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Plans that may be offered under a Medicare Advantage Plan include
Select one:
a. HMO.
b. POS.
c. PPO.
d. All are correct.Correct
Question 2
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The federal aspects of Medicaid are the responsibility of the
Select one:
a. AMA.
b. AHA.
c. HIAA.
d. CMS.Correct
Question 3
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A short-term inpatient stay that is necessary for a terminally ill patient to give temporary relief to the person who regularly assists with home care is referred to as
Select one:
a. Hospice care.
b. Respite care.Correct
c. Caregiver relief.
d. Custodial services.
Question 4
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The Social Security Act of 1935
Select one:
a. created the public assistance programs.Correct
b. made a special provision for medical assistance.
c. made a special provision for dental coverage.
d. set up the state medical programs.
Question 5
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An organization that gives members freedom of choice among physicians and hospitals and provides a higher level of benefits if the providers listed on the plan are used is called a/an
Select one:
a. health maintenance organization (HMO).Incorrect
b. managed care organization (MCO).
c. preferred provider organization (PPO).
d. exclusive provider organization (EPO).
Question 6
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What is the correct procedure to collect a copayment on a managed care plan?
Select one:
a. There is no copayment with a managed care plan.
b. Bill the plan for the copayment.
c. Bill the patient for the copayment.
d. Collect the copayment when the patient arrives for the office visit.Correct
Question 7
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Fee-for-service plans offered by private health insurance companies are also referred to as
Select one:
a. traditional insurance plans.
b. indemnity insurance plans.Incorrect
c. managed care plans.
d. both traditional insurance plans and indemnity insurance plans.
Question 8
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In the Medicare program, there is mandatory assignment for
Select one:
a. clinical laboratory tests.
b. surgery performed in the physician’s office.Incorrect
c. ECGs.
d. E/M services.
Question 9
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The Omnibus Budget Reconciliation Act
Select one:
a. helped set up a Medicaid fund for each state.
b. provided assistance for the blind who are below the poverty level and who are covered under the Medicare program.
c. provided assistance for the aged and disabled who are receiving Medicare and whose incomes are below the poverty level.Correct
d. set up counseling centers for those on Medicaid and Medicare.
Question 10
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When a physician sees a patient more than is medically necessary, it is called
Select one:
a. buffing.
b. turfing.
c. churning.Correct
d. stirring.
Question 11
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In an independent practice association (IPA), physicians are
Select one:
a. paid salaries by their own independent group.
b. paid salaries by the practice association.Incorrect
c. not employees and are not paid salaries.
d. not paid until the end of the year in which services were rendered.
Question 12
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Medigap insurance may cover
Select one:
a. all physician and hospital deductibles.Incorrect
b. the deductible not covered under Medicare.
c. 80% of the Medicare allowed amount.
d. 75% of the Medicare allowed amount.
Question 13
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When an HMO is paid a fixed amount for each patient served without considering the actual number or nature of services provided to each person, this is known as
Select one:
a. fee-for-service.
b. capitation.Correct
c. usual charges.
d. customary fees.
Question 14
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The Blue Shield plans were established primarily to cover
Select one:
a. hospital expenses.
b. physician services.
c. both hospital expenses and physician services.Incorrect
Question 15
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Under the prospective payment system (PPS), hospitals treating Medicare patients are reimbursed according to
Select one:
a. a new fee schedule established in 1983.
b. preestablished rates for each type of illness treated based on diagnosis.Correct
c. preestablished rates for each type of hospital stay based on services.
d. a hospital capitation plan.
Question 16
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Under the Spousal Impoverishment Protection Law, protection does not count
Select one:
a. cash, checking, and savings accounts.
b. life insurance policies.
c. certificates of deposit.
d. burial assets.Correct
Question 17
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Some Medicare Advantage plans may provide services not covered by Medicare, such as
Select one:
a. laboratory and x-ray services.
b. vaccines and ambulance services.
c. mammograms and Pap smears.
d. eyeglasses and prescription drugs.Correct
Question 18
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Health care organizations/providers may accept or refuse to treat Medicaid patients, based on
Select one:
a. the individual patient’s personality.
b. the individual patient’s medical situation.
c. the entire Medicaid program rather than individual’s circumstances.
d. All are correct.Incorrect
Question 19
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National health coverage for American 65 years and older known as Medicare was signed into legislation by
Select one:
a. Theodore Roosevelt.
b. Harry Truman.
c. John F. Kennedy.
d. Lyndon B. Johnson.Correct
Question 20
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The Medicaid service for prevention, early detection, and treatment for welfare children is known as
Select one:
a. CHPS.
b. EPSDT.Correct
c. EPDT.
d. CHAP.
Question 21
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The Medicaid program is funded
Select one:
a. by state government.
b. by federal government.
c. jointly by state and federal governments.Correct
d. by charitable organizations.
Question 22
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An example of an Advanced Alternative Payment Model is
Select one:
a. Accountable Care Organizations.Incorrect
b. Patient Centered Medical Homes.
c. bundled payment models.
d. All are correct.
Question 23
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Programs available to low-income individuals with out-of-pocket costs for Medicare, including Medicare Part A and Part B premiums, deductibles, copayments, and coinsurance:
Select one:
a. MSPCorrect
b. SSI
c. MCHP
d. TANF
Question 24
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A Federal government program which provides limited cash assistance to extremely low-income parents and their children when the parents or other responsible relatives cannot provide for the family’s basic needs.
Select one:
a. MSP
b. SSI
c. TANFCorrect
d. MN
Question 25
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What is the federal agency that is responsible for implementation of all rules, regulations, and health-related policies governing the Medicare program?
Select one:
a. CMS
b. DHHSIncorrect
c. The Center for Beneficiary Choices

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