Question 1

Before a practice provides an excluded service to a patient, the patient may be given written notification using the CMS form

Accepted Answer

A)  Medicare Remittance Notice (MRN) 
B)  Medicare Summary Notice (MSN) 
C)  Advance Beneficiary Notice of Noncoverage (ABN) 
D)  no notice should ever be given 
A)  Medicare Remittance Notice (MRN) 
B)  Medicare Summary Notice (MSN) 
C)  Advance Beneficiary Notice of Noncoverage (ABN) 
D)  no notice should ever be given C

Question 2

A prescription drug plan has a list of drugs it covers, called a

Accepted Answer

A)  formulary 
B)  carrier 
C)  hospice 
D)  None of these 
A)  formulary 
B)  carrier 
C)  hospice 
D)  None of these A

Question 3

People who are entitled to Medicare Part A benefits automatically qualify for Medicare

Accepted Answer

A)  Part B 
B)  Part X 
C)  Part H 
D)  Part E
People who are entitled to Medicare Part A benefits automatically qualify for Medicare Part 
A)  Part B 
B)  Part X 
C)  Part H 
D)  Part E
People who are entitled to Medicare Part A benefits automatically qualify for Medicare Part A

Question 4

What is a commonly used reason for non-coverage for Medicare?

Accepted Answer

A)  test too frequently 
B)  diagnosis 
C)  premium not paid 
D)  Medicare covers everything 
A)  test too frequently 
B)  diagnosis 
C)  premium not paid 
D)  Medicare covers everything

Question 5

Medicare Part D is a(n)

Accepted Answer

A)  prescription drug benefit plan 
B)  hospice plan 
C)  hospital plan 
D)  outpatient surgery plan 
A)  prescription drug benefit plan 
B)  hospice plan 
C)  hospital plan 
D)  outpatient surgery plan

Question 6

The amounts paid to PAR providers in Medicare Part B are based on the

Accepted Answer

A)  MSN 
B)  MRN 
C)  MFS 
D)  limiting charge 
A)  MSN 
B)  MRN 
C)  MFS 
D)  limiting charge

Question 7

Claims for Medi-Medi beneficiaries are first submitted to Medicare and then sent to Medicaid, making them known as

Accepted Answer

A)  submitted claims 
B)  redundant claims 
C)  transmitted claims 
D)  crossover claims 
A)  submitted claims 
B)  redundant claims 
C)  transmitted claims 
D)  crossover claims

Question 8

Insurance that supplements the Medicare Original Plan coverage is called

Accepted Answer

A)  Medigap Insurance 
B)  Medicaid Insurance 
C)  Medicoverage 
D)  OP Insurance 
A)  Medigap Insurance 
B)  Medicaid Insurance 
C)  Medicoverage 
D)  OP Insurance

Question 9

When filing a late claim with Medicare, what evidence needs to be sent attached?

Accepted Answer

A)  a walkout receipt 
B)  an RA 
C)  an explanation and evidence to support it 
D)  forgiveness letter 
A)  a walkout receipt 
B)  an RA 
C)  an explanation and evidence to support it 
D)  forgiveness letter

Question 10

PQRS is a

Accepted Answer

A)  voluntary program for Medicare 
B)  mandatory program for all Medicare PARs 
C)  mandatory program for all Medicare providers 
D)  voluntary program for crossover claims 
A)  voluntary program for Medicare 
B)  mandatory program for all Medicare PARs 
C)  mandatory program for all Medicare providers 
D)  voluntary program for crossover claims

Question 11

What can a provider earn via the PQRS program?

Accepted Answer

A)  CMS awards 
B)  payment for late claims 
C)  additional payment 
D)  None of these 
A)  CMS awards 
B)  payment for late claims 
C)  additional payment 
D)  None of these

Question 12

What type of claim is mandated for Medicare?

Accepted Answer

A)  CMS-1500 
B)  HCFA-1500 
C)  HIPAA 837 
D)  paper claim 
A)  CMS-1500 
B)  HCFA-1500 
C)  HIPAA 837 
D)  paper claim

Question 13

Under Medicare's timely filing guidelines, when would the claim for a patient who received surgery in August of 2014 need to be filed?

Accepted Answer

A)  on December 31, 2014 
B)  on or before December 31, 2014 
C)  on or before December 31, 2015 
D)  on or before August 31, 2015 
A)  on December 31, 2014 
B)  on or before December 31, 2014 
C)  on or before December 31, 2015 
D)  on or before August 31, 2015

Question 14

A person covered by Medicare is called a

Accepted Answer

A)  subscriber 
B)  Medicare patient 
C)  Medicare beneficiary 
D)  member 
A)  subscriber 
B)  Medicare patient 
C)  Medicare beneficiary 
D)  member

Question 15

A nonPAR may

Accepted Answer

A)  accept assignment on a particular claim 
B)  balance bill patients 
C)  refuse to file claims 
D)  All of these 
A)  accept assignment on a particular claim 
B)  balance bill patients 
C)  refuse to file claims 
D)  All of these

Question 16

An established patient is seen with a participating provider of Medicare for an office visit on August 13th for knee pain, gets a joint injection, and the electronic claim is sent on September 1st of the following year. The claim is sent out with an office visit code of 99213 and a diagnosis code of M25.569. No payment is sent back. What is the most probable reason why it was sent with no payment?

Accepted Answer

A)  incorrect codes 
B)  it was not sent on a paper form 
C)  it was a non-participating provider 
D)  claim was not sent in a timely fashion 
A)  incorrect codes 
B)  it was not sent on a paper form 
C)  it was a non-participating provider 
D)  claim was not sent in a timely fashion

Question 17

Under which type of Medicare plan can patients receive services from Medicare-approved providers or facilities of their choosing?

Accepted Answer

A)  Medicare Savings account 
B)  Medicare managed care plan 
C)  Medicare private fee-for-service 
D)  Medicare coordinated plans 
A)  Medicare Savings account 
B)  Medicare managed care plan 
C)  Medicare private fee-for-service 
D)  Medicare coordinated plans

Question 18

Under the Original Medicare Plan, what percent of the charge is the patient responsible for after paying the premium and the deductible?

Accepted Answer

A)  15 percent 
B)  20 percent 
C)  25 percent 
D)  50 percent 
A)  15 percent 
B)  20 percent 
C)  25 percent 
D)  50 percent

Question 19

Medicare law sets specific guidelines regarding what aspect of submitting claims for benefits?

Accepted Answer

A)  clean claim filing 
B)  timely filing 
C)  patient invoicing 
D)  None of these 
A)  clean claim filing 
B)  timely filing 
C)  patient invoicing 
D)  None of these

Question 20

Medicare coordinated care plans are managed care policies which may offer beneficiaries which of these advantages:

Accepted Answer

A)  minimal paperwork 
B)  coverage for the "next of kin" 
C)  care for treatment received while traveling overseas 
D)  cosmetic procedures 
A)  minimal paperwork 
B)  coverage for the "next of kin" 
C)  care for treatment received while traveling overseas 
D)  cosmetic procedures

Before a practice provides an excluded service to a patient, the patient may be given written notification using the CMS form

A prescription drug plan has a list of drugs it covers, called a

People who are entitled to Medicare Part A benefits automatically qualify for Medicare

What is a commonly used reason for non-coverage for Medicare?

Medicare Part D is a(n)

The amounts paid to PAR providers in Medicare Part B are based on the

Claims for Medi-Medi beneficiaries are first submitted to Medicare and then sent to Medicaid, making them known as

Insurance that supplements the Medicare Original Plan coverage is called

When filing a late claim with Medicare, what evidence needs to be sent attached?

PQRS is a

What can a provider earn via the PQRS program?

What type of claim is mandated for Medicare?

Under Medicare's timely filing guidelines, when would the claim for a patient who received surgery in August of 2014 need to be filed?

A person covered by Medicare is called a

A nonPAR may

Under which type of Medicare plan can patients receive services from Medicare-approved providers or facilities of their choosing?

Under the Original Medicare Plan, what percent of the charge is the patient responsible for after paying the premium and the deductible?

Medicare law sets specific guidelines regarding what aspect of submitting claims for benefits?

Medicare coordinated care plans are managed care policies which may offer beneficiaries which of these advantages:

From Patient to Payment Understanding Medical Insurance

Electronic Health Records, HIPAA, and Hitech: Sharing and Protectin

Patient Encounters and Billing Information

Diagnostic Coding

Procedural Coding

Payment Methods and Checkout Procedures

Health Care Claim Preparation and Transmission

Private Payersblue Cross and Blue Shield

Medicaid

Tricare and Champva

Workers Compensation and Automobiledisability Insurance

Claim Processing, Payments, and Collections

Hospital Insurance

Filters

Exam 9: Medicare

Before a practice provides an excluded service to a patient, the patient may be given written notification using the CMS form

A prescription drug plan has a list of drugs it covers, called a

People who are entitled to Medicare Part A benefits automatically qualify for Medicare

What is a commonly used reason for non-coverage for Medicare?

Medicare Part D is a(n)

The amounts paid to PAR providers in Medicare Part B are based on the

Claims for Medi-Medi beneficiaries are first submitted to Medicare and then sent to Medicaid, making them known as

Insurance that supplements the Medicare Original Plan coverage is called

When filing a late claim with Medicare, what evidence needs to be sent attached?

PQRS is a

What can a provider earn via the PQRS program?

What type of claim is mandated for Medicare?

Under Medicare's timely filing guidelines, when would the claim for a patient who received surgery in August of 2014 need to be filed?

A person covered by Medicare is called a

A nonPAR may

Under which type of Medicare plan can patients receive services from Medicare-approved providers or facilities of their choosing?

Under the Original Medicare Plan, what percent of the charge is the patient responsible for after paying the premium and the deductible?

Medicare law sets specific guidelines regarding what aspect of submitting claims for benefits?

Medicare coordinated care plans are managed care policies which may offer beneficiaries which of these advantages:

From Patient to Payment Understanding Medical Insurance

Electronic Health Records, HIPAA, and Hitech: Sharing and Protectin

Patient Encounters and Billing Information

Diagnostic Coding

Procedural Coding

Payment Methods and Checkout Procedures

Health Care Claim Preparation and Transmission

Private Payersblue Cross and Blue Shield

Medicaid

Tricare and Champva

Workers Compensation and Automobiledisability Insurance

Claim Processing, Payments, and Collections

Hospital Insurance

Filters