Claim Game & Billing Bonanza
HCI Confidential...Until Now
Don't Mess with My TennCare
Medicaid History -
From LBJ to...
Rocky Top...or Rocky Bottom? State of Tennessee Facts
100
Paper claim for physician services.
What is CMS-1500?
100

Who is the resident plant whisperer around here? 

Wajehah

100

What is the approximate number of TennCare recipients (within 25K)?

1.41 million

100

Why is CMS located in Baltimore instead of Washington, D.C.?

The Social Security Administration is located in Baltimore.

100

Why is Tennessee called the Volunteer State?

The name came from so many soldiers volunteering for the War of 1812.

200
Currently mandated paper claim for hospital billing.
What is UB-04 (Uniform Billing 2004)?
200

This Erie, PA native may have marched to a different beat in high school, tooting their own horn in the marching band.

Jim

200

What is TennCare's approximate annual budget?

$14 billion

200

In 1965, what was referred to as President Johnson's three-layer cake?

Medicare Part A, Medicare Part B, and Medicaid

200

Tennessee is the birthplace of many consumable products. Name two.

Mountain Dew, RC Cola, cotton candy, Moon Pie, Goo Goo Clusters, Maxwell House Coffee, Bush's Baked Beans, Little Debbie Snack Cakes, Prince's Hot Chicken, Memphis-style Barbecue, Jack Daniel's Tennessee Whiskey, and George Dickel Tennessee Whiskey, among others.

300
The electronic claim format for facilities
What is 837-I?
300

This individual may have traded in their salsa shoes for a keyboard, but they could still show you how to move to a Latin beat from their days on the University of Miami salsa dance team.

Juan

300

What percentage of births in TN does TennCare pay for?

58%

300

Home and community-based care waivers in the Medicaid program were enacted into law in what year?

1981 

In an effort to improve services to nursing-home eligible Medicaid beneficiaries who wanted to continue to live at home, home- and community-based service waivers were made available to states.

300

Tennessee is tied with Missouri for having the most state borders (8). Name at least 5.

Kentucky, Virginia, Georgia, Mississippi, Alabama, North Carolina, Arkansas, and Missouri.

400
The electronic claims form used for professionals
What is 837-P?
400

This individual might have dropped the mic on a triple major in Physics, Math, and Music, but they still rock out to their love of melodies.

Gilma

400

What does the most recent years data indicate TennCare member satisfaction is?

95%

400

What agency originally administered Medicaid?

The Social and Rehabilitative Service (SRS) administered Medicaid from 1965 until 1977. In 1977, Secretary Joseph Califano reorganized the Department of Health, Education, and Welfare (HEW) and created the Health Care Financing Administration.

400

Four cities in Tennessee have served as the state capital since it became the 16th state in 1796. What are they?

Nashville (2x), Knoxville, Kingston (1 day), Murfreesboro

500
Claims submitted by people covered by a primary and secondary insurance plan
What is a cross-over claim?
500

Hillbilly History - whose family lineage is pitted against country music legend Dwight Yoakam being able to trace their roots back to the infamous Hatfield clan.

Susannah

500

What expenditure segment accounts for the largest percentage in the FY24 TennCare budget?

Clinical Services - 72.9%

500

What was the purpose of joining Medicare and Medicaid in the Health Care Financing Administration?  

1) Move away from a two-class system of healthcare

2) Get the administrative capacity in hand and in order, ready for national health insurance

3) Improve staffing and management of Medicaid

500

Which city is Tennessee's secret city and why?

Oak Ridge for its Manhattan Project atomic bomb research and testing.