Health Insurance Today Chap 9 -next Step Chap 3
Review quiz mod 4 week 3
- 1.A federal insurance program, established in 1966, for people 65 years old and older and certain other qualifying individuals is
- A.
Medicaid
- B.
Medicare
- C.
Medigap
- D.
Managed care
- 2.The act that provides for a federal system of old age, survivors, disability, and hospital insurance is the
- A.
Federal insurance contribution act (FICA)
- B.
Health insurance portability and accountability act (HIPPA)
- C.
Emergency medical treatment and active labor act (EMTLA)
- D.
Consolidated omnibus budget reconciliation act (COBRA)
- 3.The are _____________ parts to the medicare program
- A.
Two
- B.
Three
- C.
Four
- D.
Five
- 4.Part ________ of medicare helps pay for charges incurred during an inpatient hospital stay
- A.
A
- B.
B
- C.
C
- D.
D
- 5.Part ________ of medicare helps pay for physician and outpatient charges
- A.
A
- B.
B
- C.
C
- D.
D
- 6.Part _____ of medicare includes the new medicare advantage options
- A.
A
- B.
B
- C.
C
- D.
D
- 7.Part ____ of medicare helps pay for perscription drugs
- A.
A
- B.
B
- C.
C
- D.
D
- 8.Medicare part a helps pay for all of the following except
- A.
Office visits
- B.
Home healthcare
- C.
Hospice
- D.
Blood
- 9.An individual who has health insurance coverage through both the medicare and medicaid programs is commonly referred to as a
- A.
Client
- B.
Customer
- C.
Beneficiary
- D.
Member
- 10.A private organization that contracts with medicare to pay part a and some of part b bills is referred to as a
- A.
Beneficiary
- B.
Third party
- C.
Financial mediator
- D.
Fiscal intermediary
- 11.Individuals pay for medicare part b coverage through
- A.
Wage deductions
- B.
Monthly premiums
- C.
Personal checks
- D.
Electronic funds transfers
- 12.Fees that medicare permits for a particular procedure, service, or supply are called
- A.
UR fees
- B.
Cap limits
- C.
Restrictive fees
- D.
Allowable fees
- 13.The duration of time during which a medicare beneficiary is eligible for part a benefits for inpatient hospital or skilled nursing facility charges is called a/an
- A.
Time period
- B.
Limiting phase
- C.
Benefit period
- D.
Episode of care
- 14.Medicare part d began in
- A.
1965
- B.
1996
- C.
2002
- D.
2006
- 15.The term used when medicare is not responsible for paying first because of coverage under another insurance policy is
- A.
Medigap
- B.
Medi-medi
- C.
Supplemental payer
- D.
Medicare secondary payer (MSP)
- 16.When a service or procedure meets medicares criteria for coverage, it is said to be
- A.
Eligible
- B.
Qualifying
- C.
Medically necessary
- D.
An entitlement
- 17.When it is likely the medicare will not pay for a service or procedure, that patient should be asked to sign a/an
- A.
ABN
- B.
Cms-1500
- C.
Release of information
- D.
Assignment of benefits
- 18.Medicares fee schedule is based on a system whereby each payment value is found within a range of payments known as
- A.
OOPS
- B.
RBRVS
- C.
Fee for service
- D.
Usual, customary, and reasonable
- 19.Insurance coverage that is typically primary to medicare includes all of the following except
- A.
Medicaid
- B.
Group health plans
- C.
Workers compensation
- D.
Automobile liability insurance
- 20.When a medicare claim is filed, the beneficiary receives a document explaining the claim adjudication called a/an
- A.
SPRA
- B.
MSN
- C.
ABN
- D.
EOB
- 21.Beneficiaries who are not satisfied with the amount of a claim reimbursement may file a/an
- A.
Secondary claim
- B.
Grievance
- C.
Appeal
- D.
ABN
- 22.There are ______ levels to the medicare appeals process
- A.
Three
- B.
Five
- C.
Seven
- D.
Ten
- 23.Medicare payments can be automatically deposited into a providers designated bank account using
- A.
Money orders
- B.
Cashiers checks
- C.
Certified deposits
- D.
Electronic funds transfers
- 24.Studies performed to improve the processes and outcomes of patient care are called
- A.
Appeals
- B.
Peer reviews
- C.
Redeterminations
- D.
Quality review studies
- 25.The act that established quality standards for all laboratory testing to ensure safety, accuracy, reliability, and timeliness is
- A.
CLIA
- B.
LMRP
- C.
EMTLA
- D.
COBRA
Questions: 100 | Attempts: 2848 | Last updated: Aug 18, 2016
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