HSA 525 Midterm exam
Question 1
What are the two types of forms used for health services billing?
CMS 1501 and CMS 1450
UB 04
CMS 1100 and CMS 1450
UB-05 and UB-1450
Question 2
Describe how Medicaid payments to providers are limited by the federal government.
The payments to providers are not limited by the federal government but rather by state agencies
that have predetermind estimates.
The law requires that Medicaid payments to qualified hospitals, nursing facilities, ICF/MRs, and
clinics not exceed a reasonable estimate of the amount that Medicare would pay for equivalent
services in the aggregate within state-owned or operated, non-state-owned or operated, and
private facilities.
CMS reviews state payment methodologies and supporting documentation to ensure that the
state plan methodology may be audited and is comprehensively described and that payment rates
are economic, efficient, and sufficient to attract willing and qualified providers.
All of the statements are correct.
None of the statements are correct
Question 3
What is charge explosion?
Question 1
What are the two types of forms used for health services billing?
CMS 1501 and CMS 1450
UB 04
CMS 1100 and CMS 1450
UB-05 and UB-1450
Question 2
Describe how Medicaid payments to providers are limited by the federal government.
The payments to providers are not limited by the federal government but rather by state agencies
that have predetermind estimates.
The law requires that Medicaid payments to qualified hospitals, nursing facilities, ICF/MRs, and
clinics not exceed a reasonable estimate of the amount that Medicare would pay for equivalent
services in the aggregate within state-owned or operated, non-state-owned or operated, and
private facilities.
CMS reviews state payment methodologies and supporting documentation to ensure that the
state plan methodology may be audited and is comprehensively described and that payment rates
are economic, efficient, and sufficient to attract willing and qualified providers.
All of the statements are correct.
None of the statements are correct
Question 3
What is charge explosion?
