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| 1 | |
Under Medicare Part B, patients are not permitted to |
| | A) | remain in the hospital for more than 90 days. |
| | B) | receive medical care at home. |
| | C) | purchase private insurance. |
| | D) | submit their own claims for reimbursement. |
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| 2 | |
The appropriate way to file a Medicare form for a patient who cannot sign a claim form is to |
| | A) | have the physician sign the claim form. |
| | B) | submit the patient's signature on a Lifetime Beneficiary Claim Authorization and Information Release. |
| | C) | ask a family member to sign the claim form. |
| | D) | submit the claim form with no signature. |
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| 3 | |
The payment system used by Medicare is based on |
| | A) | prevailing rates in the region. |
| | B) | resources. |
| | C) | the value of the service rendered. |
| | D) | fee for service. |
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| 4 | |
Which of the following is correct regarding electronic claims submission? |
| | A) | an in-house computer system can communicate with an insurer's system |
| | B) | a time-share computer system sends insurance information by modem directly to an insurance company's computers |
| | C) | a batch system computer enters insurance information to be stored, retrieved, edited, or printed out as needed |
| | D) | an ECT system is quick, uses no paper, and permits fewer mistakes and omissions than other methods of transmitting claims |
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| 5 | |
The amount Medicare pays the physician or health care provider after the $100 annual deductible is met is |
| | A) | 20%. |
| | B) | 50%. |
| | C) | 80%. |
| | D) | 100%. |
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| 6 | |
A patient who has been hospitalized up to 90 days for each benefit period is covered under |
| | A) | Medicare Part A. |
| | B) | CHAMPUS. |
| | C) | Medicare Part B. |
| | D) | CHAMPVA. |
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| 7 | |
An appropriate approach to maintaining patient confidentiality on the computer is to |
| | A) | change your password every 90 days. |
| | B) | keep magnetic computer disks or tapes on top of your desk. |
| | C) | make sure a co-worker knows your password. |
| | D) | allow former employees to keep their passwords. |
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| 8 | |
Medicare's new fee schedule regulating payment for all services and procedures provided by doctors is based on |
| | A) | CMS's Common Procedures Coding System. |
| | B) | the geographic practice cost index (GPI) called “gypsy,” which takes regional differences into account. |
| | C) | Medigap, to reduce the gap in coverage. |
| | D) | the fact that patients may now be billed for any services not covered by Medicare. |
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| 9 | |
When entering data in medical billing programs, always |
| | A) | use prefixes such as Mr., Mrs. or MS. |
| | B) | enter information in CAPS. |
| | C) | use “see above” for repeated data. |
| | D) | hyphens, commas and apostrophes as appropriate. |
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| 10 | |
A benefit period for Medicare begins the day a patient goes into the hospital and ends when that patient has not been hospitalized for ____ days. |
| | A) | 30 |
| | B) | 60 |
| | C) | 90 |
| | D) | 120 |
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