MEDICAL INSURANCE & BILLING
CH9 EXAM ACTUAL UPDATED QUESTIONS AND VERIFIED ANSWERS
To determine eligibility for TANF assistance at the county level, which of the following questions
are asked? (Select all that apply.) - ANSWER Does the household include at least one child under
eighteen?
Does the individual receive adoptive or foster care assistance?
According to Spousal Impoverishment legislation, which of the following resources held by both
spouses are not considered to be available to the spouse in the medical facility? (Select all that
apply.) - ANSWER Home
Household goods
Automobile
Burial funds
Medicaid beneficiaries are often referred to as which of the following? (Select all that apply.) -
ANSWER Recipients
Subscribers
A general income and asset guideline states that information provided on the Medicaid
application is checked and verified using other sources of information, including which of the
following? - ANSWER State Motor Vehicle Agency
Social Security Administration
State Department of Labor
Internal Revenue Service
,How often do some states issue Medicaid cards to their subscribers? (Select all that apply.) -
ANSWER Twice a month
Every six months
Once a month
Every two months
Which of the following would be denied if a Medicaid patient is on restricted status? (Select all
that apply.) - ANSWER Obtaining prescriptions from any pharmacy
Seeing a physician whose name is not listed on the patient's ID card
One of the general Medicaid income and asset guidelines states that only a portion of _____
income from Social Security benefits, Supplemental Security Income (SSI), and veterans'
benefits and pensions is counted toward income limits. - ANSWER unearned
Which of the following services are covered under Medicaid? - ANSWER Nurse midwife services
EPSDT services for people under age twenty-one, including physical examinations,
immunizations, and certain age-relevant services
Laboratory and X-ray services
Inpatient and outpatient hospital services
Which of the following plans are offered by Medicaid in most states? (Select all that apply.) -
ANSWER Fee-for-service
Managed care
The federal government provides Medicaid patients with matching funds for which of these
more common optional services? - ANSWER Vision care
Diagnostic services
, Prescription drugs
If the patient has coverage through any other insurance plan, the other plan is billed first and
then what is forwarded from the primary payer to Medicaid? - ANSWER Remittance advice
Which of the following are advantages in having a Medicaid managed care plan? (Select all that
apply.) - ANSWER Choice of a PCP
Increased access to preventive care
Access to specialists.
When providers agree to accept payment from Medicaid as payment in full for services, which
of the following are true? (Select all that apply.) - ANSWER They may not bill patients for
additional amounts.
The difference must be entered into the billing system as a write-off.
With Medicaid managed care plans, claims are sent to the _____ instead of to the state
Medicaid department. - ANSWER managed care organization
What are claims billed to Medicare that are automatically sent to Medicaid called? - ANSWER
Crossover claims
Billing for services that are not medically necessary by physicians who contract with Medicaid to
provide services is an _____ billing practice. - ANSWER unacceptable
Medicaid claims are submitted to which of the following agencies, depending on the particular
state? (Select all that apply.) - ANSWER County welfare agencies
Fiscal intermediaries
State Department of Health and Human Services
CH9 EXAM ACTUAL UPDATED QUESTIONS AND VERIFIED ANSWERS
To determine eligibility for TANF assistance at the county level, which of the following questions
are asked? (Select all that apply.) - ANSWER Does the household include at least one child under
eighteen?
Does the individual receive adoptive or foster care assistance?
According to Spousal Impoverishment legislation, which of the following resources held by both
spouses are not considered to be available to the spouse in the medical facility? (Select all that
apply.) - ANSWER Home
Household goods
Automobile
Burial funds
Medicaid beneficiaries are often referred to as which of the following? (Select all that apply.) -
ANSWER Recipients
Subscribers
A general income and asset guideline states that information provided on the Medicaid
application is checked and verified using other sources of information, including which of the
following? - ANSWER State Motor Vehicle Agency
Social Security Administration
State Department of Labor
Internal Revenue Service
,How often do some states issue Medicaid cards to their subscribers? (Select all that apply.) -
ANSWER Twice a month
Every six months
Once a month
Every two months
Which of the following would be denied if a Medicaid patient is on restricted status? (Select all
that apply.) - ANSWER Obtaining prescriptions from any pharmacy
Seeing a physician whose name is not listed on the patient's ID card
One of the general Medicaid income and asset guidelines states that only a portion of _____
income from Social Security benefits, Supplemental Security Income (SSI), and veterans'
benefits and pensions is counted toward income limits. - ANSWER unearned
Which of the following services are covered under Medicaid? - ANSWER Nurse midwife services
EPSDT services for people under age twenty-one, including physical examinations,
immunizations, and certain age-relevant services
Laboratory and X-ray services
Inpatient and outpatient hospital services
Which of the following plans are offered by Medicaid in most states? (Select all that apply.) -
ANSWER Fee-for-service
Managed care
The federal government provides Medicaid patients with matching funds for which of these
more common optional services? - ANSWER Vision care
Diagnostic services
, Prescription drugs
If the patient has coverage through any other insurance plan, the other plan is billed first and
then what is forwarded from the primary payer to Medicaid? - ANSWER Remittance advice
Which of the following are advantages in having a Medicaid managed care plan? (Select all that
apply.) - ANSWER Choice of a PCP
Increased access to preventive care
Access to specialists.
When providers agree to accept payment from Medicaid as payment in full for services, which
of the following are true? (Select all that apply.) - ANSWER They may not bill patients for
additional amounts.
The difference must be entered into the billing system as a write-off.
With Medicaid managed care plans, claims are sent to the _____ instead of to the state
Medicaid department. - ANSWER managed care organization
What are claims billed to Medicare that are automatically sent to Medicaid called? - ANSWER
Crossover claims
Billing for services that are not medically necessary by physicians who contract with Medicaid to
provide services is an _____ billing practice. - ANSWER unacceptable
Medicaid claims are submitted to which of the following agencies, depending on the particular
state? (Select all that apply.) - ANSWER County welfare agencies
Fiscal intermediaries
State Department of Health and Human Services
