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Flashcards in Part 8 Deck (4)
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1

A participating provider (PAR) contracts with a health insurance plan and accepts whatever the plan pays for procedures or services performed. This means that PAR ________ allowed to bill patients for the difference between the contracted rate and their normal fee.

A. are not
B. are

are not

2

What is the special group that requires states to pay Medicare part B premiums for individuals with incomes between 120 and 175% of the federal poverty level?

A. Qualifying individuals
B. Qualified working disabled individuals
C. Specified low income Medicare beneficiaries
D. Qualified Medicare beneficiaries

Qualifying individuals

3

A child is listed as a dependent on both his father's and his mother's group insurance policies. The father's birth date is March 20, 1977 and the mother's birth date is March 6, 1979. What policy is primary?

A. Mother's policy
B. Father's policy

Mother's policy

4

When a patient seeks healthcare under the TRICARE program, sponsor information is verified in the ________ computer system, which contains up to date workforce personnel information.

A. CMS
B. MTF
C. DEERS
D. DOD

DEERS