MEDICARE EXAMS TEST PAPER QUESTIONS AND
ANSWERS RATED A+
✔✔Patients may elect to use their Medicare lifetime reserve days after how many
continuous days of hospitalization? - ✔✔90
✔✔For a beneficiary to qualify for Medicare's skilled nursing benefit the individual must
have - ✔✔had at least three inpatient days of an acute hospital stay
✔✔Temporary hospitalization of a patient for the purpose of providing relief from duty
for the nonpaid primary caregiver of a patient is called _______ care. - ✔✔respite
✔✔All terminally ill Medicare patients qualify for _______ care - ✔✔hospice
✔✔Federal law requires that all providers and suppliers submit claims to Medicare if
they provide a Medicare-covered service to a patient enrolled in Medicare Part B. This
regulation does not apply if the patient is not enrolled in Medicare Part - ✔✔B
✔✔Which component of the Medicare Modernization Act of 2003 was created to
provide tax-favored treatment for individuals covered by a high-deductible health plan? -
✔✔Medicare savings account
✔✔Dr. Cummings has been practicing in town for nearly 30 years. As a courtesy to his
loyal Medicare patients, he does not charge the coinsurance. How can this affect Dr.
Cumming's practice? - ✔✔The doctor may be subject to large fines and exclusion from
the Medicare program
✔✔One of the benefits of becoming a Medicare participating provider (PAR) is -
✔✔faster processing and payment of assigned claims
✔✔The maximum that Medicare will reimburse a nonPAR for a covered service is 80
percent of the - ✔✔limiting charge
✔✔The maximum fee a provider a provider may charge is called - ✔✔limiting charge
✔✔Dr. Taylor has instructed you, as a health insurance specialist, to obtain an Advance
Beneficiary Notice (ABN) on all surgical cases in the practice just in case Medicare
denies the claim. How should you handle this situation? - ✔✔Explain to Dr. Taylor that
the practice cannot do this, as Medicare considers this activity fraudulent
✔✔What is entered in Block 11 of the CMS-1500 claim when a reference lab provides
services to Medicare patient in the absence of a face-to-face encounter? - ✔✔NONE
ANSWERS RATED A+
✔✔Patients may elect to use their Medicare lifetime reserve days after how many
continuous days of hospitalization? - ✔✔90
✔✔For a beneficiary to qualify for Medicare's skilled nursing benefit the individual must
have - ✔✔had at least three inpatient days of an acute hospital stay
✔✔Temporary hospitalization of a patient for the purpose of providing relief from duty
for the nonpaid primary caregiver of a patient is called _______ care. - ✔✔respite
✔✔All terminally ill Medicare patients qualify for _______ care - ✔✔hospice
✔✔Federal law requires that all providers and suppliers submit claims to Medicare if
they provide a Medicare-covered service to a patient enrolled in Medicare Part B. This
regulation does not apply if the patient is not enrolled in Medicare Part - ✔✔B
✔✔Which component of the Medicare Modernization Act of 2003 was created to
provide tax-favored treatment for individuals covered by a high-deductible health plan? -
✔✔Medicare savings account
✔✔Dr. Cummings has been practicing in town for nearly 30 years. As a courtesy to his
loyal Medicare patients, he does not charge the coinsurance. How can this affect Dr.
Cumming's practice? - ✔✔The doctor may be subject to large fines and exclusion from
the Medicare program
✔✔One of the benefits of becoming a Medicare participating provider (PAR) is -
✔✔faster processing and payment of assigned claims
✔✔The maximum that Medicare will reimburse a nonPAR for a covered service is 80
percent of the - ✔✔limiting charge
✔✔The maximum fee a provider a provider may charge is called - ✔✔limiting charge
✔✔Dr. Taylor has instructed you, as a health insurance specialist, to obtain an Advance
Beneficiary Notice (ABN) on all surgical cases in the practice just in case Medicare
denies the claim. How should you handle this situation? - ✔✔Explain to Dr. Taylor that
the practice cannot do this, as Medicare considers this activity fraudulent
✔✔What is entered in Block 11 of the CMS-1500 claim when a reference lab provides
services to Medicare patient in the absence of a face-to-face encounter? - ✔✔NONE
