Private-duty nursing care is:
covered by Medicare Part A.
covered by Medicare Part B.
covered by Medicare Part C.
not covered by Medicare.
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Q. 2) For supplemental information entered in form locator 24, the qualifier ZZ indicates:
anesthesia information.
a narrative description of an unspecified code.
a National Drug Code.
the contract rate.
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Q. 3) The RBRVS system establishes the nationally uniform relative value of a service based on which three cost elements?
The cost of payroll, the cost of supplies, and the cost of liability insurance
The physician's specialty, the physician's work, and the location of the practice
The location of the practice, the overhead, and the cost of liability insurance
The physician's work, the practice expense, and the cost of liability insurance
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Q. 4) When third-party payers determine reimbursement, they consider UCR, which means:
usual, customary, and reasonable charges.
usual and common rates.
uniform, customary reimbursement.
usual and customary resources.
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Q. 5) Under TRICARE Prime, visits to civilian network providers require a copayment dependent on the military rank of the sponsor.
Indicate whether this statement is true or false.
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Q. 6) Claims processing involves the verification of medical necessity for the reported procedures; this task is performed by:
medical office specialists.
medical directors.
medical review examiners.
automated claims processors.
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Q. 7) Due to the Affordable Care Act of 2010, Medicaid expenditures are expected to increase by how much over earlier projections?
3
5
8
10
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Q. 8) A claim that is removed from a payer's automated processing system for additional review is subject to:
preauthorization.
manual review.
medical-necessity examination.
claims edit.
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Q. 9) As a result of the Welfare Reform Bill, legal resident aliens who entered the United States after 1996 are NOT eligible for Medicaid for 5 years.
Indicate whether this statement is true or false.
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Q. 10) If treatment is NOT available at a military treatment facility (MTF), a TRICARE beneficiary must obtain a(n) __________ statement before receiving services from a civilian provider.
Fill in the blank with correct word.
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