Medicare
What are the two types or parts of Medicare that most people over 65 qualify for?
Part A & B
What are the 2 types of personal injury cases?
single event & mass tort
Most private plans are what kind of plans that are offered through employment?
ERISA
Medicaid is handled by each individual __________.
state
PI Test stands for what?
Predictive Index
Medicare Global has _____ set amount for all claimants to pay?
one
What are the 3 main types of mass tort cases?
Pharmaceutical, Implantation, exposure
What Medicare plans are treated as private?
Medicare part C & D
Who does Tricare Cover?
Active or retired veterans and their spouse and children/ dependents
MSA Stands for what?
master settlement agreement
Reduction at finalization takes place when using what Medicare route to a settlement? (Global or Traditional)
Medicare Traditional
VOE takes place at what stage in the lien resolution process?
Identify stage
Private health plans assert their rights though law or contracts?
contracts
What needs to be known when working a Tricare case?
The branch of service
What does IHS Stand for?
Indian health services
Who must make payments on liens when using Medicare Global?
Garretson
A third party’s claim to an individuals settlement award is also known as what?
Lien
Companies that are hired on behalf of the insurance companies or health plans are known as what?
Recovery Contractors
What needs to be known when working VA cases?
The treatment facility
PHI stands for?
Protected Health Information
How long does the firm have to pay on the Medicare lien after the final notice has been received?
60 days
What are the milestones or steps in lien resolution?
1. Identify
2. claims
3. Audit
4. Negotiate claims
5. Finalize
6. Payment
What reduction strategy is used when a claimant does not even have enough money in the settlement to pay for their care before even addressing liens?
Made whole doctrine
True or False:
VA coverage applies to honorably discharged veterans and the families of that veteran
False: It only covers the veteran. If the veteran is 100% disabled or deceased then the spouse or dependent are entitled to Champ VA
QPO Stands for?
Qualified Protective Order