Medicare medicaid plans - Study guides, Class notes & Summaries

Ahip 2024 module 3 Practice Questions and Answers 100% Pass Which of the following statements about Medicare Part D are correct? - Correct Answer ️️ -I, II, and III only -I. Part D plans must enroll any eligible beneficiary who applies regardless of health status except in limited circumstances. II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network but may choose to have one. III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only...

Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by (Ans- The Medicare Administrative Contractor (MAC) at the end of the hospice cap period Which of the following is required for participation in Medicaid (Ans- Meet Income and Assets Requirements In choosing a setting for patient financial discussions, organizations should first and foremost (Ans- Respect the patients privacy A nightly room charge will be incorrect if the patient's ...

Steps used to control costs of managed care include: correct answers Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify correct answers Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage correct answers HMO Conventional PPO and POS HDHP/SO plans - high-deductible health...

Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well, but it provides no drug coverage. She would like to keep the coverage she has but replace her existing Medigap plan with one that provides drug coverage. What should you tell her? correct answersMrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she could keep her Medigap policy and enroll in a Part D prescription drug plan. Mrs. Chen will be 65 soon, has been a citizen for twelve years, has bee...

AHIP - Final Examination (Latest Update 2022) Mr. Zachow has a condition for which three drugs are available. He has tried two but had an allergic reaction to them. Only the third drug works for him and it is not on his Part D plan's formulary. What could you tell him to do? - Mr. Zachow has a right to request a formulary exception to obtain coverage for his Part D drug. He or his physician could obtain the standardized request form on the plan's website, fill it out, and submit it to his ...

Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell him?correct answersHe may sign-up for Medicare at any time however coverage usually begins on the fourth month after dialysis treatments start. Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated. Smallcap has a workforce of15 emplo...

1. Milton is retiring on his 65th birthday. He is eligible for Medicare and already receives Social Security benefits. How does he enroll in Original Medicare? -He can only sign up for Medicare Parts A and/or B at his local Social Security office. -He can sign up for Medicare Parts A and/or B with any licensed insurance agent. -His enrollment in Medicare Parts A and B is generally automatic if he meets all eligibility requirements -He must enroll in Medicare Parts A and B through his current...

Edward IP suffered from serious kidney disease. As a result. Edward became eligible for Medicare coverage due to end-stage renal disease (ESRD). A close relative donated their kidney and Edward successfully underwent transplant surgery 12 months ago. Edward is now age 50 and asks you if his Medicare coverage will continue, what should you say? - ANSWER Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the month in which the individual receives a kidney tr...

Final Exam: NURS 6540/ NURS6540 Test Bank | Advanced Practice Care of Frail Elders| More than 200 Questions and Answers with Rationales | Complete Guide| Verified 2023/2024 1. Mrs. Keating is a 70-year-old woman suffering from arthritis. She is seeing the nurse practitioner for her regular checkup. For a person with chronic degenerative conditions, which of the following should the nurse suggest for health promotion? 1. Take herbal supplements. 2. Increase physical activity. 3. Take ...

NRNP 6675-15; NRNP 6675 Week 6 Midterm Exam 2022 100% solved -Graded A+   NRNP 6675-15; NRNP 6675 Week 6 Midterm Exam 2022 100% solved -Graded A+ 1. Which of the following are risk factors for neuroleptic malignant syndrome? Select all that apply Age Rapid dose escalation Parental route of administration Higher potency typical antipsychotics 2. Antipsychotic medications provide D2 blockade in the mesocortical pathway causing which of the following effects? Reduces negative symptoms Increases e...