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Patient to Payment
Chapter 9 Review
| Question | Answer |
|---|---|
| When patient is covered by both Medicare and Medicaid, what is it called when Medicare sends bill over to Medicaid after they pay their portion | Crossover claim |
| When would Medicare pay/cover an excluded service | Never |
| What do we have patient sign when we think a procedure might not be covered by Medicare | Advance Beneficiary Notice Form (ABN) |
| What part of Medicare covers prescriptions | Medicare Part D |
| What type of physician agrees to accept assignment and Medicare fee schedule | Participating |
| If a patient also has employee group insurance then Medicare is what insurance | secondary |
| On original Medicare what is the patients responsibility after premium and deductible are paid | twenty percent |
| What is the limiting charge for a NonPar provider | one hundred and fifteen percent |
| What is the name of the insurance that supplements Medicare | Medigap |
| If a patient over sixty-five does not receive social security benefits, what must they do to receive Medicare Part A | Pay a premium |
| If a patient is sixty-five and does receive social security benefits what part of Medicare are they automatically enrolled in and what part are they eligible for | Part A Part B |
| For Medicare what are the companies called that process claims for Part A and for Part B | ficscal intermediaries carriers |
| What is crossover claims | primary insurance pays their portion then sends bill to secondary insurance |
| What does MSN mean | Medicare Summary Notice (sent to patient) |
| Medicare and Medicaid claims are sent by whom when you have both | provider to Medicare and Medicare to Medicaid |
Created by:
dlhbears
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