What edition of the Federal Register would hospital facilities be especially interested in?
A. July
B. November or December
C. October
D. January - Answer- C. October
What edition of the Federal Register would outpatient facilities be especially interested in?
A. November or December
B. October
C. January
D. July - Answer- A. November or December
What is the largest third-party payer?
A. American government
B. Department of Health and Human Services
C. Social Security Administration
D. Food and Drug Administration - Answer- A. American government
What government organization is responsible for administering the Medicare program?
A. National Center for Health Statistics
B. National Institute of Health
C. Centers for Medicare and Medicaid Services
D. Social Security Administration - Answer- C. Centers for Medicare and Medicaid Services
What are the three items that the Medicare beneficiaries are responsible to pay before Medicare will begin to pay for services?
A. deductibles, drug costs, personal care items
B. personal care items
C. premiums
D. deductibles, premiums, and coinsurance - Answer- D. deductibles, premiums, and coinsurance
What is the group of providers who formed a network and agreed to provide enrollees a discounted rate?
A. PPO
B. EPO
C. MCO
D. HMO - Answer- A. PPO
A provider has ______ months from the date of service to submit a claim for services. A. none of the above
B. 24
C. 12
D. 16 - Answer- C. 12
These are activities involving transfer of health care information.
A. transactions
B. transmissions
C. notices
D. submittals - Answer- A. transactions
Medicare beneficiaries are automatically eligible for Part:
A. C
B. D
C. A
D. B - Answer- C. A
Part B services are reported with:
A. HCPCS
B. ICD-10-CM
C. all of the above
D. CPT - Answer- C. all of the above
Part ____of Medicare is also known as Medicare Advantage.
A. C
B. A
C. D
D. B - Answer- A. C
Services usually performed in an office setting are subject to payment discount if performed in an outpatient hospital setting.
A. True
B. False - Answer- A. True
Medicare funds are collected by:
A. National Center for Health Statistics
B. Department of the Treasury
C. Social Security Administration
D. U.S. Food and Drug Administration - Answer- C. Social Security Administration
Check the three goals of the Physician Payment Reform:
1. Decrease Medicare expenditures
2. Control costs of operative procedures
3. Ensure quality health care at a reasonable cost
4. Monitor hospital use
5. Coordinate outpatient services 6. Redistribute physician payments - Answer- 1. Decrease Medicare expenditures
3. Ensure quality health care at a reasonable cost
6. Redistribute physician payments
Check the three components of the Relative Value Unit.
1. cost differential
2. malpractice
3. inflation rate
4. work
5. office space expense
6. practice expense - Answer- 2. malpractice
4. work
6. practice expense
When two surgeons of different specialties perform a procedure as co-surgeons, Medicare pays ______% of the global fee, dividing the payment equally between the surgeons.
A. 150
B. 50
C. 100
D. 125 - Answer- D. 125
Check the three types of persons eligible for Medicare.
1. permanent kidney failure
2. 8 and under
3. some disabilities
4. diabetics
5. uninsured
6. 65 and over - Answer- 1. permanent kidney failure
3. some disabilities
6. 65 and over
The 10th revision of the ICD was issued in _____ by the WHO.
A. 1985
B. 1993
C. 1973
D. 1983 - Answer- B. 1993
What 7th character indicates a subsequent encounter?
A. A
B. None of the above
C. D
D. S - Answer- C. D
This identifies when two conditions cannot occur together:
A. Excludes1