Exam 9: Conquering Medicare’s Challenges

If a beneficiary has a Medicare Advantage plan,he or she still needs a supplemental policy.

An individual who has health insurance coverage through either the Medicare and Medicaid programs is commonly referred to as a:

For Medicare Part A,a benefit period begins the day an individual is _______________ to a hospital or SNF and ends when the beneficiary has not received care in a hospital or SNF for _____ days in a row.

A Medicare beneficiary can sign a special release of information that is good for his or her lifetime.

If a claim is denied because it was submitted after the "timely filing period," it is subject to appeal.

The 6-month period during which an individual can sign up for the Medicare program is called the open enrollment period.

Medicare non-PARs do not have to submit claims for their Medicare patients.

There are _____ parts to the Medicare program.

A claim for which a beneficiary elects to assign benefits under a Medigap policy is called a "mandated Medigap transfer."

All Medicare beneficiaries pay the same monthly premium regardless of income.

The duration of time during which a Medicare beneficiary is eligible for Part A benefits for inpatient hospital or skilled nursing facility charges is called a/an:

Unlike original Medicare,Medicare managed care plans often pay for what items?

A local coverage determination (LCD)consists only of information pertaining to when a procedure is considered medically reasonable and necessary.

An individual must be eligible for Part A or B to enroll in a Medicare Advantage plan.

The intention of Part D is for all Medicare beneficiaries to choose a prescription drug plan to help offset the increasing cost of ______________.

An individual is generally not eligible to elect a Medicare Advantage plan if he or she has been diagnosed with _________.

The act that established quality standards for all laboratory testing to ensure safety,accuracy,reliability,and timeliness is:

Under ASCA's mandatory electronic claim submission rules,claims for which Medicare is the secondary payer (and there is only one primary payer)do not have to be submitted electronically.

Providers that bill Medicare administrative contractors (or FIs)can also submit claims electronically using:

Part _____ of Medicare helps pay for prescription drugs.