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Medicaid Test Review

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Question
Answer
UNDER BROAD FEDERAL GUIDELINES   show
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PAYER OF LAST RESORT   show
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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.  
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MEDICAID ELIGIBILITY   show
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show (TRUE OR FALSE) Medicaid is state administered and federally mandated  
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TANF   show
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SSI   show
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Individuals classified as medically needy   show
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QMB   show
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QWDI   show
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show Medicare Part A premiums  
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show Qualifying individuals  
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show Specified low-income medicare beneficiary  
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show Medicare Part B premiums  
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SCHIP   show
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Presumptive eligibility   show
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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
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show will provide eligivle children with coverage until the age of 19.  
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show Community spouse -spouse residing at the home  
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show spouse residing at the home  
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Medicaid Services   show
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show Early and periodic screening, diagnosis, and treatment  
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Family planning services and supplies   show
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show (TRUE OR FALSE) Family planning services and supplies (for mandatory eligiblility group)  
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show preauthorized  
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To request information about the local medicaid program the insurance specialist should contact the   show
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Dual eligible   show
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show any provider who accepts a medicaid patient must accept the medicaid-determined payment as payment in full  
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Medicaid elgibility verificaton system   show
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show (TRUE OR FALSE) Eligibility should be verified at each encounter  
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show -point-of-service device -computer software -automated voice response  
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TRUE   show
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show is one that medcaid should not have orginally paid and results in a deduction from the lump-sum payment provider  
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show adjusted claim  
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Utilization Review   show
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show Medicaid reimbursement information sent to the provider is called remittance advice  
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TRUE   show
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show -Co-payments -Deductibles -Non-covered services -Monthly premiums  
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FMAP   show
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The Mother/baby claim   show
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show Mother/baby claim  
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Medicaid eligibility for infants born to medicaid-elgible pregnant woman can   show
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When filing an medicaid secondary claim,   show
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If patient has Medicaid and TRICARE,   show
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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.  
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show NOT acceptable  
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Individuals classidied as medically needy MAY have   show
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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.  
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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).  
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Define payer of last resort   show
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Three ways to verify eligibility   show
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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  
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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.  
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Discuss use mother/baby claim   show
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show 1. Co-payments 2. Deductibles 3. Non-covered services 4. Monthly premiums  
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List 5 Mandatory federal eligibility requirements for medicaid (1-3)   show
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List 5 Mandatory federal eligibility requirements for medicaid (4-5)   show
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