL INSURANCE, MANY INSURANCE CARRIER GROUP PLANS AND MCO SENIOR PLANS REQUIRE

Answer

PRECERTIFICATION
PREAUTHORIZATION
PREDETERMINATION
COPAYMENT

Question 26

Question

AS OF OCTOBER 1, 2009, PROVIDERS NOW HAVE _______ MONTHS FROM THE DATE OF SERVICE TO FILE AND SUBMIT MEDICARE PLANS

Answer

Question 27

Question

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

Answer

A PATIENT AUTHORIZES PAYMENT FOR SERVICES
PATIENT IS DECEASED
PATIENT DIED ON (INSERT DATE)
PATIENT EXPIRED

Question 28

Question

MEDICARE'S VERSION OF SENDING A CHECK IS A DOCUMENT CALLED

Answer

EXPLANATION OF EOB
EXPLANATION OF MEDICARE PAYMENTS
MEDICARE REMITTANCE ADVICE
EXPLANATION OF MEDICARE BENEFITS

Question 29

Question

THE DOCUMENT RECEIVED BY BENEFICIARY'S IN THE MAIL TO INDICATE HOW THEIR SERVICES WERE PAID IS CALLED

Answer

EXPLANATION OF BENEFITS
BENEFICIARY EXPLANATION
MEDICARE SUMMARY NOTICE
MEDICARE REMITTANCE ADVICE

Question 30

Question

A __________ IS THE AMOUNT THAT MEDICARE PARTICIPATING PROVIDERS AGREE TO ACCEPT

Answer

ALLOWED AMOUNT
REASONABLE FEE
ALLOWABLE FEE
REIMBURSEMENT FEE

Question 31

Question

_________ ESTABLISHED FEDERAL STANDARDS, QUALITY CONTROL, AND SAFETY MEASURES FOR ALL FREESTANDING LABORATORIES, INCLUDING PHYSICIAN OFFICE LABORATORIES

Answer

CCI
COBRA
DCG
CLIA

Question 32

Question

THE PRIOR _______ NUMBER IS USED WHEN BILLING THE MEDICARE CARRIER AND IS ENTERED ON THE CMS-1500 CLAIM FORM

Answer

CERTIFICATION
DETERMINATION
CLAIM
AUTHORIZATION

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MEDICARE BY LETTY

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	Created by letty reyes over 6 years ago