Medicare
Each Medicare enrollee receives a Medicare Card issued by the
Social Security Administration.
Medicare Part B is known as
Supplementary Medical Insurance (SMI)
Urgently needed care is defined in the Medicare program as unexpected illness or injury that requires
immediate treatment
Services supervised by the physican but provided by nonphysician practicioners are billed under
incident-to rules. Ex physician assistants or nurse practitioners.
ABN
Advance Beneficiary Notice
Who is Eligible for Medicare?
Age 65, who receives social security benefits is automatically enrolled in Medicare part A and eligible for part b.
The modifier ____ is appended to procedure codes for non-covered Medicare services when the item is excluded and an ABN is not required.
GY
A ______ plan offers fill in the gap insurance
medigap
The Medicare Limiting Charge is the highest fee that can be charged for a procedure by a
nonparticipating provider
What is Medicare Part A
Hospital insurance Care for skilled nursing facility is also covered under part A.
A_______ _________ is performed for a patient who does not have symptoms, abnormal findings, or any past history of disease.
screening service
Retired Fed Employees who are enrolled in the civil service retirement system are eligible for benefits and their spouces
true
Medicare Part D provides
voluntary Medicare prescription drug plans
CLIA is administered by
CMS
CWF
Common working file
Medicare part C was originally called
Medicare + choice
Roster billing applies to
Medicare Part B claims
Patients receive a MSN that details the services they were provided over a thirty-day period, the amounts charged, and the amounts they may be billed.
Medicare Summary Notice
All lab work paid for by Medicare is regulated by
CLIA rules, (Clinical Laboratory improvement amendments).
Medicare Advantage offers three types of plans including
Medicare private fee-for service plans, Medicare coordinated care plans (CCP's) and Medicare Savings Accounts (MSA's)
Medicare Part B services Covered
Physician services, outpatient hospital services, DME, medical equipment and other services and supplies
Medicare part B does not provide benefits for _______ surgery
cosmetic
People age 65 are not eligible for part A can
enroll by paying a premium