Medicare
Can We handle Medicare files that start with a “3”
No
This type of health plan is provided through a private non government employer and is funded by contributions from the employee and employer. It is a finite "pot" of money.
What is ERISA Self-Funded?
This United States Supreme Court case is the most important case in regards to Medicaid lien resolution because it established that Medicaid could only recover for the portion of the settlement intended to compensate for medical expenses.
What is Arkansas Dept. Of Health v. Ahlborn.
This 2020 album, featuring tracks like "Cardigan" and "Exile," marked a shift to indie folk and alternative rock for Taylor Swift
What is Folklore?
This 8 foot tall furry alien is best friends with Han Solo
Who is Chewbacca?
You are given a file where CMS is taking all the settlement after fees and costs and all the claims on the Final Demand are related to the case. The IP has many assets and is well off. What are your suggestions to the PA for moving forward?
A compromise request or best interest of the program request
This type of health plan is provided through a private non government employer and funded through premium payments as it is an insurance contract.
What is a fully insured health plan?
The acronym is MCO
What is a Managed Care Organization?
This six-second app gave us unforgettable memes, including "What are those?!," and a kid yelling "Lebron James."
What is Vine?
Harry Potter received this broomstick in Harry Potter and the Philosopher’s Stone.
What is The Nimbus 2000
You receive a Tobacco case and are preparing to submit a dispute. What are you doing differently when submitting the dispute on this case?
Submit the disputes to Dee Dee and not through the CMS portal
This document is generally considered to be the governing document for an ERISA Self-funded plan.
What is a Master plan?
We do not handle this type of Medicaid lien
What is a Medicaid estate lien
This 2012 song by Psy became the first YouTube video to surpass 1 billion views and made an invisible horse dance a global trend.
What is Gangnam Style?
Professor McGonagall teaches this class
Transfiguration
You check the portal and see the lien amount is small, and all claims are for years after the DOI. We do not have any open companion files. What would be your suggestion to the PA?
You should check with the PA if the IP had any other insurance that would have paid accident related claims from the doi to when your claims begin (Med Adv, etc.)
A government employee health plan or a Church Plan would not be subject to this legislation.
What is ERISA?
In this state we argue that a MCO does NOT have the same recovery rights as the state Medicaid office.
What is Florida?
This 2008 superhero movie directed by Christopher Nolan introduced Heath Ledger’s chilling portrayal of the Joker
What is The Dark Knight?
This dragon was a one time pet for Hagrid
Norbert
A PA inquires about wrongful death case and if he can get the lien waived. What three documents will CMS request be provided.
1. Complaint (the original and any amendments)
2. Release
3. Court Order
This doctrine requires that a person recover all of their damages before a health plan has a right of subrogation or reimbursement.
What is the made whole or full compensation doctrine.
Theses entities jointly fund the Medicaid Program
State and Federal Government
In 2024, this rapper stole the spotlight from the Super Bowl by dropping a brutal diss track aimed at Drake, making the internet collectively forget the big game was even happening.
Who is Kendrick Lamar?
"That's no Moon"
What is the Death Star or a space station