AAPC CPB - Chapter 11 Review Questions and Answers

AAPC CPB - Chapter 11 Review Questions and Answers Medicare's payment amount for services are determined by which of the following formulas? a. Sustainable growth rate (SGR) X Geographic Practice Cost Index (GPCI) = Medicare payment b. Total RVU X Conversion factor = Medicare payment c. Total Practice Expense (PE) X Conversion factor = Medicare payment d. Total Malpractice insurance (MP) X Conversion factor (CF) = Medicare payment - Answer️️ -b. Total RVU X Conversion factor = Medicare payment The total RVU is composed of which of the following components: a. Conversion factor (CF), practice expense (PE), and malpractice insurance (MP) b. Physician work, practice expense (PE), and malpractice insurance (MP) ©SOPHIABENNET@ Thursday, August 22, 2024 10:21 AM Certified Professional Biller By: American Academy of Professional Coders(AAPC) 2 c. Sustainable growth rate (SGR), conversion factor (CF), and malpractice insurance (MP) d. Sustainable growth rate (SGR), practice expense (PE), and physician work. - Answer️️ -b. Physician work, practice expense (PE), and malpractice insurance (MP) Medicare Supplement Insurance policies or Medigap is sold by: a. Medicare b. Medicaid c. Private insurance companies d. Healthcare providers - Answer️️ -c. Private insurance companies Medicare statutorily excluded services are: a. Non-covered items and services b. Not reimbursed by Medicare c. Reimbursed on a case-by-case basis. d. Both A & B - Answer️️ -d. Both A & B ©SOPHIABENNET@ Thursday, August 22, 2024 10:21 AM Certified Professional Biller By: American Academy of Professional Coders(AAPC) 3 Albert has purchased a Medigap policy to supplement his Medicare benefits. To which entity will Albert pay his monthly premium for this policy? a. Medicare b. MAC c. Medicaid d. Medigap insurance company - Answer️️ -d. Medigap insurance company The term for a supplemental policy for Medicare is: a. Medifill b. Medicare Plus c. Medigap d. Medicare Secondary - Answer️️ -c. Medigap Dr. Allen who is a non-PAR provider performs an appendectomy on a 67 year-old Medicare patient. The physician's UCR for the surgery is $1500. Medicare's approved fee for this procedure is $1100.