MEDICARE
Another word for Supplement Plans
What is Medigap Plans?
Medicaid is the same in every state (T/F)
False
Set Amount a Patient pays at doctors office
What is a Copay?
What is an Prior Authorization?
A Prior Authorization
What is need for HMO plans?
No Out-of-Network cost for the patient/member if purchased
What is Medigap Plan F
Arizona Medicaid
What is Arizona Health Care Cost Containment System (AHCCCS)?
Once this is met the insurance will pay 100%
What is an Out-of-Pocket Max?
Medicare, Medicaid, and HMO Plans
Filling the CMS1500 or E-CMS1500
What is using caps when filling out CMS1500?
100% Coverage after Deductible is met every Year
What is Medigap Plan G
California Medicaid
What is Medi-Cal?
A person can have for 18 months after loosing a job
What is COBRA?
What type of insurance does not usually need Prior Authorizations?
Signature on File
What to place instead of a patient and guarantor name on field 12 and 13?
Works as similar to Commercial Insurance
What is Medicare Advantage or Plan C?
Who is the largest demographics for Medicaid?
Assists patients with Medicare costs
What is a Medicare Savings Program?
inpatient hospitalizations, new or experimental procedures, and certain diagnostic studies
Who will usually will ask for a prior authorizations?
Office Ally
What is an electronic claim?
Pays 80% of Medical Bill
What is Medicare Plan B Coinsurance?
Federal Government pays 70% of the cost
What is the Federal portion of Arizona Medicaid?
Pays for Medicare Premium and patient must apply annually
What is MSP QI?
emergency services, but they require a follow-up with the insurance company
What services do NOT need Prior Authorizations?
CMS1500 PDF Filler
What is a paper claim?