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14 terms

chapter 13

Medicaid and other State Programs
STUDY
PLAY
Medicaid is administered by ___ with partial ___ funding
state goverenment;federal
in all other states, the program is known as Medicaid, but in California the program is called
Medi-cal
name two broad classification of people eligible for Medicaid assistance
categorically and medically needy
the insurance claim form for submitting Medicaid claims in all states is
CMS-1500 health insurance claim form
when professional services are rendered, the Medicaid identification care or electronic vertification must show eligibility for
month of service
when a medicaid patient is injured in an automobile accident and the care has liability insurance, this involves a third-party payer so the insurance claim is sent tothe
automobile insurance carriee
the only state without a Medicaid program that is similar to those existing in other states that has an alternative prepaid medical assistance program is
arizona
a patient's Medicaid eligiblity may be verified by
touch-tone telephone;modem;special Medicaid terminal equipment
when a medicaid patient requires a piece of durable medical equipment, the
obtain prior authorization, preferably written
medicare beneficiaries who are disabled but have annual incomes below the federal poverty level may be eligible for
medicaid qualified medicare beneficiary program; qualifying individuals program; specified low-income medicare beneficiary program
TRUE
cerebral palsy is a condition that qualifies a child for benefits under the Maternal and Child Health Program
TRUE
when filing a claim for a Medicaid managed care patient, transmit the claim to the manages care organization and not the Medicaid fiscal agent
TRUE
Providers must enroll for participation in the Medicaid program with the fiscal agent for their region
TRUE
a state agency that investigates complaints of mistreatment in long-term care facilities is the Medicaid Fraud control Unit (MFCU).