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MEDICARE BY LETTY

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MEDICARE
letty reyes
Quiz by letty reyes, updated more than 1 year ago
letty reyes
Created by letty reyes almost 7 years ago
23
1
1

Resource summary

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
  • 6-4
  • 7-8
  • 4-8
  • 3-4

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
  • A
  • B
  • C
  • D

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
  • A
  • B
  • C
  • D

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
  • CCN
  • CBS
  • CBN
  • ABN

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
  • 12
  • 15
  • 24
  • 6

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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