Ex 1 Par 1 Flashcards
Chiropractic is covered. Under what parts of Medicare?
B and C
Does Medicare pay for maintenance care?
No
What does HSA stand for?
Health savings account
What empowers the patient to spend their own money using a tax exempt trust or custodial account?
Health saving account.
What does HRA stand for?
Health reimbursement arrangement
What is when the patient determines how when and where the money is spent.
HRA
what does MSA stand for?
Medicare——Medical saving account
What is when the patient pays for services not covered by Medicare and can save up for future expenses?
MSA
What is VEBA?
Voluntary employee benefit association
What is employees in geographic area band together ?
VEBA
What does MEWA stand for>
Multiple employer welfare arrangements
What is 2 plus unrelated employers may establish a healthcare plan. Gives small employers access to low cost health coverage?
MEWA
What are the Medicare eligibility requirements?
65+, disabled/anyone receiving SS benefits in the last 2 years. Renal disease/ALS
What is NPI?
National provider identifier
What does an NPI re validation requirements?
Every 5 years
Medicare part A=
Hospital
Medicare part B= ?
Physician
Medicare part C= ?
Advantage plans
Mediacare part D= ?
Rx coverage
Par vs non par ? Par is….
Contract, accept assignment on all claims, payments made to provider, secondary insurance automatically billed, payments up to 15% higher than non par, provider listen in directory.
What are used to call attention to a code on the claim form?
Modifiers
What does AT indicate?
Active care and payment goes to the DC/pt.
What does GA indicate?
Patient will pay
What code can trigger and audit?
GZ
What does GZ indicate?
DC failed to get an ABN form signed
What does GY indicate?
Service excluded, medicare wont pay
What does GP indicate?
Non CMT therapies
What does GX indicate?
ABN used to tell pt they will pay
What produces local coverage determinations?
MAC
What specifies under what circumstances a service is considered reasonable and necessary ?
LCDs
