Government Payers

Front 1

Medicare is available to people who are what age?

Back 1

65 and older

Front 2

Medicare Part A

Back 2

Covers hospital care, skilled nursing home care, and home health care

Front 3

Medicare Part B

Back 3

Covers outpatient care and physician services

Front 4

UCR fees (usual customary reasonable)

Back 4

Usual- the fee that the specific physician charges most of his patients for the same treatment

Reasonable- the midrange of fees charged for a type of visit

Customary- the average charge for a specific procedure by all the physicians practicing the same speciality in a specific geographical location

Front 5

Medicaid is funded by both the federal and the state government

Back 5

True

Front 6

What determines the eligibility for Medicaid coverage?

Back 6

Income, employment status, and state specific requirements

Front 7

If a patient has both Medicare and Medicaid which insurance plan gets billed first?

Back 7

Medicare

Front 8

TRICARE covers....?

Back 8

Dependents of active duty personnel, retired personnel, and dependents of personnel who died on active duty

Front 9

CHAMPVA covers....?

Back 9

Spouses and unmarried dependent children of veterans with permanent total disabilities from service related injuries

And

Surviving spouses and children of veterans who died of service related disabilities

Front 10

CHAMPVA stands for....?

Back 10

Civilian

Health

And

Medical

Program

Veteran

Affairs

Front 11

TRICARE and CHAMPVA are billed after all other insurance except for....?

Back 11

Medicaid

Front 12

A person can be covered by both TRICARE and CHAMPVA

Back 12

False

Front 13

If a patient is self insured, call the plan administrator before scheduling an appointment, to be sure of the claim requirements

Back 13

True