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Medicare provides insurance for disablled individuals if they have received Social Security disability benefits for 24 months.
Whan a Medicare recipient chooses a Medicare senior plan, he or she forfeits the Medicare card.
Nonparticipating physicians have an option regarding addpting assignment on a Medicare patient.
A nonparticipating physician who is not accepting assignment may bill any fee he or she wishes.
Because Medicare is a federal program providing uniform benefits, payment of each medical service rendered to Medecare patient is consistent across the United States.
When a CMS-1500 claim form is automatically transferred by Medicar to a Medigap carrier, there is no need to obtain a separate signature authorization for the Medigap carrier.
The assignment on a patient with Medicare-Medicaid must alwys be accepted or Medicaid will no pick up the residual.
The letters preceding the number on the patient's Medicare identification card indicate
Medicare Part A benefit period endsw when a patient
has not been a bed patient in any hospital or nursing facility for 60 consecutive days
Medicare provides a one-time baseline mammographic examination for women ages 35 to 39 and preventive mammogram screenings for women 40 years or older
once a year
The frequency of Pap testss that may be billed for a Medicare patient who is low risk is
once every 24 months
When a Medicare beneficiary has employer supplemental coverage, Medicare refvers to these plans as
Some senior HMOs may provide services not covered by Medicare, such as
eyeglasses and prescription drugs
A state-based group of doctors working under government guidelines reviewing cases for hospital admission and discharge is known as a
A participating physician with the Medicare plan agrees to accept
80% of the Medicare-approved charge
In the Medicare program, there is mandatory assignment for
surgery performed in the physician's office
When a Medicare patient signs an advance beneficiary notice, the procedure code for the service provided must be modified using the HCPCS Level II modifier
Under the prospective payment system (PPS), hospitals treating Medicare patients are reimbursed according to
preestablished rates for each type of illness treated based on diagnosis
Organizations handling claims from hospitals, nursing facilities, intermediate care facilities, long-term care facilities, and home health agencies are called
The time limit for submitting a Medecare claim is
the end of the calendar year following the fiscal year in whichb services were performed
When a Medicare carrier transmits a Medigap claim electronically to the Medigap carrier, it is referred to as
a crossover claim
An explanation of benefits document for a patient under the Medicare program is referred to as the
Medicare remittance advice document
A claims assistance professional (CAP)
may act on the Medicare beneficiary's behalf as a client representative
Whe a remittance advie (RA) is received for Medicare, the insurance billing specialist should
post each patient's name and the amount of payment on the day sheet and the patient's ledger card
If a check is received form Medicare and it is obvious that it is an overpayment, the insurance billing spedialist should
deposit the check and then write to Medicare to notify them of the overpayment
Medicare provides insurance for people who are this old or older who are retire on Social Security
This alpha letter follow the identification number on a female patient's Medicare card indicates that is is her husband's number
A specialized insurance policy that is predefined by the federal government for the Medicare beneficiary to cover the deductible and copayment amounts is referred to as
The Civil Monetary Penalties Law carries a sanction for a penalty of up to this much for each item or service wrongfully listed in a payment request to Medicare or Medicaid
Organizations handling claims for physicians and other supplier of services covered under medicare Part B are called fiscal intermediaries or
When a Medicare patient's payment authorization is on file, this abbreviation may be used on the CMS-1500 claim form
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