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Flashcards in Part 5 Deck (10)
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Coordination of benefits (COB) is a provision in _________ health insurance policies intended to keep multiple insurers from paying benefits covered by other policies

A. Group
B. Private
C. Commercial
D. All



The Medicare Catastrophic coverage Act of 1988 implemented spousal impoverishment protection legislation in 1989to prevent married couples from being required to spend down income and other liquid assets (cash and property) before one of the partners could be declared eligible for medicaid coverage for nursing facility care. The spouse residing at home is called the _______ spouse.

A. Eligible
B. Surviving
C. Partner
D. Community



Medicare lifetime reserve days, which total _______ days, are used once during a patient's lifetime and are usually reserved for use during the patient's final, terminal hospital stay.

A. 120
B. 90
C. 30
D. 60



What is the term for a model of primary care that seeks meet the healthcare needs of patients and to improve patient and staff experiences, outcomes, safety, and, system efficiency?

A. Accountable care organization
B. Patient centered medical home
C. Demonstration project
D. Affordable care organization

Patient centered medical home


All of the following are true of state Medicaid programs EXCEPT:

A. Services offered to beneficiaries are the same in each state
B. Federal funds allocated. to each state are based on the average income per person for that state
C. The program must cover infants born to medicaid-eligible pregnant women
D. States may offer a managed care option

Services offered to beneficiaries are the same in each state


Which program pays for physician services, outpatient hospital care, and durable medical equipment?

A. Medicare Part B
B. Medicare Part A
C. Medicare Part C
D. Medicare Part D

Medicare Part B


Do you have to apply for Medicare on the exact day that you turn 65?

A. No
B. Yes



Which is the percentage the patient pays for covered services after the deductible has been met and the copayment has been paid?

A. Premium
B. Coinsurance
C. Deductible
D. Copayment



Providers have the option of arranging for ________, which means that payers deposit reimbursement for health care services to the provider's account electronically.

A. Electronic funds transfer
B. Electronic flat file formats
C. Electronic media claims
D. Electronic Data interchange

Electronic funds transfer


Which is a comprehensive health care program for which the department of veterans affairs shares costs of covered health care services ad supplies with eligible beneficiaries?

C. Medicare
D. Tricare