Ch 1: Text Questions Flashcards
Reimbursement, HIPAA, and Compliance
What Medicare part provides automatic coverage under Social Security?
A
What Medicare part provides optional coverage under Social Security?
B, C, & D
What Medicare part provides hospice care coverage?
A
What Medicare part provides Prescription drug coverage?
D
What Medicare part provides physician visit coverage?
B
What Medicare part requires that the beneficiary pay a premium for coverage?
B, C, & D
What Medicare part assigns codes for payment using diagnosis; CPT; and HCPCS?
A, B, & C
Who is the major third-party payer in the United States?
The government
The Medicare program was established in what year?
1965
What Medicare part includes hospice insurance?
A
What Medicare part is Supplemental Medical Insurance?
B
What edition of the “Federal Register” is of special interest to hospital facilities?
October
What edition of the “Federal Register” is of special interest to outpatient facilities?
November or December
What does RBRVS stand for?
Resource-Based Relative Value Scale
The Medicare Economic Index is published in what publication?
Federal Register
In 1989, a major change took place in Medicare with the enactment of what law?
OBRA (Omnibus Reconciliation Act)
The intentional deception or misrepresentation that an individual knows to be false or does not believe to be true and makes knowing that the deception could result in some unauthorized benefit
Fraud
What organization develops a work plan to identify areas of the Medicare program that will be monitored?
OIG (Office of the Inspector General)
The physician responsible for controlling and managing the health care of an HMO enrollee is the _____?
Gatekeeper
What does the abbreviation PACE stand for?
Program for All-Inclusive Care of the Elderly
