Medicare part - Study guides, Class notes & Summaries

Exam 1: NUR257/ NUR 257 (New 2023/ 2024 Update) Aging and Chronic Illness in Nursing Exam Review| 100% Correct- Galen QUESTION are eligibility? does medicare cover Answer: be eligible for social security t services & must be medically necessary QUESTION costs of medicare Answer: ed by employer & employee tax of 2.9% iciary in form of premiums, deductibles, co-pays QUESTION medicare part A Answer: care or short term rehab if receive social sec...

HFMA CRCR EXAM LATEST EXAM 170+ QUESTIONS AND CORRECT ANSWERS(100% VERIFIED ANSWERS) HFMA CRCR EXAM LATEST EXAM 170+ QUESTIONS AND CORRECT ANSWERS(VERIFIED ANSWERS) IF outpatient diagnostic services are provided within three days of the admission of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to these charges - ANSWER- They must be billed separately to the part B Carrier what is a recurring or series registration? - ANSWER- One registr...

Medical Billing & Coding: Final Exam Study Guide with Complete Solutions The largest federal program providing healthcare is __________________ which provides health insurance for citizens aged 65 and older as well as certain patients under the age of 65. Medicare The ___________________ ______________ is responsible for filing insurance claims in most medical offices.. Medical Assistant Patients are generally asked to sign an _____________ of _____________statement, in which the p...

UNITED HEALTHCARE (UHC) – ETHICS AND COMPLIANCE LATEST 2023-2024 EXAM| ACTUAL QUESTIONS AND VERIFIED ANSWERS |A+ GRADE Q: Agent Jacob learns that Emily, the consumer with whom he is meeting, is the authorized legal representative for her father. What must Jacob explain to Emily when completing an Enrollment Application for her father? Answer: Jacob must explain that Emily will sign the Enrollment Application and must be able to provide documentation upon request by the Plan that indic...

True or False: The ACA requires that all providers adopt a compliance plan as a condition of enrollment with Medicare, Medicaid, and Children's Health Insurance Program (CHIP). - Answer True ref. ACA section 6102 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) - Answer 1.Protect our programs 2.Protect your patients 3.Protect the Provider At which level of the Medicare Part A or Part B appeals process is the...

AHIP Practice Exam Updated Questions and Answers (2024 / 2025) (Verified Answers). 1. Mr. Carlini has heard that Medicare prescription drug plans are only offered through private companies under a program known as Medicare Advantage (MA), not by the government. He likes Original Medicare and does not want to sign up for an MA product, but he also wants prescription drug coverage. What should you tell him ANS Mr. Carlini can stay with Original Medicare and also enroll in a Medicare prescription...

CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023 Steps used to control costs of managed care include: Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage HMO Conventional PPO and POS H...

What part of Medicare covers prescription drug services - correct answer Part D What is medical coding? - correct answer Translating medical documentation into codes. Which is NOT a covered entity of HIPAA... Medicare, Worker's Comp, Dentists, Pharmacies - correct answer Workers compensation What is an NCD (National Coverage Determination) interpreted at the MAC level considered? - correct answer LCD (Local Coverage Determinations) When should an ABN (Advance Beneficiary Not...

Through what document does a hospital establish compliance standards? code of conduct What is the purpose OIG work plant? Identify Acceptable compliance programs in various provider setting If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? Non-diagnostic service provided on Tuesday through Friday What does a modifier allow a provider to do? Report a specific circumstance that affected a procedure or service without chan...

Annuity Certain - ANSWERSMaria would like an annuity that provides a guaranteed accumulation or payout. The type of annuity she is seeking is called Survivorship Life - ANSWERSThe type of policy which pays on the death of the last person is called Malign another insurer - ANSWERSDefamation occurs when a producer makes a false statement intended to A 70 year old NOT eligible for Social Security *You are not eligible to receive Medicare Part A benefits at age 65 or older if you are el...