Medicaid
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each of the black spaces below before clicking
on it to display the answer.
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| physician services | medicare part B
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| medicare | administered by the CMS and is a federally funded program
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| medicare started | to provide coverage for the aged, retired, disabled individuals, and people with chronic kidney disease
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| medicaid may pay for (when a patient has medicare and medicaid) | the deductible, premium, and coinsurance
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| ID card contains | wage earners SSN, followed by an alpha letter, along with the effective dates
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| medicare part C | medicare's HMO plan, patient does not need part A or part B if they have this
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| medigap insurance | are regulated by the federal government and include basic benefits
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| medicare secondary payer (MSP) | bill medicare secondary
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| stark I & II regulations | prohibit physician who has a financial relationship with a designated health service from referring patients to the facility (finanal interest)
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| federal false claims act | federal law to prevent overuse of services and to spot medicare fraud
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| modifier used when a waiver of liability is signed | -GA
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| medicare coding claims | HCPCS level I, II, & III
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| limiting charge | percentage limit that a nonpar physician may bill medicare over the allowed amount
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| T/F - letters that precedes the insurance claim number on the ID card indicate a disabled person | F (answer railroad retiree)
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| T/F - medicare non benifits include routine physical exams, foot care, eye or hearing exams, and cosmetic surgery | T
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| respite care | inpatient stay provided for terminally ill to give temporary relief to the patients caregiver
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| fiscal intermediary | organization under contract with government that handles claims under medicare part A & B
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| benefit period | (hospitalization)when patient enters hospital and is discharged and not readmitted for 60 days
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| medicare part A | hospital coverage
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| correct coding initiative (CCI) | implemented by CMS to eliminate unbundling
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| medicare part B | supplementary medical insurance (physician services)
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| HMO risk plan | medicare restricted beneficiaries that receive services from contracted providers and facilities
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| medicare part C | receives fixed amount of money from Medicare to spend on their member (HMO)
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| HMO cost plan | medicare beneficaries receive services from sources outside the HMO network
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| medicare managed care | senior HMO
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