Medicare beneficiary Study guides, Class notes & Summaries

HFMA CRCR (ACTUAL) EXAM | 170 QUESTIONS AND VERIFIED SOLUTIONS 2024/2025 IF outpatient diagnostic services are provided within three days of the admission of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to these charges - CORRECT ANSWER- They must be billed separately to the part B Carrier what is a recurring or series registration? - CORRECT ANSWER- One registration record is created for multiple days of service What are nonemergen...

Xcel solutions final exam Maryland Life and health questions and answers 100% pass What is normally the consequence for NOT obtaining preadmission certification prior to receiving inpatient medical care? A reduction in benefits A group-owned insurance company that is formed to assume and spread the liability risks of its members is known as a Risk retention group During the application process, a statement made by an applicant that becomes part of the contract is considered to be a(n) Warrant...

CRCR EXAM WITH CORRECT CHOICES, CERTIFIED AND VERRIFIED What are collection agency fees based on? - CORRECT ANSWER-A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - CORRECT ANSWER-Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - CORRECT ANSWER-Case rates What customer service improvements might improve the patie...

Employer health plans must provide primary coverage for individuals with end-stage renal disease before medicare becomes primary care for how many months? - Answer- 30 months the sole beneficiary of a life insurance policy dies before the insured. the policy will then go to? - Answer- The insured's estate An insured buys a 5-year level premium term policy with a face amount of $100,000. The policy also contains renewability and convertibility options. When the insured renews the policy in...

AHIP 2024 Exam 3 | A++ Exam with All New Qs & As - Guaranteed Pass! 1. Mr.Wells is trying to understand the difference between Original Medicareand Medicare Advantage. What would be the correct description? Answer: Medicare Advantage is a way of covering all the Original Medicare benefits through private health insurance companies. 2. Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but is not sure about what type of plan designs are available through...

Florida 2-15 Insurance Final Exam Test Bank (All Chapters complete 1-30, Questions and Answers, 100% Verified) Latest 2023/2024 1. A life insurance company is organized in Orlando where it maintains its home office. In Florida, the company is classified as a a. domestic company b. local company c. foreign company d. preferred company a 2. With regard to life insurance, all of the following statements are correct EXCEPT a. all individuals are considered to have insurable interests i...

(The correct answer has been verified, selected and highlighted in yellow for all of the questions below.) 1 What form is used to submit a provider’s charge to the insurance carrier? a. ABN b. UB-04 c. CMS-1500 d. Provider reimbursement form 2 AAPC credentialed coders have proven mastery of what information? a. Code sets b. Evaluation and management principles c. Documentation guidelines d. All of the above 3 When coding an operative report, what action would NOT be recommended? a....

Part A and Part B. 4 Marks: 1 Mrs. Roswell is a new Medicare beneficiary and is interested in selecting a Medicare Part D prescription drug plan. She takes a number of medications and is concerned that she has not been able to identify a plan that covers all of her medications. She does not want to make an abrupt change to new drugs that would be covered and asks what she should do. What should you tell her? Choose one answer. a. Every Part D drug plan is required to cover a single...

Which of the following laws requires an insurer to notify an applicant in writing that an investigative consumer report may be made on the applicant? -Uniform Provisions Law. -Freedom of Information Act. -Medical Information Bureau Disclosure Act -Fair Credit Reporting Act (Insurance Information and Privacy Protection Act) correct answers Fair Credit Reporting Act (Insurance Information and Privacy Protection Act) Group health insurance specifies that what percentage of eligible individua...

Which of the following Medicare policies determines if a particular item or service is covered by Medicare? - CORRECT ANSWER National Coverage Determination (NCD) A patient's employer has not submitted a premium payment. Which of the following claim statuses should the provider receive from the third-party payer? - CORRECT ANSWER Denied A billing and coding specialist should routinely analyze which of the following to determine the number of outstanding claims? - CORRECT ANSWER Agin...