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Insurance

Epic Hospital

QuestionAnswer
Medicare is run by the Federal government. What are the 3 criteria that make the patient eligible for Medicare? 65 years old or older ESRD DIAGNOSIS Permanently physically /mentally disable
Traditional Medicare Part A Part B A+B traditional Medicare A+ B PROVIDES MAJORITY OF PTS MEDICAL INSURANCE COVERAGE. HOW EVER THE PTS IS SUBJECT TO SOME OUT OF POCKET FEE
Medicare Part B Out Patient
Medicaid Financially needed Resident
ACESS payer PA Medicaid Plan Medicaid PA
The subscriber ID for BCBS has two parts? What are they? prefix (3 letters) numbers
Duale ELIGIBLE MEANS THAT THEY ARE ELIGIBLE FOR? Medicare and Medicaid
A pts presents these insurance cards. How should they be register? Primary = Highmark wholecare Gateway Medicare Advantage/HM Wholecare Dual assured Diamond Secondary= PA Medicare/ Medicaid PA
The MSPQ is needed for every HAR with traditional Medicare coverage, 30 days
4) When Searching a payer/ Plan using a BCBS PREFIX and no match was found which Commercial payer/plan may be used (select all) Highmark Blue shield/Highmark Blue Shield-- BlueCard out of State/Blue card includes out of state
The defense Benefits Number or Military SSN should be entered in the Subscriber ID field for Tricare insurance? True
1) What is the most effective way to find the correct payer /Plan for BlueCross /Blue Shield insurance card? Prefix
4) Medicaid is a ______run Medical Coverage State
Who is eligible for Medicaid? Financially needed resident
All Medicaid Replacement use the pts social security for Member ID’S False
The MSPQ is not needed when traditional Medicare is the pts secondary coverage False
Created by: kadams2660
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