While staying within the national guidelines provided by the federal government pertaining to Medicaid, each state may establish its own guidelines related to:
a. Establishing the location of Medicaid offices
b. Setting the rate of employee salaries
c. Determining the type, amount, duration, and scope of services
d. Administering drugs and medical supplies
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Q. 2) What is the common Medigap percentage option?
a. 30 coinsurance for reasonable charges
b. 20 coinsurance for reasonable charges
c. 50 coinsurance for reasonable charges
d. 80 coinsurance for reasonable charges
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Q. 3) What is the limiting charge?
a. The limiting charge for services is 100 of the nonparticipating fee schedule amount.
b. Balance billing by nonparticipating physicians is flexible depending on this amount.
c. The limiting charge applies only to ambulance companies and other nonphysician providers.
d. The limiting charge applies to services billed on a nonassigned basis.
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Q. 4) What is one way that Medicare encourages physicians to accept assignment?
a. Medicare allowance is flexible for physicians who agree to accept assignment.
b. Medicare allowance is higher for physicians who agree to accept assignment.
c. Participating physicians do not have to practice balance billing.
d. Participating physicians are allowed to charge patients for more than the Medicare allowance.
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Q. 5) Recovery Audit Contractors (RACs) are government contracted auditors provided with the task of finding and stopping Medicare fraud.
Indicate whether this statement is true or false.
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Q. 6) Which of the following are considered job-related injuries?
a. Injuries which happen during the performance of work-related duties
b. Injuries which happen in or out of the home
c. Injuries that happen while driving your own car to work
d. Injuries that happen after work
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Q. 7) The terminated member roster shows those members
a. Who have appealed second opinion denials
b. Who have died
c. Whose coverage is being considered for renewal
d. Whose coverage has been terminated
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Q. 8) Which of the following is considered a Part B benefit?
a. A biannual charge.
b. After the deductible has been satisfied, generally 80 of the approved charge will be paid.
c. After the deductible has been satisfied, generally 50 of the approved charge will be paid.
d. The amount charged for the Part B deductible will depend on the amount spent by the patient for payments for services.
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Q. 9) What is Medicaid?
a. A program established under Title XIX of the Social Security Act of 1945
b. A federal-state entitlement program providing healthcare services to certain low-income people
c. A federal-state entitlement program with eligibilty at the age of 65 and older
d. A program whose purpose is to offer healthcare to the elderly
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Q. 10) What constitutes employee negligence?
a. Being overly cautious
b. Willfully not abiding by established workplace rules
c. Talking back to the boss
d. Asking for a raise
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