Ch 9: True and False

Question 1

T/F: Medicare Parts A and B are provided free of charge for all individuals older than 65

Answer 1

False

Question 2

T/F: Part A covers custodial and long-term care

Answer 2

False

Question 3

T/F: For durable medical equipment (DME) to qualify for Medicare payment, it must be ordered by a physician for use in the home, and items must be reusable

Answer 3

True

Question 4

T/F: Neither Medicare Part A nor Part B covers any preventive care services

Answer 4

False

Question 5

T/F: Most Medicare Part B beneficiaries pay for Part B coverage in the form of a premium deducted from their monthly Social Security check

Answer 5

True

Question 6

T/F: The private organization that determines payment of part B-covered items and services is called a peer review organization (PRO)

Answer 6

False

Question 7

T/F: Part A Medicare beneficiaries are allowed only one “benefit period” per year

Answer 7

False

Question 8

T/F: If individuals do not sign up for Medicare Part B when first becoming eligible and later decide to enroll, the monthly premiums may be higher due to penalties

Answer 8

True

Question 9

T/F: An individual must be eligible for Part A or B to enroll in a Medicare Advantage Plan

Answer 9

True

Question 10

T/F: If a beneficiary has a Medicare Advantage Plan, he or she still needs a supplemental policy

Answer 10

False

Question 11

T/F: An individual who has original Medicare Part A and B must have a supplemental policy

Answer 11

False

Question 12

T/F: When an individual turns 65 and enrolls in Medicare Part B, federal law forbids insurance companies from denying eligibility for Medigap policies for 6 months

Answer 12

True

Question 13

T/F: Workers’ compensation would likely be a primary payer to Medicare

Answer 13

True

Question 14

T/F: Medicare HMOs typically have no yearly cap on how much the enrollee pays for Part A and B services during the year

Answer 14

False

Question 15

T/F: Under certain circumstances, a signed release of information form for Medicare beneficiaries can be valid for more than 1 year

Answer 15

True

Question 16

T/F: Medicare’s definition of medical necessity must meed specific criteria

Answer 16

True

Question 17

T/F: Medicare HICNs are typically in the format of nine numeric characters followed by one alpha character

Answer 17

True

Question 18

T/F: The Medicare physicians’ fee schedule has been changed from a fee-for-service to a resource-based relative value system (RBRVS)

Answer 18

True

Question 19

T/F: Medicare nonPARs do not have to submit claims for their Medicare patients

Answer 19

False

Question 20

T/F: ASC X12 Version 5010 has been replaced by Version 4010/4010A1 as the standard for all HIPAA-covered transactions

Answer 20

False