H08V EXAM 3 ANSWERS - ASHWORTH

H08V EXAM 3 ANSWERS - ASHWORTH

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H08V Medical Coding II Exam 3 Answers (Ashworth)
Question 1

5 / 5 points
A patient has been denied the privately offered supplemental insurance that covers the things that Medicare doesn’t cover. Which one of the following choices might be a reason the patient has been denied?
Question options:
a) 
The patient makes too much money.

b) 
The patient has unmatched diagnoses on his claims.

c) 
The patient hasn’t chosen a primary care physician.

d) 
The patient is enrolled in an HMO.

Question 2

5 / 5 points
An elderly Medicare patient has prescription drug coverage but isn’t enrolled in Medicare Part D. She is probably covered under
Question options:
a) 
SSA.

b) 
PACE.

c) 
FFS.

d) 
MAGI.

Question 3

5 / 5 points
Civil penalties, in addition to triple damages, can be imposed on providers who
Question options:
a) 
refuse to work with Medicare patients.

b) 
accept Medicare Part A patients only and no other insurances.

c) 
are found in violation for Medicare abuse or fraud.

d) 
can’t participate in supplemental insurance plans.

Question 4

5 / 5 points
It’s March 2018, and Dr. Smith still hasn’t converted to an EHR. How much will Dr. Smith be penalized in the Medicare Part B reimbursement for not using an EHR?
Question options:
a) 
1%

b) 
2%

c) 
3%

d) 
4%

Question 5

5 / 5 points
Which law established Medicare Part C?
Question options:
a) 
Balanced Budget Act of 1997

b) 
Health Care Financing Act

c) 
Tax Relief and Health Care Act

d) 
Health, Education, and Welfare Act

Question 6

5 / 5 points
Which one of the following choices helps determine reimbursement for providers and also assesses the quality of health care provided by facilities?
Question options:
a) 
FAR

b) 
MAC

c) 
CMS

d) 
RAC

Question 7

0 / 5 points
The decision of whether or not to reimburse Medicare payments to physicians who are noncompliant can be made by
Question options:
a) 
AMA.

b) 
LCD.

c) 
DHHS.

d) 
LMP.

Question 8

5 / 5 points
A private health insurer that has been granted a specific geographic area to adjudicate Medicare Part A and Medicare Part B is known as
Question options:
a) 
RAC.

b) 
LTR.

c) 
MAC.

d) 
SNF.

Question 9

0 / 5 points
Which one of the following choices was implemented, in part, to help determine errors by FIs?
Question options:
a) 
CMS

b) 
MMA

c) 
RAC

d) 
SNF

Question 10

5 / 5 points
A patient over age 65 was admitted to the hospital for a hip fracture and surgery. Which one of the following choices is probably the patient’s primary hospital insurance?
Question options:
a) 
Medicare Part A

b) 
Medicare Part B

c) 
Medicare Part C

d) 
Medicare Part D

Question 11

5 / 5 points
A physician just received information that tells her what payment she will receive for treating a Medicare patient and how much the patient owes. She is probably reviewing a(n)
Question options:
a) 
ERA.

b) 
CMS-1500.

c) 
MAC.

d) 
MSP.

Question 12

5 / 5 points
A hospital doesn’t have the blood type that it needs for a Medicare patient and has to buy it from a blood bank. What is probably the cost to the patient?
Question options:
a) 
The patient isn’t responsible for any of the cost.

b) 
The cost for first three units

c) 
20% of the cost for the first three units

d) 
80% of the cost for the first three units

Question 13

5 / 5 points
A Medicare Part A patient has been hospitalized for 72 days. For how many of those days will the patient need to pay coinsurance?
Question options:
a) 
0

b) 
12

c) 
60

d) 
72

Question 14

5 / 5 points
A patient has a mole removed that posed no harm, but she didn’t like the way it looked on her face. Coverage would probably be denied under Medicare because
Question options:
a) 
the mole was removed by a specialist.

b) 
the mole was removed on an outpatient basis.

c) 
she did not notify Medicare ahead of time.

d) 
it wasn’t medically necessary.

Question 15

5 / 5 points
Which one of the following choices is covered for Medicare Part A inpatients?
Question options:
a) 
Television in the room

b) 
Semiprivate rooms

c) 
Telephone access in the hospital room

d) 
Private nursing

Question 16

5 / 5 points
Which one of the following choices is an example of Medicare fraud?
Question options:
a) 
A nonparticipating physician treats Medicare patients

b) 
A physician makes no effort to collect coinsurance for Medicare patients

c) 
A physician files Medicare claims on a daily basis

d) 
A physician refuses to treat Medicare patients

Question 17

5 / 5 points
Which one of the following choices helps the CMS collect Medicare premiums?
Question options:
a) 
DRG

b) 
SSA

c) 
MA

d) 
FI

Question 18

5 / 5 points
A Medicare Part A patient was in the hospital for 4 coinsurance days in 2017. How much will the patient have to pay total for those coinsurance days?
Question options:
a) 
$25

b) 
$289

c) 
$1,316

d) 
$4,624

Question 19

0 / 5 points
Which one of the following choices is a responsibility of a MAC?
Question options:
a) 
Putting new healthcare legislation in place

b) 
Keeping records on the quality of Medicare providers

c) 
Creating SNF day requirements for reimbursement

d) 
Providing annual updates for AT billing modifiers

Question 20

5 / 5 points
Which one of the following individuals is eligible for Medicare hospital insurance?
Question options:
a) 
7-year-old healthy child

b) 
34-year-old wife of a man currently enlisted in the army

c) 
12-year-old girl receiving dialysis for end-stage renal disease

d) 
67-year-old man who has never paid FICA


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