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officebiling 11,12
physicians office billing CH
| Question | Answer |
|---|---|
| ppl with low income and few resources | categorically needy |
| agency that provides financial assistance to low income ppl | temporaty assistance for needy families (TANF) |
| offers on opportuniey to develop plans for insurance coverage for uninsured children | state childrens health insurance program (SCHIP) |
| provides health care to chilrn under age of 21 who are enrolled in medicaid | EPSDT-early preventitive screening and diagnosis treatment |
| fee for service program that replaced the CHAMPUS program | tricare standard |
| eligible for both medicaid and medicare | medi-medi beneficiary |
| tricare term for coinsurance, the amount that is the Pts responsibility | cost share |
| government health insurance program for veterans with 100% service related disabilities | CHAMPVA |
| plan available for certain national guard and reserve members activated after 9/11 | tricare reserve select |
| plan that provides no-cost care through civilian providers for service members that live and work more than 50 miles from nearest MTF | tricare prime remote |
| plan all active duty service members are automatically enrolled in | tricare prime |
| coordinates and manages tricare prime members care | PCM (primary care manager) |
| alternative managed care plan for individuals who ant to recive services promarily from civilian facilities | tricare extra |
| if a medicaid beneficiary is covered by a group plan, then medicaid would be | the secondary payer |
| claims billed to medicare that are automatically sent to medicaid are called | crossover claims |
| a classification for ppl with high medical expenses and low income, although not low enough to receive cash assistance | medically needy |
| people classified as restricted status must | see a specific provider |
| medicaid is run by | state programs |
| two types of plans offered by medicaid are | fee-for-service and managed care |
| for medicaid to receive federal matching funds, states must cover | vaccines for children |
| for individuals enrolled in tricare-for-life, the primary payer would be | medicare |
| maximum annual amount a tricare beneficiary must pay is called | catastrophic cap |
| the worldwide database of tricare and champva beneficiaries is known as | DEERS |
Created by:
cpar
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