Medicare

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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


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