Exam 8: Understanding Medicaid

Medicaid is allowed to impose cost-sharing charges and premiums on certain categories of Medicaid recipients.

Every state has the same Medicaid benefits.

It is good practice to file all Medicaid claims:

Hospitals that receive additional payments to ensure that communities have access to certain high-cost services are called disproportional share hospitals.

Medically needy individuals can reduce their assets to the Medicaid eligibility level by deducting medical expenses;this is called a/an:

Individuals who receive medical assistance because their income falls within the poverty or FPL guidelines or as a result of SSI eligibility are considered:

States that offer a medically needy program must cover pregnant women and their children regardless of age.

A combination federal/state medical assistance program that provides comprehensive and quality medical care for certain categories of low-income and qualifying elderly people is:

Every time a claim is sent to Medicaid,a document is generated explaining how the claim was adjudicated,or how the payment was determined,which is called a:

In most states,SSI beneficiaries also qualify for Medicaid assistance to pay for hospital stays,doctor bills,prescription drugs,and other health costs.

Facilities that receive additional payments to ensure that communities have access to certain high-cost services such as trauma and emergency care and burn services are called ______________.

List four examples of third parties that may be liable to pay for services before Medicaid pays.

In 1972 federal law established the ______________program,which provides federally funded cash assistance to qualifying elderly and disabled poor.

The Affordable Care Act provides Americans with opportunities for better healthcare by:

Individuals eligible for Medicaid assign their rights to third-party payments to the state Medicaid agency.

As a general rule,Medicaid only pays for services that are determined to be medically necessary.Give a definition of "medically necessary."

List at least five of the federally mandated services under the Medicaid program.

CMS determines eligibility criteria for SSI.

Most states have their own specific form to use for Medicaid claims.

A comprehensive federal policy established to prevent and reduce provider fraud,waste,and abuse in the Medicaid program.