The Medicare program is administered by the Centers for Medicare and Medicaid Services (CMS), a division of the United States Department of Health and Human Services.
Indicate whether this statement is true or false.
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Q. 2) A health problem that results from exposure to a workplace health hazard such as chemical fumes is a(n):
terminal disease.
workplace injury.
workers' compensation accident.
occupational disease.
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Q. 3) If a patient is the primary policyholder on two insurance plans, the primary plan is considered:
the plan with the highest level of benefits.
the plan in effect for the longest period of time.
the plan that has the highest premium.
the plan in effect for the shortest period of time.
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Q. 4) A spouse of a deceased, retired, or disabled individual who was or is eligible for Medicare benefits:
is not eligible for Medicare coverage.
is also eligible for Medicare coverage.
must apply for Medicaid benefits.
is eligible for Supplemental Security Income benefits.
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Q. 5) Under a capitation arrangement, a provider is paid a per-member-per-month (PMPM) fee for all enrolled members:
who are seen that month.
whether or not they are seen that month.
who are not referred to specialty care that month.
who are not hospitalized that month.
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Q. 6) To obtain Medicare Part B coverage, individuals must qualify by meeting eligibility requirements for Part A or:
qualifying as a disabled individual.
purchasing Part D coverage.
purchasing Part A coverage.
qualifying based on income status.
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Q. 7) The medical office specialist should verify a patient's Medicaid eligibility:
at every visit.
twice a month.
every 2 months.
every 6 months.
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Q. 8) Providing additional clinical information to an insurance company as part of an attempt to overturn a claim denial is known as submitting a(n):
appeal.
audit.
adjudication.
reconsideration.
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Q. 9) Healthcare Common Procedure Coding System (HCPCS) codes are required on both Medicaid physician and hospital claim forms.
Indicate whether this statement is true or false.
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Q. 10) Seventy-five percent of the physician's work value under the resource-based relative value scale (RBRVS) is adjusted by geographic cost differences.
Indicate whether this statement is true or false.
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