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Exam of 2 pages for the course Capa Test Questions at Capa Test Questions (EPIC Study Guide)

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EPIC Study Guide
MCO - ANS-Managed Care Organization

Nine Maryland MCOs - ANS-Aetna Better Health, Amerigroup, Jai, Kaiser, MedStar
Family Choice, MD Physicians Care, Priority Partners, UHC MCO, CareFirst
Community Health Plan

Five Maryland MCOs that have a separate policy # than the MA# - ANS-Amerigroup,
Kaiser, MedStar Family Choice, Priority Partners, UHC MCO

Three processes for verifying MA eligibility - ANS-EVS Web, EVS Phone, RTE

Four types of patients that we EVS - ANS-MA, Medicare no secondary, Prisoners,
Self-Pay

Who do we bill for behavioral health for MA? - ANS-Optum Health

SLMB; Who do we bill? - ANS-Specified Low-Income Medicare Beneficiary; Medicare
ONLY!

QMB; Who do we bill? - ANS-Qualified Medicare Beneficiary; Medicare and MA

Who is the subscriber for MA? - ANS-The patient; Except newborns within 30 days of
life

If a patient presents a Medicare card and a Medicare Advantage card, what would the
insurance selection look like? - ANS-Medicare Advantage ONLY!

IMM - ANS-Important Message from Medicare

What is the deadline for getting the IMM signed? - ANS-Within 48 hours of inpatient
admission

MSPQ - ANS-Medicare Secondary Payor Questionnaire

What is the purpose of the MSPQ? - ANS-To determine if Medicare pays primary

GHP - ANS-Group Health Plan

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Study: Capa Test Questions
Uploaded on: June 15, 2024
Number of pages: 2
Written in: 2023/2024
Type: Exam (elaborations)
Contains: Questions & answers

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