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  1. What services do medicare Part A, B & D Pay
    Part A-Hospital Ins Part B-Physician Services Part D-Prescribe Drugs
  2. The Privacy Rule Standards address the use and disclosure of individuals health information called
    HIPPA - Health Insurance Portability and Accountability Act
  3. Updates of special interest to hospital facilities are published in which month i the Federal Register?
    October
  4. In the RBRVS system payments for services are determined by the resource costs needed to provide them.  The cost of providing each service is divided into what three components?
    • 1. Physicians actual charge for services
    • 2. Physicians customary charge for services
    • 3. Physicians prevailing similar service in locality
  5. Who is responsible for developing an annual work plan to identify fraud.
    OIG - Office of the Inspector General
  6. The purpose of managed health care is to provide _____ services and theoretically to _____ the healthcare services provides to the enrollee.
    The purpose of managed health care is to provide network services and theoretically to improve the healthcare services provides to the enrollee.
  7. Two insurance programs were established in 1965 by amendments to the Social Security Act known as
    Part A and Part B
  8. The secretary of DHHS has delegated responsibilityfor Medicare to which department
    CMS's - Centers for Medicare Medicaid Services
  9. Who administer funds to medicare
    Social Security Administration
  10. Who is eligible for Medicare
    • Endstage Renal disease - Kidney Failure
    • 65 and over
    • Disability benefit
  11. Three component of the relative unit are
    work, overhead and malpractice insurance
  12. RBRVS
    Resource based relative value scale
  13. What is the fastest growing segment of our population today
    Elderly
  14. What is the name of group that handles the daily operations.
    Centers for Medicare and Medicaid services
  15. Intentional deception or misrepresentation is known as
    fraud
  16. Quality improvement organizations were previously termed
    PROS
  17. MS-DRG assignment reports Part   ____ services
    Part A
  18. ____ editions of the Federal Register are of special interest to hospital facilities.
    October editions of the Federal Register are of special interest to hospital facilities.
  19. OBRA 1990 contained modifications and clarifications regarding the ________
    Physician Fee Schedule.
Author
fcc
ID
340942
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Chapter 1
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