Medicare Part A is run by

the center for Medicare and Medicaid Services

medicare Part A benefit period ends when a patient

has not been a bed patient in any ospital or nursing facility for 60 consecutive days.

Medigap insurance may cover

the deductible not covered under Medicare.

Some senior HMOs may provide services not covered by Medicare, such as

eyeglasses and prescription drugs.

Stark I and II regulations

prohibit the referral of a Medicare or Medicaid patient to a laboratory or other outside provider/facility in which the physician has a financial relationship.

A participating physician with the Medicare plan agrees to accept

80% of the Medicare-approved charge.

Under the prospective payment system (PPS), hospitals treating Medicare patients are reimbursed according to

preestablished rates for each type of illness treated based on diagnosis.

RBRVS was established as a means to

redistribute Medicare dollars among physicians more equitably.

An explanation of benefits document for a patient under the Medicare program is referred to as the

Medicare remittance advice document.

A claims assistance professional (CAP)

may act on the Medicare benefiniary's behalf as a client representative.

If a check is received from Medicare and it is obvious that it is an overpayment, the insurance billing specialist should

deposit the check and then write to Medicare notifying them of the overpayment.

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Test 12

Medicare Insurance

Question	Answer
Medicare Part A is run by	the center for Medicare and Medicaid Services
The letters preceding the number on the patient's Medicare identification card indicate	railroad retiree.
Part A of Medicare covers	hospice care.
medicare Part A benefit period ends when a patient	has not been a bed patient in any ospital or nursing facility for 60 consecutive days.
The Part B Medicare annual deductible is	$100
The frequency of Pap tests that may be billed for a Medicare patient who is not at risk is	once every 3 years
Medigap insurance may cover	the deductible not covered under Medicare.
When a Medicare beneficiary is still working and has employer supplemental coverage, Medicare refers to these plans as	MSP.
If you were processing a claim for MSP, Medicare would always be billed	second.
Some senior HMOs may provide services not covered by Medicare, such as	eyeglasses and prescription drugs.
Stark I and II regulations	prohibit the referral of a Medicare or Medicaid patient to a laboratory or other outside provider/facility in which the physician has a financial relationship.
A participating physician with the Medicare plan agrees to accept	80% of the Medicare-approved charge.
In the Medicare program, there is mandatory assignment for	Clinical laboratory tests.
A medicare prepayment screen	Both A and B
When a Medicare patient signs an advance beneficiary notice, the procedure code or the service provided must be modified using the HCPCS Level II modifier	-GA
Under the prospective payment system (PPS), hospitals treating Medicare patients are reimbursed according to	preestablished rates for each type of illness treated based on diagnosis.
Payments to hospitals for Medicare services are classified according to	DRGs.
The 1987 Omnibus Budget Reconciliation Act (OBRA) established the	MAAC.
RBRVS was established as a means to	redistribute Medicare dollars among physicians more equitably.
RBRVS consists of a/an	All of the above
The HCPCS national alphanumeric codes are referred to as	Level II codes.
When a Medicare carrier transmits a Medigap claim electronically to the Medigap carrier, it is referred to as a/an	crossover claim.
An explanation of benefits document for a patient under the Medicare program is referred to as the	Medicare remittance advice document.
A claims assistance professional (CAP)	may act on the Medicare benefiniary's behalf as a client representative.
If a check is received from Medicare and it is obvious that it is an overpayment, the insurance billing specialist should	deposit the check and then write to Medicare notifying them of the overpayment.

Created by: bunnyfinley

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