Exam 4: Reimbursement Issues Related to Documentation

According to the rules and regulations under Medicare, what activities can a physical therapist aide provide in the clinical setting?

How many months before a person turns 65 can he or she enroll for Medicare benefits?

At what age can most individuals access Medicare benefits if they meet the requirements?

Which states do not have vocational rehabilitation provisions in their workers' compensation laws?

Identify the program that provides comprehensive medical and social services in a non-institutional setting specifically for older individuals and may not be available in every state.

Which part of Medicare provides for physician visits and outpatient services (e.g., physical therapy) and requires that a monthly premium be paid by the patient?

Under what circumstances can a person younger than age 65 access Medicare benefits?

Identify the group of practitioners who cannot receive reimbursement for patient treatments under Medicare Part B requirements.

Within a skilled nursing facility, students must meet certain requirements for their patient treatments to be billable as skilled therapy minutes.Identify the requirements that must be met for services to be billable.

What do the letters HMO represent?

What does Medicare Part A cover for individuals who qualify for those services?

What is one qualification, besides age, that an individual must meet to be eligible for Medicare benefits?

Workers' compensation insurance is provided by an employer to cover an individual employee who may be injured or become ill on the job.If the employee dies, up to what age can his or her surviving children typically expect to receive benefits?

What is one of the expectations a company employee might have regarding workers' compensation insurance?

To qualify for Medicaid services, the patient must be meet specific financial guidelines in addition to other qualifications of which FPL is one.What do the initials FPL represent?

Under which program is the patient not required to have a primary care provider or receive a referral for access to medical services?

Under Medicare Part A, a student's patient treatment may be reimbursed under specific conditions.Identify the condition under which the student must treat the patient for services to be reimbursed.

Within which organization is the patient required to select a primary care provider (PCP) from a list the organization provides to direct all medical care the patient receives?

Even with Medicare, it is important for patients to have additional coverage in a supplemental plan to cover costs outside of those that Medicare covers, commonly referred to as Medigap insurance.Identify an example of such a supplemental plan.

All states require workers' compensation laws to provide complete medical coverage, without durational or monetary limitations, with the exception of seven states.Identify two of the states that have separate provisions to this requirement.