Show:
1-5
6-10
11-15
16-20
21-25
100
What percentage of the fee on the Medicare NonPAR Fee Schedule is the limiting charge? A. 115 percent B. 100 percent C. 85 percent D. 80 percent
What is A. 115 percent
100
If a Medicare PAR physician thinks that a planned procedure will not be found medically necessary by Medicare and so will not be reimbursed, the patient should be asked to sign a A. advance beneficiary notice B. notice of exclusions from Medicare benefits C. Medicare Summary Notice D. Medicare waiver
What is A. advance beneficiary notice
100
The modifier GY is appended to procedure codes for noncovered Medicare services when: A. the item is expected to be denied and there is a signed ABN B. the item is expected to be denied as not reasonable but there is not a signed ABN C. the item is excluded and an ABN is not required
What is C. the item is excluded and an ABN is not required
100
An easy to perform low-risk lab test that can be performed by CLIA in the physician's office is called a A. rapid strep test B. waived test C. incident-to test D. roster test
What is B. waived test
100
. In general, Medicare requires claims to be filed no later than the end of the calendar year following the year of service. If a service is provided on June 30, 2009, when must the claim be filed by? A. June 30, 2010 B. December 31, 2010 C. December 31, 2009
What is B. December 31, 2010
200
86. Anyone over age 65 who receives Social Security benefits is automatically A. enrolled in Medicare Part A B. eligible for Medicare Part B C. both a and b D. neither a nor b
What is C. both a and b
200
If a Medicare PAR physician knows that a planned procedure (such as a screening test) is not covered under Medicare and so will not be reimbursed, the patient may be asked to sign a A. advance beneficiary notice B. notice of exclusions from Medicare benefits C. Medicare Summary Notice D. Medicare waiver
What is A. advance beneficiary notice
200
Which program under Medicaid offers health insurance coverage for uninsured children? A. FMAP B. TANF C. SCHIP D. EPSDT
What is C. SCHIP
200
The Medicaid program is jointly funded by the federal government and A. local townships B. state governments C. state capitols D. Medicaid regional carriers
What is B. state governments
300
. People who are over age 65 but who are not eligible for free Part A coverage may enroll by A. paying a deductible B. paying a premium C. paying into a Medical Savings Account D. enrolling in a Medicare HMO
What is B. paying a premium
300
Services supervised by the physician but provided by nonphysician practitioners are billed under A. clinical lab rules B. incident-to rules C. Medicare Part A D. Medicare Part C
What is B. incident-to rules
300
Medicare generally requires claims to be filed no later than the end of the calendar year following the year of service. An exception is for services provided during the last three months of the year, which count as they were done during the next year. If a service is provided on October 30, 2009, when must the claim be filed by? A. October 30, 2010 B. December 31, 2010 C. December 31, 2009 D. December 31, 2011
What is D. December 31, 2011
300
Which program under Medicaid offers financial assistance for people with low incomes and few resources? A. FMAP B. TANF C. SCHIP D. EPSDT
What is A. FMAP
300
Which of the following assets must be taken into account to determine Medicaid eligibility? A. money in bank accounts B. stocks and bonds C. cash surrender value of life insurance D. all of these
What is D. all of these
400
Under the Medicare program, if the approved amount for a procedure is $100, the participating physician will be paid $100 (by Medicare and the patient), and the nonparticipant who accepts assignment will be paid A. $115 B. $100 C. $95 D. $80
What is C. $95
400
The modifier GZ is appended to procedure codes for noncovered Medicare services when: A. the item is expected to be denied but there is a signed ABN B. the item is expected to be denied as not reasonable but there is not a signed ABN C. the item is excluded and an ABN is not required
What is B. the item is expected to be denied as not reasonable but there is not a signed ABN
400
A program that provides incentives for physicians who log their patient care performance on predetermined health factors is called A. Advance Beneficiary Notice B. False Claim act notice C. Physician Quality Reporting Initiative D. Notice of Exclusions from Medicare Benefits
What is C. Physician Quality Reporting Initiative
400
Under which program does the federal government send Medicaid funding to states? A. FMAP B. TANF C. SCHIP D. EPSDT
What is A. FMAP
400
If people receive employment income, what is the effect on eligibility for Medicaid? A. They cannot be eligible B. They may qualify, depending on the income amount C. They automatically qualify D.T hey are dual eligibles
What is B. They may qualify, depending on the income amount
500
Under the Medicare program, a nonparticipating physician may not bill more than 115 percent of A. the Medicare approved amount from the MFS B. the approved charge on the nonPAR fee schedule C. either a or b, whichever is lower D. neither a nor b
What is B. the approved charge on the nonPAR fee schedule
500
The modifier GA is appended to procedure codes for noncovered Medicare services when: A. the item is expected to be denied and there is a signed ABN B. the item is expected to be denied as not reasonable but there is not a signed ABN C. the item is excluded and an ABN is not required
What is A. the item is expected to be denied and there is a signed ABN
500
All laboratory work paid for by Medicare is regulated by A. NPI rules B. HPSA rules C. CLIA rules D. NEMB rules
What is C. CLIA rules
500
Under which program does Medicaid provide preventive services to children under age 21? A. FMAP B. TANF C. SCHIP D. EPSDT
What is D. EPSDT
500
. Most states have moved Medicaid beneficiaries into which type of plan? A. fee for service B. health savings accounts C. managed care plans D. None of these
What is C. managed care plans