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