Question 1

Which option on an ABN allows the beneficiary to receive the non-covered items and/or services and pay for them out of pocket?

Accepted Answer

A)   Option 1
B)   Option 2
C)   Option 3
D)   Option 4 B

Question 2

The Medicare Correct Coding Initiative (CCI) is designed to correct what types of errors?

Accepted Answer

A)   unintentional coding errors resulting from a misunderstanding of coding
B)   intentionally incorrect coding done to increase payments
C)   patient misrepresentation to a physician
D)   both unintentional coding error and intentionally incorrect coding done to increase payments D

Question 3

Each calendar year, Medicare enrollees must satisfy a ___________ for covered services under which Medicare Part

Accepted Answer

A)   deposit
B)   deductible
C)   ABN
D)   coinsurance B

Question 4

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

Question 5

The federal health insurance program for people who are sixty-five or older is known as

Accepted Answer

A)   Medicare
B)   Medicaid
C)   Medigap
D)   Social Security

Question 6

Which of these is a notice sent to physicians with information about the coding and medical necessity of a service?

Accepted Answer

A)   LCD
B)   IRA
C)   ABN
D)   MSP

Question 7

Medicare Part B deductibles, coinsurance, and some noncovered services can be covered by buying policies from federally approved private insurance carriers. These policies are known as

Accepted Answer

A)   Medicare insurance policies
B)   Medigap insurance policies
C)   Medicaid insurance policies
D)   both Medicare insurance policies and Medigap insurance policies

Question 8

Medicare is the secondary payer when the patient has

Accepted Answer

A)   Medigap
B)   Medicaid
C)   Railroad Medicare
D)   workers' compensation or federal black lung benefits

Question 9

What part of Medicare is authorized under the MMA, and provides voluntary Medicare prescription drug plans that are open to people who are eligible for Medicare?

Accepted Answer

A)   Medicare Part A
B)   Medicare Part B
C)   Medicare Part C
D)   Medicare Part D

Question 10

The plan that combines a high-deductible fee-for-service plan with a tax-exempt trust to pay for qualified medical expenses is the

Accepted Answer

A)   Medicare Savings Account (MS
A)  
B)   Medicare Summary Notice (MSN) 
C)   Medical Savings Account (MS
A)  
D)   Medical Remittance Notice (MRN)

Question 11

How is a secondary payer informed of what has been covered by Medicare?

Accepted Answer

A)   MAC automatically forwards the claim payment data to the Medigap payer
B)   by the Medicare Secondary Payer Program
C)   an RA must be sent with a secondary claim
D)   wait for the remittance advice before collecting any deductible

Question 12

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

Question 13

Which section on the ABN includes the Options Box?

Accepted Answer

A)   Option 1
B)   Option 2
C)   Section 3
D)   Section 4

Question 14

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

Question 15

Physicians who participate in the Medicare program can bill patients for services that are

Accepted Answer

A)   covered by Medicare
B)   medically necessary
C)   excluded from coverage
D)   they cannot bill patients

Question 16

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

Question 17

What is a policy that states whether and under what circumstances a service is covered?

Accepted Answer

A)   MSP
B)   NCD
C)   ABN
D)   IRA

Question 18

What type of claim is mandated for Medicare?

Accepted Answer

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

Question 19

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

Question 20

Claims for services for a Medicare/Medicaid beneficiary are called

Accepted Answer

A)   service claims
B)   Medicaid claims
C)   Medicare claims
D)   crossover claims

Exam 9: Medicare