AAPC CPB Chapter 11-14| 182 questions| with complete solutions

Which coverage under TRICARE is a Medicare wrap around plan? a. TRICARE for Life b. TRICARE Reserve Select c. TRICARE Prime d. CHAMPVA correct answer: a. TRICARE for Life A patient has Medicare and a Medigap policy. Box 13, signature on file, is checked off on the electronic claim submission. An EOMB is received with remittance notice MA19. What does the office need to do? a. Nothing. This means the claim has been crossed over to the Medigap plan. b. The biller must file the secondary insurance as the cross-over claim is not going to be sent due to missing information. c. The biller must check the claim filed for missing information, add the missing information, and send back to Medicare for processing. d. Nothing. The notice means that the patient is responsible for the bill. correct answer: b. The biller must file the secondary insurance as the cross-over claim is not going to be sent due to missing information. A Medicare patient receives services from a participating provider on January 6, 2016, but the charges are missed and don't get entered in to the computer. How long does the office have to bill Medicare for the services? a. 3 months b. 12 months c. 6 months d. 1 month correct answer: b. 12 months What is true regarding Medigap policies? a. They cover everything that Medicare does not. b. They cover deductibles, copayments, and coinsurances usually. c. All Medigap policies are the same and offer the same coverage. d. Medigap policies must cover patients if they injured outside the United States. correct answer: b. They cover deductibles, copayments, and coinsurances usually. A 21 year-old patient presents for fillings for two if his teeth. Are these services covered under EPSDT? a. No, because these types of services are not covered. b. Yes, if the patient lives in a state that covers d