Alcohol and other drugs (AOD) case study Anna* (not her
See PPT”/content/enforced/1556987-2024SU-ESC-LMET-218_E2-52335/Medical Billing and Insurance Chapter 15.pptx” 1. What title does Medicaid fall under? 2. How is Medicaid funded? How does each state manage their funding? 3. What groups are Medicaid eligible? 4. Please list the special groups? 5. Describe the special groups. 6. What is the specified Low-income Medicare Beneficiary? What is the purpose? 7. What individuals are covered under the SLMB? 8. What is the purpose of the SCHIP under Medicaid? 9. Who implemented the SCHIP? 10. Describe the PACE. 11. Who implemented spousal impoverishment protection? 12. What is a community spouse? 13. Under the spousal impoverishment protection what income is used to pay nursing costs? 14. What is Medicaid Remittance Advice? 15. Define the term Subrogation. How does subrogation apply to major medical and injury coverage? 16. Why must Medicaid patients assign benefits to provider? 17. Why must participating Medicaid providers accept assignment? 18. Covered services under Medicaid must be______________. What must the covered services be consistent with? 19. What does SURS represent? What is its purpose? 20. Which utilization review process recovers overpayments and monitors the use and delivery of health services? 21. What is the difference between and adjusted claim and a voided claim? 22. What options are available to providers to verify eligibility? 23. What are the Medicaid Managed Care Preauthorization Guidelines? 24. What role does a provider play for patients enrolled in primary care case management (PCCM) plans? 25. How does Medicaid reimburse services for dual eligible patients?
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