In general, Medicaid can request refunds for overpayments to providers for up to:
180 days.
1 year.
3 years.
5 years.
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Q. 2) Physicians have the right to establish their fees at a level that they believe fairly reflects the costs of providing a service.
Indicate whether this statement is true or false.
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Q. 3) In medical record documentation, a commonly used format is SOAP, which stands for:
subjective, objective, audit, process.
subjective, objective, action, plan.
subjective, objective, assessment, plan.
subjective, objective, assessment, payment.
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Q. 4) The section of the explanation of benefits (EOB) that indicates who was paid, how much, and when is the:
service information.
coverage determination.
benefit payment information.
summary information.
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Q. 5) To take a Medicare appeal to the level of a decision by an administrative law judge, the claim must be for a minimum of:
130.
150.
360.
500.
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Q. 6) The set amount a patient must pay at the time of service is the:
coinsurance.
copayment.
deductible.
premium.
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Q. 7) The types of Medicare Advantage plans include health maintenance organizations (HMOs).
Indicate whether this statement is true or false.
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Q. 8) What types of costs are included in a patient's out-of-pocket expenses?
What will be an ideal response?
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Q. 9) The nationally uniform relative values are adjusted by:
physician training and specialty.
geographic practice cost differences.
liability insurance cost differences.
the number of employees of the practice.
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Q. 10) Services covered under TRICARE Standard include all of the following EXCEPT:
podiatry services.
durable medical equipment (DME).
mental health care.
routine physical examinations.
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