Referrals
If a low income bene says he needs help paying his Part B premiums who do you refer him to for assistance?
Medicaid
Name the two pieces of disclosure that are required?
Medicare and Social Security number.
What is Medicaid?
Medicaid is a joint federal and state program that helps pay medical costs for some people with limited incomes and resources.
Who would a beneficiary talk to if they want to appeal an early discharge?
QIO
How many pieces of disclosure are required?
4
What two probing questions help determine if someone is eligible for low income assistance?
Are you single or married?
What is your income each month before any deductions?
Which agency is in charge of make sure that all health care facilities comply with federal health, safety, and quality standards?
State Survey Agency
What is the piece of disclosure you never release?
Address
Which list applet will let us know what Medicare savings program a beneficiary has?
State Program History list applet
A bene calls and says, “I want to file a complaint about my Medigap policy.” Who handles these complaints?
Which part of the address is not required?
If a bene is single and makes more than 1350 but less than 1616, which program may they qualify for?
Specified low-income assistance program (SLMB)
Which agency outside of Medicare can help a beneficiary understand their Medicare coverage options, resolve disputes and understand Medicare bills?
SHIP (State Health Insurance Assistance Program)
Name one action that can be taken without passing disclosure?
Provide General info, order a replacement card, provide referral info, use care compare, report fraud
Name all possible programs that are available to benes who don't qualify for low-income assistance.
Spenddown, State pharmaceutical assistance program, and pharmaceutical assistance program