Medicaid Test Review
Help!
|
|
||||
---|---|---|---|---|---|
UNDER BROAD FEDERAL GUIDELINES | show 🗑
|
||||
PAYER OF LAST RESORT | show 🗑
|
||||
show | (TRUE OR FALSE) Medicaid can be billed only if the other coverage denies responsibility for payment, if it pays less than the Medicaid fee schedule, or if Medicaid covers procedures not covered by other policy thus all additional health and liability.
🗑
|
||||
MEDICAID ELIGIBILITY | show 🗑
|
||||
show | (TRUE OR FALSE) Medicaid is state administered and federally mandated
🗑
|
||||
TANF | show 🗑
|
||||
SSI | show 🗑
|
||||
Individuals classified as medically needy | show 🗑
|
||||
QMB | show 🗑
|
||||
QWDI | show 🗑
|
||||
show | Medicare Part A premiums
🗑
|
||||
show | Qualifying individuals
🗑
|
||||
show | Specified low-income medicare beneficiary
🗑
|
||||
show | Medicare Part B premiums
🗑
|
||||
SCHIP | show 🗑
|
||||
Presumptive eligibility | show 🗑
|
||||
What allows immediate access to services for children who are eligible as well as woman who are in need of treatment for breast or cervical cancer, Eligibility is part of the CDC's national breast and cervival cancer early detection program? | show 🗑
|
||||
show | will provide eligivle children with coverage until the age of 19.
🗑
|
||||
show | Community spouse -spouse residing at the home
🗑
|
||||
show | spouse residing at the home
🗑
|
||||
Medicaid Services | show 🗑
|
||||
show | Early and periodic screening, diagnosis, and treatment
🗑
|
||||
Family planning services and supplies | show 🗑
|
||||
show | (TRUE OR FALSE) Family planning services and supplies (for mandatory eligiblility group)
🗑
|
||||
show | preauthorized
🗑
|
||||
To request information about the local medicaid program the insurance specialist should contact the | show 🗑
|
||||
Dual eligible | show 🗑
|
||||
show | any provider who accepts a medicaid patient must accept the medicaid-determined payment as payment in full
🗑
|
||||
Medicaid elgibility verificaton system | show 🗑
|
||||
show | (TRUE OR FALSE) Eligibility should be verified at each encounter
🗑
|
||||
show | -point-of-service device -computer software -automated voice response
🗑
|
||||
TRUE | show 🗑
|
||||
show | is one that medcaid should not have orginally paid and results in a deduction from the lump-sum payment provider
🗑
|
||||
show | adjusted claim
🗑
|
||||
Utilization Review | show 🗑
|
||||
show | Medicaid reimbursement information sent to the provider is called remittance advice
🗑
|
||||
TRUE | show 🗑
|
||||
show | -Co-payments -Deductibles -Non-covered services -Monthly premiums
🗑
|
||||
FMAP | show 🗑
|
||||
The Mother/baby claim | show 🗑
|
||||
show | Mother/baby claim
🗑
|
||||
Medicaid eligibility for infants born to medicaid-elgible pregnant woman can | show 🗑
|
||||
When filing an medicaid secondary claim, | show 🗑
|
||||
If patient has Medicaid and TRICARE, | show 🗑
|
||||
show | (TRUE OR FALSE) The federal government mandates that medicaid remittance advice forms are to be kept by providers for a period set by the state in which they practice.
🗑
|
||||
show | NOT acceptable
🗑
|
||||
Individuals classidied as medically needy MAY have | show 🗑
|
||||
show | 1. Individuals who meet requirements of TANF program. 2. Children under the age of six and pregnant women whose family income is at or below 133% of the federal poverty level. 3. Supplemental Security Income recipients.
🗑
|
||||
show | 4. Indiciduals and couples living in medical institutions who have a monthly income up to 300% of the SSI income. 5. Caretakers (relatives or legal guardians who take care of children who are under age 18 or 19 if still in school).
🗑
|
||||
Define payer of last resort | show 🗑
|
||||
Three ways to verify eligibility | show 🗑
|
||||
show | a sample of medicaid recipients is sent a montly survery letter requesting verification of services paid the previous month on their behalf to help verify receipt of medicaid services
🗑
|
||||
show | benefit that allows indivduals to be enrolled in medicaid for a limited time before full medicaid applications are filed and processed. This allows children who are eligible for SCHIP and woman in need of treatment for breast or cervical cancer.
🗑
|
||||
Discuss use mother/baby claim | show 🗑
|
||||
show | 1. Co-payments
2. Deductibles
3. Non-covered services
4. Monthly premiums
🗑
|
||||
List 5 Mandatory federal eligibility requirements for medicaid (1-3) | show 🗑
|
||||
List 5 Mandatory federal eligibility requirements for medicaid (4-5) | show 🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
cthomp