Medicare part d - Study guides, Class notes & Summaries

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...

North Carolina Medicare Supplement and Long-Term Care Certification Exam || Questions & 100% Correct AnswersNorth Carolina Medicare Supplement and Long-Term Care Certification Exam || Questions & 100% Correct AnswersNorth Carolina Medicare Supplement and Long-Term Care Certification Exam || Questions & 100% Correct AnswersNorth Carolina Medicare Supplement and Long-Term Care Certification Exam || Questions & 100% Correct Answers An individual who is not eligible for premium-free Medicare Part...

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...

Test Bank for Medical-Surgical Nursing 5E Holly Stromberg Chapter 01: Caring for Medical-Surgical Patients Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th Edition MULTIPLE CHOICE 1. Which statement accurately describes the primary purpose of the state nurse practice act (NPA)? a. To test and license LPN/LVNs b. To define the scope of LPN/LVN practice c. To improve the quality of care provided by the LPN/LVN d. To limit the LPN/LVN employment placement ANS: B While improv...

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...

Test Bank For Basic Geriatric Nursing 8th Edition by Patricia A. Williams 2023/2024 Chapter 1-20 PLUS Nclex Case Studies with Answers | All Chapters. Chapter 01: Trends and Issues Williams: Basic Geriatric Nursing 8th Edition MULTIPLE CHOICE 1. Which fact explains the shift of health care focus toward the older adult in the late 1960s? a. Disability was viewed as unavoidable. b. Complications from disease increased mortality. c. Older adults’ needs are similar to those of all adults. d....

Shawn, Mike, and Dave are brothers who have a $100,000 "first to die" joint life policy covering all three of their lives. If Mike dies first, the policy proceeds A.) Will no longer provide insurance protection B.) Will go to Mike's estate C.) Wwill be divided by probate D.) Will not be paid until the last brother dies - A.) Will no longer provide insurance protection Susan is insured through her Group Health Insurance plan and changed her coverage to an individual plan with the sa...

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...

Dual special needs plans are defined as? Medicare advantage plans uniquely designed for consumers enrolled in both Medicare and Medicaid. Meredith a d- snp member loses Medicaid eligibility. What impact does this have on her D-SNP enrollment? She will enter a grace period during which she is responsible for plan, cost sharing and she will be disenrolled at the end of the grace. If she does not re-establish Medicaid eligibility. Brainpower Read More Previous Play Next Rewin...

PTCB Pharmacy Billing and Reimbursement Practice Test Questions and Answers Latest Rated 100%. DAW/DNS stand for which of the following? A. Dispense as written B. Distribute and work C. Distribution and working D. Dispense as well 3. Which of the following third party plans requires the patient to designate a primary care physician (PCP)? A. Health maintenance organization (HMO) B. Preferred provider organization (PPO) C. Medicare Part D D. TRICARE 4. The cost of the coverage of an i...