Which of the following duty is not performed by the Centers for Medicare and Medicaid Services (CMS)?

Paying claims for Medicare beneficiaries

Medicare Part C plans are offered through:

HMO Plans, PPO Plans and Fee-for-Service Plans

To calculate your responsibility for a service after the deductible is met:

1. Identify the Allowed Amount 2. Apply Coinsurance: Multiply the allowed amount by your plan's coinsurance percentage (e.g., if you have 20% coinsurance, you pay 0.20 x cost) 3. Add Copays: Add any fixed fees required for that visit.

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HIT 130 Quiz 3

HIT 130 Quiz 3 Review

Question	Answer
True or false? The charge description master (CDM) includes procedure codes, procedure descriptions, service descriptions, charges, and revenue codes.	True
A facility designed for patients receiving minor surgical procedures who are expected to be discharged the same day.	ASC
A method of reimbursement for hospitals for inpatient stays.	MS-DRG
An indicator used for inpatient diagnosis codes to clarify if the diagnosis was present at the time of admission.	POA
A prospective payment system used for ambulatory services.	APC
Which payment method was initiated by Medicare and means before services are rendered?	Prospective Payment System
A preexisting condition that effects the principal diagnosis and increases the length of stay by at least 1 day is called a(n) __________.	comorbidity
Which Medicare program covers hospital services?	Medicare Part A
Which of the following duty is not performed by the Centers for Medicare and Medicaid Services (CMS)?	Paying claims for Medicare beneficiaries
Medicare Part C plans are offered through:	HMO Plans, PPO Plans and Fee-for-Service Plans
A physician who chooses NOT to contract with a Medicare health plan is known as a:	nonparticipating provider.
True or false? Medicare is considered the primary payer when an individual age 65 or older is covered by Medicaid.	True
The portion of Medicare that provides for coverage of physician services.	Medicare Part B
The form sent to patients by the Medicare contractor (carrier) that itemizes services billed to Medicare, the amount paid, and the amount the beneficiary is responsible.	Medicare Summary Notice
Supplementary health insurance policy that covers portions of the costs NOT paid for by Medicare.	Medigap
The portion of Medicare that provides for inpatient hospital coverage.	Medicare Part A
The portion of Medicare that provides prescription drug coverage.	Medicare Part D
To calculate your responsibility for a service after the deductible is met:	1. Identify the Allowed Amount 2. Apply Coinsurance: Multiply the allowed amount by your plan's coinsurance percentage (e.g., if you have 20% coinsurance, you pay 0.20 x cost) 3. Add Copays: Add any fixed fees required for that visit.

Created by: mkaila

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