Business Of Medicine

Question 1

Mid level provides

Answer 1

Physician assistant, nurse practitioner

Question 2

Medicare Part A

Answer 2

Covers inpatient hospital care, as well as skilled nursing facilities, hospice, and home health

Question 3

Medicare Part B

Answer 3

Covers two types of services. Medically necessary provider services, and preventive services. Part B is an optional benefit.

Question 4

Medicare Part C

Answer 4

Medicare Advantage. Combines part A, B and sometimes D. Managed by private insurers approved by Medicare.

Question 5

Medicare Part D

Answer 5

Prescription drug program available to all Medicare beneficiaries for a fee. Private companies provide for a fee.

Question 6

Medicare Administrative Contractor

Answer 6

Responsible for interpreting national policies into regional policies

Question 7

Local Coverage Determinations

Answer 7

Further define what codes are needed and when an item or service is covered. Have jurisdiction only in their region.

Question 8

HIPPA covered entities

Answer 8

Healthcare provider, health plans, healthcare clearing house.

Question 9

Excluded from HIPPA regulations

Answer 9

Accident or disability income insurance, supplements to liability insurance, liability insurance, workers comp, automobile medical payment insurance, credit only insurance, coverage for on site medical clinics, other similar insurance coverage