study guide
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| show | Must be disabled for no less than 12 months, & must receive disability benefits for 24 months before Medicare benefits begin.
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| What are the requirements to receive Medicare Part B? | show 🗑
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| What age is an individual eligible to receive Medicare benefits? | show 🗑
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| show | Through an annually increasing basic premium.
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| show | Yes, if they have resided in the U.S. for 5 years or more.
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| How do employers contribute to Medicare Part A services? | show 🗑
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| How long is a benefit period? | show 🗑
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| Is there a limit to how many benefit periods an individual can have? | show 🗑
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| show | Insurance designed to help cover costs of medical care that are not covered by an individual's primary insurance.
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| Where do funds for Medicare Part B come from? | show 🗑
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| What services does Medicare cover for a chiropractor? | show 🗑
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| Is a physical a covered benefit under Medicare? | show 🗑
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| What are the state to state policy for Medigap? | show 🗑
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| show | Only if receiving care from out of network providers and want to avoid out of pocket expenses.
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| When patients choose a Medicare Senior Plan, do they forfeit their medicare card? | show 🗑
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| show | No, they do not have to remain with it for a calendar year.
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| Do non-par physicians have the option to accept Medicare patients? | show 🗑
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| Can non-par physicians charge any fee they choose? | show 🗑
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| show | No, reimbursements are not consistent nationwide.
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| Who handles Medicare Part B payments? | show 🗑
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| Another name for a fiscal intermediary is? | show 🗑
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| show | The patient has signed authorization papers in their file, updated annually.
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| Is a patient's signature required on all CMS claim forms? | show 🗑
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| What is the time limit on professional claim forms? | show 🗑
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| show | No Medicaid does not pick up the balance on Medi/Medi claims.
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| show | Yes, if Medigap information has already been provided.
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| show | Private insurance companies.
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| show | Document detailing services billed & payment determination issued to providers.
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| Who runs the Medicare Part A program? | show 🗑
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| show | Yes, Medicare is a federal program.
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| What does Medicare Part A cover? | show 🗑
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| show | Outpatient care, such as doctor visits & diagnostic tests.
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| When does the benefit period for Medicare Part A end? | show 🗑
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| What is the current annual deductible for for medicare Part B? | show 🗑
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| show | Yes preventative care mammograms are covered by Medicare, for women 40 & over, once a year.
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| show | Once every 24 months if low risk, once every 12 months if high risk.
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| What does Medigap insurance cover? | show 🗑
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| show | MSP(Medicare Secondary Payer).
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| show | Eyeglasses & prescription drugs.
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| What program contracts with CMS to review for medical necessity? | show 🗑
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| What percent does Medicare generally agree to pay? | show 🗑
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| show | Total amount billed.
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| In the Medicare program, what is a mandatory assignment in benefits covered? | show 🗑
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| show | Identifies claims to review for a medical necessity & monitor the number of times billed for such procedures during a specific time frame.
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| show | HCPCS Level II modifier "GA"
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| What is a perspective payment system? | show 🗑
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| What are payments to hospitals classified as? | show 🗑
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| show | In the case of a current/former employee or dependent younger than 65, & eligible for Medicare solely because of ESRD, the employer's group coverage is primary for up to 30 months.
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| What level are alpha-numeric HCPCS codes? | show 🗑
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| What is a fiscal intermediary? | show 🗑
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| What do the letters after the medical ID numbers on the medicare card stand for? | show 🗑
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| What does the letter "D" stand for on Medicare Part D plan? | show 🗑
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