Medicare Part A
$458
What is Part A premium amount for 2020 if a beneficiary has less than 30 credits?
If you do not sign up for Part B during your initial enrollment period, you may have to pay a ___________
Lifetime Penalty/Part B Late Enrollment Penalty
120 calendar days from the date a beneficiary received the MSN
What is the timeframe to submit a level 1 appeal (Redetermination)?
The view tab used to inform a Medicare Beneficiary how much he currently owes for his Part A and Part B premiums
What is Premiums Summary View Tab?
$1408.00
What is the Medicare Part A deductible for 2020?
Provides relief if you have suffered a financial hardship due to a government error, misrepresentation of program information, delay in Medicare Part B enrollment, premium collection, termination of entitlement, or local emergency or disaster.
Equitable Relief
Type of coordinated care plan that is required to provide all Medicare Part A and Part B covered services, except hospice care. It also typically require you to get a referral from your doctor to see another network provider.
What is Health Maintenance Organization (HMO) Plans
What are ways to file an appeal for Original Medicare Coverage?
The _________________ list applet displays the monthly premium amounts for the current year.
What is the Monthly Premium Amounts?
Health care to prevent or detect illness at an early stage, when treatment is likely to work best. Examples are Pap tests, flu shots, and screening mammograms.
What is Medicare Preventive Services?
Billing cycle code A means the premium payment is due the twenty-fifth of January, April, July, and October.
Billing cycle code B means the premium payment is due the twenty-fifth of February, May, August, and November.
Billing cycle code C means the premium payment is due the twenty-fifth of March, June, September, and December.
What are the 3 quarterly billing cycle codes
You have Medicare Part A and Part B,
You do not have end-stage renal disease,
You live in the plan’s service area, and
You are a US citizen or lawfully present in the United States.
What are the eligibility requirements for a Medicare Advantage Plan?
The 1st phase or Level of the appeals process after the beneficiary receives the MSN (Medicare Summary Notice)
What is Level 1: Redeterminations – Claims contractors?
$458
What is Part A premium amount for 2020 if a beneficiary has less than 30 credits?
Social Security Administration or Railroad Retirement Board
Who enrolls you into Medicare?
3 months before, the month of and 3 months after a beneficiary's 65th birthday.
What is the Initial enrollment Period?
Medicare pays Medicare Advantage plans a set amount of money for each person with Medicare who is enrolled in the plan
What is Medicare Advantage Capitation Rates?
"Can you tell me what what the letter says?"
"Did you file an appeal after receiving your MSN?"
"Do you see anything stating the beneficiary is liable?"
What are probing questions you might ask when receiving a call from a beneficiary that has Redetermination Notice ( Level 1 appeal)?
A beneficiary with an income greater than $109,000 and less than or equal to $136,000 in 2020, would pay $___________ for their part b coverage.
What is $289.20?
Begins the day you're admitted as an inpatient in a hospital or skilled nursing facility. It ends when you haven't received any inpatient hospital care or skilled care in a skilled nursing facility for 60 days in a row.
Benefit Period
Form CMS-500
What is Medicare Premium Bill
This enrollment period allows anyone in a Medicare Advantage (MA) or Medicare Advantage prescription drug (MA-PD) plan to switch MA or MA-PD plans from January 1 to March 31 every year.
What is Medicare Advantage Open Enrollment Period?
Time Frame for Medicare’s Response for an appeal to the Office of Medicare Hearings and Appeals (OMHA)
What is typically within 90 calendar days of receipt of the request?
________ is an________ between Medicare and doctors, other health care providers, and suppliers of health care equipment, such as wheelchairs, oxygen, braces, and ostomy supplies. Doctors, providers, and suppliers who agree to accept ________ agree to the Medicare-approved amount as payment in full for covered Part B services and supplies.
What is assignment?