week 6

Created by moneia_reed 

Upgrade to
remove ads

TRUE

The Health Maintenance Organization Act 1973 required most employers to offer HMO coverage to their employees as an alternative to traditional heath insurance.

FALSE

Managed care plans allow laboratory test to be preformed at any facility the patient chooses.

TRUE

Patients who elect Medicare Part B coverage pay annually increasing basic premium payments.

TRUE

If a primary care physician sends a patient to a specialist for consultation and the specialist is nor in the managed care plan, the specialist may bill the primary care physician for payment.

TRUE

The assignment on a patient with medicare-medicaid must always be accept or medicaid will not pick up the residental

TRUE

A co-payment in managed care plan is usually a fixed dollar amount (predertermined fee).

FALSE

Medicare Part A is called supplementary medical insurance (SMI).

FALSE

When CMS-1500 claim form is automatically transferred by Medicare to a Medigap carrier, there is no need to abtain a separate signature authorization for the Medigap carrier.

TRUE

Medicare provides insurance for disabled individuals if they have recieved Social Security disability benefits for 24 months.

FALSE

Medicare-eligible patients are not involved with HMOs or prepaid health plans,

FALSE

Managed care plans never require a CMS-1500 claim form to be completed and submitted

FALSE

All persons age 65 who meet elgibility requirements for Medicare recieve Medicare Part B (outpatient coverage).

FALSE

Once a outpatient changes from Medicare to a senior HMO, the patient must stay with that HMO for the remainder of the calender year.

TRUE

Usually, there are no deductibles for managed care plans.

TRUE

A Medicare patient with an HMO does not need a supplement insurance policy.

TRUE

It is possible for an alien to be eligible for Medicare Part A and Part B.

TRUE

In a point of service (POS) program, members may choose to use a nonprogram provider at the time.

TRUE

In certain managed care plans there is an incentive for the gatekeeper to limit patient referrals to specialists.

TRUE

Medicare transmits Medigap claims electronically for participating physicians when medigap information is provided on the oringinal Medicare claim.

FALSE

In the Medicare program, a physical examination is covered benefit when preformed within 12 months of enrollment.

TRUE

Employee and employer contributions help pay for Medicare Part A health services.

FALSE

When Medicare recipient chooses a Medicare senior plan, he or she forfeits the Medicare card.

TRUE

The term "turfing" means to tranfer the sickest high-cost patients to other physicians so that the provider appears as low utilizer.

TRUE

Medicare provides insurance for disabled workers for any age.

Please allow access to your computer’s microphone to use Voice Recording.

Having trouble? Click here for help.

We can’t access your microphone!

Click the icon above to update your browser permissions above and try again

Example:

Reload the page to try again!

Reload

Press Cmd-0 to reset your zoom

Press Ctrl-0 to reset your zoom

It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.

Please upgrade Flash or install Chrome
to use Voice Recording.

For more help, see our troubleshooting page.

Your microphone is muted

For help fixing this issue, see this FAQ.

Star this term

You can study starred terms together

NEW! Voice Recording

Create Set