# BAS 03 Medicaid
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| The federal government is in control of each State's medicaid program. | FALSE. The Feds have general guidelines to follow. The State controls the details of the program.
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| Medicaid is funded by the federal government only. | FALSE. Both Sate and Federal funds contribute.
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| The patient's medicaid card needs to be checked at each office visit. | TRUE. A patient can be on Medicaid one month and off Medicaid
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| Medicaid benefits of the same from state to state. | Medicaid benefits very from state to state they are not identical.
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| Reciprocity allows one state to accept the charges of Medicaid from another state. | This is true, however, reciprocity is usually allowed only for states that are next to each other (contiguous).
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| If a patient is covered by Medicaid and another health insurance plan, Medicaid will pay… | Last.
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| What is a TAR | Authorization from Medicaid which allows a procedure to be performed or allows equipment to be prescribed.
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| Balance billing is allowed and Medicaid | Balance billing is not allowed in Medicaid, Medicare, and most managed-care plans.
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| All states processing medical claims must build using which claim form? | CMS 1500
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| EPS DT is supported and encouraged by Medicaid for… | Pregnant women and children.
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| Assignment should be accepted at all Medicaid claims if… | The doctor wants to be paid
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| The category "medically needy" means… | The family makes too much gross income to qualify for Medicaid. However, due to medical expenses they have had, they can only afford insurance through Medicaid.
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| "Categorically needy" are those who... | Have a low income and do qualify for medicaid.
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| Who is Medicaid available to: | The blind, the disabled, the aged (65 years or older), pregnant women and children
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| On the CMS claim form, the doctor will check "accept assignment". This means that the doctor will accept… | The fee amount approved by Medicaid as the complete payment.
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| Aged and disabled persons who are very poor are covered under both the Medicaid and Medicare programs. These individuals are referred to as… | Dual eligibles, or Medi-Medi.
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| Medical necessity is… | Appropriate treatment ort care for a particular diagnosis which was arrived at using standard accepted medical diagnostic testing.
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| The Medicaid patient may be responsible for some copayment as a "cost sharing" fee. | TRUE. Medicaid may have copayments required in order to help fund the program.
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| The FPL is… | The federal pover line. Individuals below this number can qualify for Medicaid.
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| When does making more than the FPL allow a person to qualify for Medicaid? | (1) Obama care now accepts those over the FPL by 13 percent. (2) those who are categorically "medically needy".
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| Medicaid was established by… | Congress under title XIX of the Social Security act.
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| providesThe SSI program provides cash assistance to… | The elderly and disabled poor.
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| Medicaid is administered by... | CMS under the direction of the Department of Health and Human Services (HHS).
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| QMBs are... | MedicareQualified Medicare beneficiary. This is an individual that is receiving Medicare but also qualifies for Medicaid.
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| Federal standards dictate that categorically needy individuals must be provided with |
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| EPSDT stands for… | Early periodic screening and diagnosis
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| The SCHIP is... | State Children's Health Insurance program. This allows States to expand the categories of children covered.
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| Doctors can decide if they wish to treat Medicaid patients. | This is true; each state has its own rulings.
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rjmtoss
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