Busy. Please wait.
Log in with Clever
or
show password
Forgot Password?
Don't have an account?  Sign up 
Sign up using Clever
or
Username is available taken
show password

Your email address is only used to allow you to reset your password. See our Privacy Policy and Terms of Service.

Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.

Week 3 Test

Enter the letter for the matching Answer
incorrect
1.
Family planning is a Medicaid basic benefit.
incorrect
2.
The health maintenance organization provided for dependents of active duty military personnel is called
incorrect
3.
A nonparticipating physician who is not accepting assignment may bill any fee he or she wants.
incorrect
4.
An organization under contract to the government that handles insurance claims for care received under the TRICARE program is known as a(n)
incorrect
5.
How does an HMO receive payment for the services its physicians provide?
incorrect
6.
State Children's Health Insurance Programs (SCHIPs)
incorrect
7.
A certification from a military hospital stating that it cannot provide the care needed is called a(n)
incorrect
8.
A program that contracts with CMS to review medical necessity and appropriateness of inpatient medical care is known as a(n)
incorrect
9.
In the Medicare program, there is mandatory assignment for
incorrect
10.
People NOT entitled to benefits under TRICARE are
incorrect
11.
An NAS is a certification
incorrect
12.
If a check is received from Medicare and it is obvious that it is an overpayment, the insurance billing specialist should
incorrect
13.
Currently the Part B Medicare annual deductible is
incorrect
14.
A primary care physician who controls patient access to specialists is called a(n)
incorrect
15.
A significant contribution to HMO development was the
incorrect
16.
Medicare Part A is run by
incorrect
17.
Benefits under the HMO Act fall under two categories: __________ health services and supplemental health services.
incorrect
18.
In an independent practice association (IPA), physicians are
incorrect
19.
A Medicare nonparticipating physician may bill no more than the Medicare __________.
incorrect
20.
How are physicians who work for a prepaid group practice model paid?
A.
fiscal intermediary
B.
fee for service
C.
not employees and are not paid salaries.
D.
True
E.
salary paid by independent group
F.
NAS
G.
basic
H.
limiting charge
I.
CHAMPVA beneficiaries.
J.
TRICARE Prime.
K.
Health Maintenance Organization Act of 1973.
L.
certification from a military hospital stating that it cannot provide the necessary care.
M.
deposit the check and then write to Medicare to notify them of the overpayment
N.
clinical laboratory tests.
O.
gatekeeper
P.
Quality Improvement Organization (QIO)
Q.
The Centers for Medicare and Medicaid Services.
R.
$147
S.
False
T.
operate with federal grant support under Title V of the Social Security Act
Type the Answer that corresponds to the displayed Question.
incorrect
21.
Managed care plans allow laboratory tests to be performed at any facility the patient chooses.
incorrect
22.
Managed care plans never require a CMS-1500 claim form to be completed and submitted.
incorrect
23.
Benefits of Medigap policies may vary from one state to another.
incorrect
24.
Medicare is a _____ health insurance program.
incorrect
25.
All state Medicaid programs operate with a fee-for-service reimbursement system.
incorrect
26.
All persons age 65 who meet eligibility requirements for Medicare receive Medicare Part B (outpatient coverage).
incorrect
27.
A physician may accept or refuse Medicaid patients on the basis of the individual patient and his or her circumstances.
incorrect
28.
It is not possible for a person to be eligible for Medicaid benefits and also have additional group health insurance coverage.
incorrect
29.
Because Medicare is a federal program providing uniform benefits, payment of each medical service rendered to Medicare patients is consistent across the United States.
incorrect
30.
America's oldest privately owned, prepaid medical group is the

edit
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how
Created by: csalamon722
Popular Insurance sets