What type of insurance is paid for by employers and takes advantage of purchasing power of
having large member numbers? - answer✔Group health plan
An internist sees a 20-year-old patient for an office visit. The patient needs to see an
endocrinologist for a consultation regarding her diabetes. The internist is a participating provider
in her plan. She can choose any provider she wishes for her consultation, but she will save
money if she sees a specialist that is in her network. She does not require a referral for her
consultation. What type of insurance does the patient have? - answer✔PPO
What are the options for a provider with regard to participation with Medicare? -
answer✔Providers may participate, may choose not to, or can op-out
A family practitioner sees a Medicare patient and bills a 99213. This provider has opted-out of
Medicare. His fee for the service is $125.00. Medicare's approved amount is $73.08, and the
patient has met $0 of his deductible. What can the provider bill the patient? - answer✔$125.00
Under the Patient Protection and Affordable Care Act, what was banned - answer✔Lifetime
Limits
What does ACA stand for? - answer✔Affordable Care Act
At what age are you eligible for Medicare Part A? - answer✔65
What is Medicare Part A? - answer✔Covers inpatient hospital care, as well as care provided in
skilled nursing facilites, hospice care, and home health care
What is Medicare Part b? - answer✔Covers medically necessary doctors' services, outpatient
care, DME, Mental health Services, ambulance services
What is Medicare Part C? - answer✔Medicare Advantage Plans - private plans
What is Medicare Part D? - answer✔Prescription drug coverage
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