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NC Medicare Insurance bolded topics Exam Questions and Answers
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NC Medicare Insurance bolded topics Exam Questions and Answers
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NC Medicare Insurance bolded topicsExam Questions and Answers
Who enrolls people into Medicare and processes claims?
The Social Security Administration (SSA) enrolls individuals in Medicare and
processes any premium payments.
_____________is the amount billed by the medical provider for services provided.
. The actual charge (amount) is the amount billed by the medical provider for services
provided.
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________________________________ is the dollar amount that Medicare considers to
be the reasonable charge for a particular medical service.
The Medicare approved charge (amount)
the difference between the actual charge and the Medicare approved charge
The excess charge is the difference between the actual charge and the Medicare
approved charge
A. This is a document from medicare that states what services will be covered, although
claims may still be denied
B. A summary of services billed to Medicare over a 3 month period, what they paid, and
what you owe
A. Advance Beneficiary Notice
B. Medicare Summary Notice
This notice shows all your services or supplies that providers and suppliers billed to
Medicare during the three-month period, what Medicare paid, and what you may owe
the provider.
The Medicare Summary Notice
A group of medical professionals that audits medicare received by patients
Peer Review organizations
Who do I contact to make a fast appeal about my medicare summary notice to dispute a
bill?
Fast appeals may be made by contacting the local Quality Improvement
Organization.
How is medicare funded?
FICA and Unearned Income Tax
Who makes up the Quality Improvement Organization? Who do they work under?
health care experts, doctors, and consumers
They all work under CMS
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