Exam 12: Medicare

A Medicare nonparticipating physician may bill no more than the Medicare ____________________.

A claims assistance professional (CAP)

An explanation of benefits document for a patient under the Medicare program is referred to as the

Scenario: The following questions pertain to a participating physician who bills Medicare $480; Medicare allows $400, and the patient has met the Medicare deductible for the calendar year. -What is the amount of the check that Medicare sends to the physician?

A nonparticipating physician who is not accepting assignment may bill any fee he or she wants.

It is possible for an alien to be eligible for Medicare Part A and Part B.

When a Medicare recipient chooses a Medicare senior plan, he or she forfeits the Medicare card.

When a Medicare carrier transmits a Medigap claim electronically to the Medigap carrier, it is referred to as a/an

If a check is received from Medicare and it is obvious that it is an overpayment, the insurance billing specialist should

In the Medicare program, there is mandatory assignment for

Medicare Part A is called supplementary medical insurance (SMI).

The assignment on a patient with Medicare-Medicaid must always be accepted or Medicaid will not pick up the residual.

The number of Medicare benefit periods a patient can have for hospital care is limited.

Medicare Part A

Patients who elect Medicare Part B coverage pay annually increasing basic premium payments.

Medicare provides insurance for people ____________________ years of age or older who are retired on Social Security.

The time limit for sending in Medicare claims is the end of the calendar year in which professional services were performed.

When Medicare payments are posted to a separate daysheet, what should the daysheet payment total agree with?

The HCPCS national alphanumeric codes are referred to as

The Medicare HCPCS coding system has ____________________ levels.