MEDICAID CHAPTER 15 TEST 2025
adjusted claim - ANSWER payment correction resulting in additional
payments to the provider
Dual eligibles - ANSWER individuals entitled to Medicare and eligible
for some type of Medicaid benefit
federal poverty level (FPL) - ANSWER income guidelines established
annually by the federal government
Medicaid - ANSWER cost-sharing program between the federal and
state governments to provide healthcare services to low-income
Americans; originally administered by the Social and Rehabilitation
Service (SRS)
Medicaid remittance advice - ANSWER sent to the provider; serves as
an explanation of benefits from Medicaid and contains the current status
of all claims (including adjusted and voided claims)
Medical assistance program - ANSWER program for individuals with
incomes below the federal poverty level
recipient eligibility verification system (REVS) - ANSWER aka Medicaid
EVS; allows providers to electronically access the state's eligibility file
through point-of-sale device, computer software, and automated voice
response
Temporary Assistance for Needy Families (TANF) - ANSWER makes
cash assistance available on a time-limited basis for children deprived of
support because of a parent's death, incapacity, absence, or
unemployment
voided claim - ANSWER claim Medicaid should not have originally
paid, resulting in a deduction from the lump-sum payment made to the
provider
adjusted claim - ANSWER payment correction resulting in additional
payments to the provider
Dual eligibles - ANSWER individuals entitled to Medicare and eligible
for some type of Medicaid benefit
federal poverty level (FPL) - ANSWER income guidelines established
annually by the federal government
Medicaid - ANSWER cost-sharing program between the federal and
state governments to provide healthcare services to low-income
Americans; originally administered by the Social and Rehabilitation
Service (SRS)
Medicaid remittance advice - ANSWER sent to the provider; serves as
an explanation of benefits from Medicaid and contains the current status
of all claims (including adjusted and voided claims)
Medical assistance program - ANSWER program for individuals with
incomes below the federal poverty level
recipient eligibility verification system (REVS) - ANSWER aka Medicaid
EVS; allows providers to electronically access the state's eligibility file
through point-of-sale device, computer software, and automated voice
response
Temporary Assistance for Needy Families (TANF) - ANSWER makes
cash assistance available on a time-limited basis for children deprived of
support because of a parent's death, incapacity, absence, or
unemployment
voided claim - ANSWER claim Medicaid should not have originally
paid, resulting in a deduction from the lump-sum payment made to the
provider
