Question 1

Medicare is considered the primary payer when an individual age 65 or older:

Accepted Answer

A)  is eligible for coverage through the Veterans Administration. 
B)  receives treatment for an accident-related claim. 
C)  fails to apply for end-stage renal disease (ESR
D) -based coverage. 
D)  is covered by another policy that is NOT a group policy. 
A)  is eligible for coverage through the Veterans Administration. 
B)  receives treatment for an accident-related claim. 
C)  fails to apply for end-stage renal disease (ESR
D) -based coverage. 
D)  is covered by another policy that is NOT a group policy. D

Question 2

Match the following

-The portion of Medicare that provides prescription drug coverage

Accepted Answer

A)  Medicare Development Letter 
B)  coordination of benefits contractor 
C)  Medicare abuse 
D)  Medicare Part B 
E)  Medicare contractor
F) Medicare secondary payer
G) Advance Beneficiary Notice (ABN)
H) Medigap
I) Medicare Part D
J) Medicare Part A 
A)  Medicare Development Letter 
B)  coordination of benefits contractor 
C)  Medicare abuse 
D)  Medicare Part B 
E)  Medicare contractor
F) Medicare secondary payer
G) Advance Beneficiary Notice (ABN)
H) Medigap
I) Medicare Part D
J) Medicare Part A I

Question 3

Knowingly and willfully executing a scheme to defraud any healthcare benefit program is considered ________.

Accepted Answer

fraud.

Question 4

For a service to be considered medically necessary by Medicare, which of the following criteria must be met?

Accepted Answer

A)  It is delivered at the most appropriate level. 
B)  It is an elective procedure. 
C)  It is an investigational procedure. 
D)  It is performed for the patient's convenience. 
A)  It is delivered at the most appropriate level. 
B)  It is an elective procedure. 
C)  It is an investigational procedure. 
D)  It is performed for the patient's convenience.

Question 5

Notices sent to physicians on a regular basis that contain detailed and updated information about the coding and medical necessity of a specific service are ________ Determinations.

Accepted Answer

The answer of Notices sent to physicians on a regular...

Question 6

The Medicare program is administered by the Centers for Medicare and Medicaid Services (CMS), a division of the United States Department of Health and Human Services.

Accepted Answer

A) True 
 B)False

Question 7

Routinely waiving coinsurance and/or deductibles for Medicare patients when the patient has the ability to pay is considered abuse.

Accepted Answer

A) True 
 B)False

Question 8

An additional health insurance policy sold by a private carrier that provides limited coverage for services that Medicare does NOT cover is known as a:

Accepted Answer

A)  Medicare Part C plan. 
B)  Medicare secondary plan. 
C)  Medicaid plan. 
D)  Medigap plan. 
A)  Medicare Part C plan. 
B)  Medicare secondary plan. 
C)  Medicaid plan. 
D)  Medigap plan.

Question 9

Only Medicare participating providers are required to file claims on behalf of Medicare patients.

Accepted Answer

A) True 
 B)False

Question 10

Medicare Part D consists of:

Accepted Answer

A)  home healthcare coverage. 
B)  wellness coverage. 
C)  prescription drug coverage. 
D)  long-term care coverage. 
A)  home healthcare coverage. 
B)  wellness coverage. 
C)  prescription drug coverage. 
D)  long-term care coverage.

Question 11

Nonparticipating providers who collect amounts from patients in excess of the limiting charge are subject to financial penalties.

Accepted Answer

A) True 
 B)False

Question 12

Hearing aids are NOT routinely covered by Medicare.

Accepted Answer

A) True 
 B)False

Question 13

Coverage for hospice care is provided by:

Accepted Answer

A)  Medicare Part A. 
B)  Medicare Part B. 
C)  Medicare Part D. 
D)  Medicare Advantage (M
A) . 
A)  Medicare Part A. 
B)  Medicare Part B. 
C)  Medicare Part D. 
D)  Medicare Advantage (M
A) .

Question 14

Organizations that are hired by the CMS to carry out day-to-day Medicare program operations are known as:

Accepted Answer

A)  administrators. 
B)  contractors. 
C)  intermediaries. 
D)  carriers. 
A)  administrators. 
B)  contractors. 
C)  intermediaries. 
D)  carriers.

Question 15

When Medicare is the secondary payer, a copy of the primary insurance remittance notice must be submitted with the claim.

Accepted Answer

A) True 
 B)False

Question 16

If a veteran is entitled to Medicare benefits, he or she may choose whether to receive coverage through Medicare or through the Veterans Administration.

Accepted Answer

A) True 
 B)False

Question 17

The Medicare Part B premium is determined by the patient's annual income.

Accepted Answer

A) True 
 B)False

Question 18

Match the following

-The use of Medicare funds to pay for items or services when the provider is NOT legally entitled to this payment but has NOT deliberately committed fraud

Accepted Answer

A)  Medicare Development Letter 
B)  coordination of benefits contractor 
C)  Medicare abuse 
D)  Medicare Part B 
E)  Medicare contractor
F) Medicare secondary payer
G) Advance Beneficiary Notice (ABN)
H) Medigap
I) Medicare Part D
J) Medicare Part A 
A)  Medicare Development Letter 
B)  coordination of benefits contractor 
C)  Medicare abuse 
D)  Medicare Part B 
E)  Medicare contractor
F) Medicare secondary payer
G) Advance Beneficiary Notice (ABN)
H) Medigap
I) Medicare Part D
J) Medicare Part A

Question 19

What is Medicare Part D?

Accepted Answer

Medicare Part D prov

Question 20

In which of the following cases involving a patient who is age 65 or older is Medicare considered the primary payer?

Accepted Answer

A)  The patient's condition is the result of an automobile accident. 
B)  The patient works for an employer with 20 or fewer employees. 
C)  The patient has group health insurance through a working spouse. 
D)  The patient's injury or condition is covered by workers' compensation. 
A)  The patient's condition is the result of an automobile accident. 
B)  The patient works for an employer with 20 or fewer employees. 
C)  The patient has group health insurance through a working spouse. 
D)  The patient's injury or condition is covered by workers' compensation.

Medicare is considered the primary payer when an individual age 65 or older:

Match the following -The portion of Medicare that provides prescription drug coverage

Knowingly and willfully executing a scheme to defraud any healthcare benefit program is considered ________.

For a service to be considered medically necessary by Medicare, which of the following criteria must be met?

Notices sent to physicians on a regular basis that contain detailed and updated information about the coding and medical necessity of a specific service are ________ Determinations.

The Medicare program is administered by the Centers for Medicare and Medicaid Services (CMS), a division of the United States Department of Health and Human Services.

Routinely waiving coinsurance and/or deductibles for Medicare patients when the patient has the ability to pay is considered abuse.

An additional health insurance policy sold by a private carrier that provides limited coverage for services that Medicare does NOT cover is known as a:

Only Medicare participating providers are required to file claims on behalf of Medicare patients.

Medicare Part D consists of:

Nonparticipating providers who collect amounts from patients in excess of the limiting charge are subject to financial penalties.

Hearing aids are NOT routinely covered by Medicare.

Coverage for hospice care is provided by:

Organizations that are hired by the CMS to carry out day-to-day Medicare program operations are known as:

When Medicare is the secondary payer, a copy of the primary insurance remittance notice must be submitted with the claim.

If a veteran is entitled to Medicare benefits, he or she may choose whether to receive coverage through Medicare or through the Veterans Administration.

The Medicare Part B premium is determined by the patient's annual income.

Match the following -The use of Medicare funds to pay for items or services when the provider is NOT legally entitled to this payment but has NOT deliberately committed fraud

What is Medicare Part D?

In which of the following cases involving a patient who is age 65 or older is Medicare considered the primary payer?

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Hcpcs Coding and Compliance

Auditing

Physician Medical Billing

Hospital Medical Billing

Medicaid Medical Billing

Tricare Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Workers Compensation

Filters

Exam 12: Medicare Medical Billing

Medicare is considered the primary payer when an individual age 65 or older:

Match the following -The portion of Medicare that provides prescription drug coverage

Knowingly and willfully executing a scheme to defraud any healthcare benefit program is considered ________.

For a service to be considered medically necessary by Medicare, which of the following criteria must be met?

Notices sent to physicians on a regular basis that contain detailed and updated information about the coding and medical necessity of a specific service are ________ Determinations.

The Medicare program is administered by the Centers for Medicare and Medicaid Services (CMS), a division of the United States Department of Health and Human Services.

Routinely waiving coinsurance and/or deductibles for Medicare patients when the patient has the ability to pay is considered abuse.

An additional health insurance policy sold by a private carrier that provides limited coverage for services that Medicare does NOT cover is known as a:

Only Medicare participating providers are required to file claims on behalf of Medicare patients.

Medicare Part D consists of:

Nonparticipating providers who collect amounts from patients in excess of the limiting charge are subject to financial penalties.

Hearing aids are NOT routinely covered by Medicare.

Coverage for hospice care is provided by:

Organizations that are hired by the CMS to carry out day-to-day Medicare program operations are known as:

When Medicare is the secondary payer, a copy of the primary insurance remittance notice must be submitted with the claim.

If a veteran is entitled to Medicare benefits, he or she may choose whether to receive coverage through Medicare or through the Veterans Administration.

The Medicare Part B premium is determined by the patient's annual income.

Match the following -The use of Medicare funds to pay for items or services when the provider is NOT legally entitled to this payment but has NOT deliberately committed fraud

What is Medicare Part D?

In which of the following cases involving a patient who is age 65 or older is Medicare considered the primary payer?

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Hcpcs Coding and Compliance

Auditing

Physician Medical Billing

Hospital Medical Billing

Medicaid Medical Billing

Tricare Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Workers Compensation

Filters