Exam 13: Medicaid Medical Billing

The cost of Medicaid benefits has been decreasing rapidly since the 1990s.

The goal of the Children's Health Insurance Program Reauthorization Act (CHIPRA) is to expand Medicaid eligibility to more:

In a Medicaid managed care plan, the role of the care coordinator is to do all the following EXCEPT:

Eligibility for Temporary Assistance for Needy Families (TANF) is determined by the:

For a dependent 6-year-old child, form locator 6 should indicate that the patient's relationship to the insured is:

If a Medicaid patient is on restricted status when eligibility is verified, the patient is required to:

Claims filed by a hospital for inpatient services must be received by Medicaid within 95 days of the discharge date.

A copayment may NOT be collected from a Medicaid patient for:

Medicaid is paid for by:

If a claim is denied by Medicaid because prior authorization was NOT obtained, the physician can bill the patient for the services.

The program that provides states with grants to be spent on time-limited cash assistance to low-income families is called ________.

Healthcare Common Procedure Coding System (HCPCS) codes are required on both Medicaid physician and hospital claim forms.

States determine the amount and duration of Medicaid services and can set limits based on medical diagnoses or conditions.

Match the following: -An amount paid by the federal government to states to cover the cost of Medicaid services

To be considered for payment, Medicaid claims for inpatient services must be received within:

To be considered for payment, a denied Medicaid claim must be appealed within 60 days of the date of denial notification.

If Medicaid does NOT cover a service, under what conditions can a provider bill the patient?

Medicaid patients enrolled in managed care plans must select a primary care provider.

To qualify for federal matching funds for the medically needy, states must include coverage for:

Mandatory Medicaid services include coverage for: