EPIC TEST STUDY SET QUESTIONS
AND ANSWERS WITH COMPLETE
SOLUTIONS WELL ELABORATED !!!
Question 1
True or False: During the initial 30-month coordination of benefits period for
a patient with ESRD, does their commercial insurance remain the primary
payer over Medicare? ✔️✔️
Answer: True. For the first 30 months of coordination, the employer-sponsored or
commercial plan pays first, and Medicare acts as the secondary payer.
Question 2
Under what specific conditions can a patient qualify for "dual entitlement" to
Medicare? ✔️✔️
Answer: Dual entitlement occurs when an individual qualifies based on Age
combined with ESRD (End-Stage Renal Disease) or Disability combined with
ESRD.
Question 3
Which of the following actions is not considered a part of the Financial
Clearance process? ✔️✔️
Answer: Receiving the final payment from the insurance company is not part
of clearance; financial clearance involves verifying coverage and obtaining
authorizations before the service is rendered.
Question 4
If Medicare is expected to deny coverage for a specific portion of a spine
surgery, which CMS-mandated document must be signed by the patient to
acknowledge their financial responsibility? ✔️✔️
AND ANSWERS WITH COMPLETE
SOLUTIONS WELL ELABORATED !!!
Question 1
True or False: During the initial 30-month coordination of benefits period for
a patient with ESRD, does their commercial insurance remain the primary
payer over Medicare? ✔️✔️
Answer: True. For the first 30 months of coordination, the employer-sponsored or
commercial plan pays first, and Medicare acts as the secondary payer.
Question 2
Under what specific conditions can a patient qualify for "dual entitlement" to
Medicare? ✔️✔️
Answer: Dual entitlement occurs when an individual qualifies based on Age
combined with ESRD (End-Stage Renal Disease) or Disability combined with
ESRD.
Question 3
Which of the following actions is not considered a part of the Financial
Clearance process? ✔️✔️
Answer: Receiving the final payment from the insurance company is not part
of clearance; financial clearance involves verifying coverage and obtaining
authorizations before the service is rendered.
Question 4
If Medicare is expected to deny coverage for a specific portion of a spine
surgery, which CMS-mandated document must be signed by the patient to
acknowledge their financial responsibility? ✔️✔️
