Unit 2: Quiz 1

Question 1

Medicare Part A

Answer 1

• Hospital Insurance
• Mandatory
• IRF, SNF, certain home health, Hospice
• funded by FICA

Question 2

Medicare Part B

Answer 2

• Supplemental medical insurance
• Voluntary
• Physician Services, OP Hospital Services, select home health services

Question 3

Medicare Part C

Answer 3

• Medicare Advantage Plan
• private insurance companies that contract with medicare for Part A and Part B benefits

Question 4

Medicare Part D

Answer 4

• prescription drug coverage

Question 5

The following statement describes payment for which setting:

A prospective payment system that covers a 30-day episode of care that covers all services except DME, with no limit on the number of episodes of care.

Answer 5

Home Health Care

Question 6

Define an Advanced Beneficiary Notice (ABN):

Answer 6

A notification to a Medicare beneficiary that Medicare might not cover the services and there is the possibility of having to pay for services out of pocket​

Question 7

Which of the following determines payment in the Acute Care Setting?

Answer 7

MS-DRG

Question 8

Health Maintenance Organization (HMO)

Answer 8

assumes both the financials risks associated with providing comprehensive medical services (insurance and service risk)
- and the ____

Question 9

Preferred Provider Organization​ (PPO)​

Answer 9

provides coverage to participants through a network of selected healthcare providers

• the enrollees may go outside the ____

Question 10

Exclusive Provider Organization​ (EPO)

Answer 10

must use providers from specified network of physicians and hospitals to receive coverage

• no coverage for care received___

Question 11

Point of Service​ (POS​)

Answer 11

• hybrid
• fixed, prepaid for in network services
• services received outside of the network are usually reimbursed in a manner _____

Question 12

Which of the following provides information used to determine the payment rate for a Home Health Agency?

Answer 12

Outcome and Assessment Information Set (OASIS)

Question 13

Which of the following settings use a Prospective payment system for health care payment?

Answer 13

• SNF
• IRF
• Acute Care
• LTACH
• Home Health Care

Question 14

Considering payment, what setting does the following statement describe?

The first 60 days are fully covered with a co-pay starting on day 61; 60% of the facilities population must meet 1 of the pathological conditions specified by CMS; specific quality measures must be submitted annually or the facility will incur a 2% reduction in payment.

Answer 14

IRF

Question 15

T or F: Parents must pay a minimal fee for their child to receive Physical Therapy services under IDEA in the school setting.

Answer 15

FALSE

Question 16

a therapist is treating 2 patients at the same time, one patient is performing seated exercises in a wheelchair and the therapist is working on gait training with the other patient in the parallel bars

what type of therapy?

Answer 16

CONCURRENT