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HI chp 14-15

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Question
Answer
What part of Medicare pays for inpatient hospital critical care access; skilled nursing facility stays; hospice care; and some home health care?   Medicare Part A  
What part of Medicare pays for doctors' services; outpatient hospital care; DME; and some medical services that are not covered by Part A?   Medicare Part B  
What part of Medicare was formerly called Medicare+Choice, includes managed care and private fee-for-service plans that provide contracted care to Medicare patients?   Medicare Part C  
What part of Medicare adds prescription drug coverage to the Original Medicare Plan?   Medicare Part D  
What is the standard method for providers to obtain Medicare eligibility information?   Electronic Data Interchange  
What begins with the first day of hospitalization and ends when the patient has been out of the hospital for 60 consecutive days?   Benefit Period  
How many Lifetime Reserve Days are Medicare patients allowed?   Sixty  
What do patients need to become inpatients at a SNF after an acute hospital stay?   Three-day-minimum stay  
What is an autonomous, centrally administered program of coordinated inpatient and outpatient palliative services for terminally ill patients and their families?   Hospice  
What is another name for a physician fee schedule?   RBRVS  
What program combines medical, social and long-term care services for frail people who live and receive health care in the community?   PACE  
What is the maximum fee for a nonPAR that may be charged for a covered service?   Limiting Charge  
What is a written document provided to a Medicare beneficiary by a supplier, physician, or provider prior to service being rendered?   Advance Beneficiary Notice  
What is an easy-to-read monthly statement that clearly lists health insurance claims information for Medicare beneficiaries?   Medicare Summary Notice  
What was developed to enable Medicare beneficiaries to participate in mass PPV and influenza virus vaccination programs offered by public health clinics and other entities that bill Medicare payers?   Roster Billing  
What is forbidden as the result of legislation passed by some states?   Balance Billing  
What four programs are dual eligible?   QMB, QWDI, QI, and SLMB  
What allows states to create or expand existing insurance programs, providing more federal funds to states for the purpose of expanding Medicaid eligibility to include a greater number of currently uninsured children?   SCHIP  
If the Medicare beneficiary has Medicare for its primary insurance, what do you need to type into box 11 on the CMS-1500 claim?   None  


   





 
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