study guide
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each of the black spaces below before clicking
on it to display the answer.
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| show | Must be disabled for no less than 12 months, & must receive disability benefits for 24 months before Medicare benefits begin.
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| What are the requirements to receive Medicare Part B? | show 🗑
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| show | At any age, so long as the patient meets with the criteria.
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| show | Through an annually increasing basic premium.
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| show | Yes, if they have resided in the U.S. for 5 years or more.
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| How do employers contribute to Medicare Part A services? | show 🗑
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| show | From the first day you enter a hospital/NSF until no treatment is received for 60 consecutive days.
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| show | No, benefit periods are unlimited.
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| show | Insurance designed to help cover costs of medical care that are not covered by an individual's primary insurance.
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| show | Through those who sign up for benefits, & federal government funded programs equally.
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| show | Manual manipulation for subluxation(a slight misalignment of the vertebrae of the spine).
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| show | Yes, an annual physical is covered under Medicare.
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| What are the state to state policy for Medigap? | show 🗑
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| Do patients with HMO need supplementary policies? | show 🗑
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| When patients choose a Medicare Senior Plan, do they forfeit their medicare card? | show 🗑
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| show | No, they do not have to remain with it for a calendar year.
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| Do non-par physicians have the option to accept Medicare patients? | show 🗑
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| Can non-par physicians charge any fee they choose? | show 🗑
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| Are Medicare reimbursement policies consistent nationwide? | show 🗑
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| show | The patient handles the payments for Medicare Part B.
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| Another name for a fiscal intermediary is? | show 🗑
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| show | The patient has signed authorization papers in their file, updated annually.
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| show | No, signature on file is sufficient.
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| show | 12 months.
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| show | No Medicaid does not pick up the balance on Medi/Medi claims.
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| show | Yes, if Medigap information has already been provided.
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| Where do Medigap claims go to? | show 🗑
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| show | Document detailing services billed & payment determination issued to providers.
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| Who runs the Medicare Part A program? | show 🗑
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| Is Medicare a federal program? | show 🗑
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| show | Inpatient care, such as hospital stays, & hospice care.
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| show | Outpatient care, such as doctor visits & diagnostic tests.
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| When does the benefit period for Medicare Part A end? | show 🗑
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| show | $104.90
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| Are preventative care mammograms covered by Medicare? | show 🗑
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| How often can Medicare be charged for pap-smears? | show 🗑
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| What does Medigap insurance cover? | show 🗑
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| show | MSP(Medicare Secondary Payer).
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| What does Senior HMO cover that Medicare does not? | show 🗑
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| show | Quality Improvement Organization (QIO).
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| show | Most commonly 80%.
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| What is the negotiated amount based on? | show 🗑
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| In the Medicare program, what is a mandatory assignment in benefits covered? | show 🗑
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| show | Identifies claims to review for a medical necessity & monitor the number of times billed for such procedures during a specific time frame.
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| show | HCPCS Level II modifier "GA"
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| show | Hospitals treating Medicare patients are reimbursed according to pre-established rates of illnesses based on diagnosis.
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| show | D.R.G.s, diagnosis-related groups.
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| What is the Omnibus Reconciliation Act? | show 🗑
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| show | Level 2.
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| show | Organization under contract to the state to process claims for a Medicaid program, for hospitals, nursing facilities, home health agencies, long term care facilities, and intermediate facilities.
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| show | The status of the individual.
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| show | Widow status.
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