PT 833 Medicare Reimbursement Exam Questions With Correct Answers.
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Course
PT 833
Institution
PT 833
T 833 Medicare Reimbursement Exam
Questions With Correct Answers.
What 3 criteria must be met in order to be reimbursed by Medicare? - Answer1. Through
supportive documentation
2. Doctor's prescription/referral with appropriate ICD code
3. Filing claims within window period
What is the defini...
PT 833 Medicare Reimbursement Exam
Questions With Correct Answers.
What 3 criteria must be met in order to be reimbursed by Medicare? - Answer✔1. Through
supportive documentation
2. Doctor's prescription/referral with appropriate ICD code
3. Filing claims within window period
What is the definition of Medicare? - Answer✔Health insurance program for individuals 65 and
over, people under 65 who are disabled and persons of all ages who have ESRD or ALS
How do you automatically qualify for Medicare Part A at at retirement age? What is the cost? -
Answer✔If you qualify for Social Security at 65 yo, then you have paid into Medicare through
Medicare taxes (FICA)
Will be provided service at no cost
Can you receive Medicare if you retire at 62 yo? - Answer✔No, even though you can retire early
at 62 yo to collect Social Security you cannot access Medicare benefits until 65 yo
When do you begin to receive Medicare once you are 65 yo? - Answer✔1st day of your birthday
month (ex. birthday is Jan 15--will receive benefit Jan 1)
What is the window period for notifying Medicare plans? - Answer✔7 month window (3 mo
before/3 mo after + birthday month)
When will Medicare Part A be dispersed with ALS or ESRD diagnosis? - Answer✔1st of the
month you are diagnosed (if dx in middle of month, you will be retropaid)
What is the benefit period for Medicare Part A? - Answer✔Must have 60 day wellness between
access to Part A services
If you use hospital, SNF/inpt or HH you will start over a whole new benefit period of # of days
(60)
What can you do if you do not qualify for Part A (not have enough work credits)? What's the
cost? - Answer✔Purchase Part A for $451/month for premium
*If you choose Part A, you may be required to buy Part B
What is the cost of Medicare Part A premium if you are still working based on annual income? -
Answer✔Between $96-$451
What is the penalty % for not electing to joining Medicare Part A within the 7 mo window
period? - Answer✔10% higher based on the # of years not paying into it
What does Medicare Part A cover? (8) - Answer✔1. Hospital
2. Inpt in mental hospital
3. SNF
4. HH
5. Hospice/medical support services
6. Blood
7. Critical access hospital
8. Inpt rehab
What are 4 items Medicare Part A covers with hospital stays? - Answer✔1. Semiprivate room or
isolation
2. Meals
3. General nursing
4. Other hospital services/supplies
What are 6 items Medicare Part A does not cover under hospital stays? - Answer✔1. Private duty
nursing
2. TV
3. Phone
4. Razor
5. Slippers
6. Private rooms unless medically necessary
Medicare Part A covers inpt stay at mental facility, but is limited to how many days per lifetime?
- Answer✔190 days
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