Tricare for life - Study guides, Class notes & Summaries

CCM WITH COMPLETE SOLUTIONS 100% 2023/2024 HMO health maintenance organization ACO Accountable Care Organization Viatical Settlements ability to sell own insurance policy CHAMPVA Civilian Health and Medical Program of the Veterans Administrationtr CHAMPVA for Life provides healthcare benefits to families of permanently disabled veterans, or killed in line of duty, not eligible for tricare. Covers 65 or older, is a Medicare supplement. TRICARE is a U.S. government ...

A 6 year-old is seen in the pediatrician office for the first time. He has insurance coverage through both his mother (DOB: 02/08/86 and his father (DOB: 05/15/85). Whose insurance is primary? A. Mother's insurance plan B. Father's insurance plan C. The policy that has the best benefits D. Either mother's or father's insurance plan depending who brings the child in for medical care. - A. Mother's insurance plan Which managed care plan has the patient receiving care from participating p...

Which coverage under TRICARE is a Medicare wrap around plan? a. TRICARE for Life b. TRICARE Reserve Select c. TRICARE Prime d. CHAMPVA - ANSWERSa. TRICARE for Life A patient has Medicare and a Medigap policy. Box 13, signature on file, is checked off on the electronic claim submission. An EOMB is received with remittance notice MA19. What does the office need to do? a. Nothing. This means the claim has been crossed over to the Medigap plan. b. The biller must file the secondary insu...

AAPC CPB Practice Exam/ 459 Q&A/ A+ Score Solution/ . When a nonparticipating provider files a claim for a patient to BC/BS, how is the payment processed? A. The payment is sent to the patient and the patient must pay the provider. B. The payment is sent to the provider if the provider agrees to accept assignment. C. The payment is sent to the provider regardless if he accepts assignment. D. The claim is not paid because the provider is not participating in the plan. - Answer: A. Th...

Joe and Mary are a married couple and both carry insurance from their employers. Joe was born on February 23, 1977 and Mary was born on April 4, 1974. Using the birthday rule, who carries the primary insurance for their children for billing? A. Joe, because he is the male head of the household. B. Mary, because her date of birth is the 4th and Joe's date of birth is the 23rd. C. Mary, because her birth year is before Joe's birth year. D. Joe, because his birth month and day are before Mary...

A 6 year-old is seen in the pediatrician office for the first time. He has insurance coverage through both his mother (DOB: 02/08/86 and his father (DOB: 05/15/85). Whose insurance is primary? A. Mother's insurance plan B. Father's insurance plan C. The policy that has the best benefits D. Either mother's or father's insurance plan depending who brings the child in for medical care. Answer A. Mother's insurance plan Which managed care plan has the patient receiving care from pa...

Which coverage under TRICARE is a Medicare wrap around plan? a. TRICARE for Life b. TRICARE Reserve Select c. TRICARE Prime d. CHAMPVA - Answer a. TRICARE for Life A patient has Medicare and a Medigap policy. Box 13, signature on file, is checked off on the electronic claim submission. An EOMB is received with remittance notice MA19. What does the office need to do? a. Nothing. This means the claim has been crossed over to the Medigap plan. b. The biller must file the secondary in...

AAPC CPB Practice Exam (500 Questions, All Answered Correctly) Updated Joe and Mary are a married couple and both carry insurance from their employers. Joe was born on February 23, 1977 and Mary was born on April 4, 1974. Using the birthday rule, who carries the primary insurance for their children for billing? A. Joe, because he is the male head of the household. B. Mary, because her date of birth is the 4th and Joe's date of birth is the 23rd. C. Mary, because her birth year is bef...

AAPC CPB Chapter 11 Review Practice Questions 2024. A Medicare patient presents with an injury sustained at his part-time job. His injury status is verified by his company. After services are rendered, in what order are the claims submitted? a. The worker's compensation is primary, and Medicare is secondary b. Either may be filed first, whichever pays better c. Medicare is primary, and Worker's compensation is secondary d. The patient must pay for services and files claims him...

Joe and Mary are a married couple and both carry insurance from their employers. Joe was born on February 23, 1977 and Mary was born on April 4, 1974. Using the birthday rule, who carries the primary insurance for their children for billing? A. Joe, because he is the male head of the household. B. Mary, because her date of birth is the 4th and Joe's date of birth is the 23rd. C. Mary, because her birth year is before Joe's birth year. D. Joe, because his birth month and day are before...