Exam 14: Medicaid Medical Billing

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The largest funding for healthcare for America's low-income individuals comes from: A)Medicare. B)Medicaid. C)private insurance. D)individuals.

(Short Answer)
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What are some of the specific services that may be available under Medi-Medi?

(Essay)
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The code ST used in form locator 24H in regard to early and periodic screening, diagnosis, and treatment (EPSDT) services means: A)services were not available. B)services were available and used. C)new services were requested. D)services were available but not authorized.

(Short Answer)
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If a Medicaid claim was NOT filed within the required time limits because of an error or neglect on the part of the medical office staff, the physician can appeal the denial and seek payment.

(True/False)
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States determine the amount and duration of Medicaid services and can set limits based on medical diagnoses or conditions.

(True/False)
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Providers participating in Medicaid must accept the Medicaid payment rate as payment in full and cannot balance-bill the patient.

(True/False)
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Medicaid patients enrolled in managed care plans must select a primary care provider.

(True/False)
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Eligibility for Temporary Assistance for Needy Families (TANF) is determined by the: A)city. B)county. C)state. D)nation.

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Due to the Affordable Care Act of 2010, millions more low-income Americans will be eligible for Medicaid coverage as of: A)2013. B)2014. C)2015. D)2016.

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A physician may bill a Medicaid patient for services if the: A)service was not medically necessary. B)patient signed an advance beneficiary notice (ABN). C)claim was not filed in a timely manner. D)necessary preauthorization was not obtained.

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Those Medicaid beneficiaries who are excluded from cost-sharing provisions include: A)the blind. B)the elderly. C)pregnant women. D)the disabled.

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