Insurance MCQ

A Medicare patient signature on an advanced beneficiary notice must be obtained Answer: For all services Medicare does not deem "medically necessary"

What is the statement called that is sent to Medicare patient summarizing the disposition of a claim in layman's terms? Answer: Medicare summary notice

The "birthday rule" helps determine the primary insurance plan Answer: When a child is covered by both parents

Assign consent to release medical information for treatment, payment, and healthcare operations Answer: Is no longer mandated by HIPAA

A "taxonomy code" on a claim form is used to designate Answer: The physicians specialty

For TRICARE patients, a nonavailability statement is needed when a patient lives with in the hospital ZIP Code area and Answer: Non-emergency care is not available

To supplement Medicare, the department of defense offers Answer: TRICARE for Life

State disability insurance is offered in Answer: California, Hawaii, New Jersey, New York, Rhode Island, and Puerto Rico

Patient patient having both Medicare and Medicaid is referred to as Answer: Medi/Medi case

What is the acronym used one another pair is primary to Medicare? Answer: MSP

Eligibility for a TRICARE patient is verified by using Answer: the VRU system + the tricare website

Medicare physicians and practitioners Answer: Can "opt out" of the Medicare program for two years

When examining a Medicare card, which has been presented for services in a physicians office, Be sure the patient has Answer: Part B coverage

To contain cost and prosecute cases of Medicare and Medicaid fraud, what law did the government pass? Answer: Civil Monetary Penalties Law

The Medicaid program is generally for A. low income any individuals b. Members of families receiving a dependent children c. The blind and disabled d. All the above Answer: d. All the above

With healthcare reform Medicare patients who now belong to Medicare advantage plans that are higher incomes will soon Answer: No longer qualify for Medicare

Medicaid is a health assistant program sponsored by Answer: Both state and federal governments

Under which type of managed-care plan can physician see capitated managed care patients in private pay patient and maintain their own offices? Answer: IPA

Healthcare reform ushers that they will no longer be a. Limitations on coverage b. limits for lifetime maximum benefits c. Pre-existing condition clauses d. All the above Answer: d. All of the above

With healthcare reform, parents will be able to keep adult children on their policies until age Answer: 26