Question 1

Most states provide electronic verification of Medicaid eligibility.

Accepted Answer

Most states have implemented electronic verification systems for Medicaid eligibility. This allows healthcare providers to quickly verify a patient's eligibility status and reduces errors and fraud in the system.

Question 2

Medicaid claims that are denied due to incomplete information can be corrected and resubmitted.

Accepted Answer

Medicaid allows denied claims due to incomplete information to be corrected and resubmitted. However, the resubmission must include all the necessary information to get approval.

Question 3

Legal resident aliens who entered the United States after 1996 are eligible for Medicaid after __________ years.

Accepted Answer

The answer of Legal resident aliens who entered the United...

Question 4

All Medicaid beneficiaries are exempt from copayments for __________ and __________ services.

Accepted Answer

The answer of All Medicaid beneficiaries are exempt from copayments...

Question 5

The federal government makes payments to states for a portion of the cost of medical services provided to Medicaid beneficiaries under the __________ program.

Accepted Answer

The answer of The federal government makes payments to states...

Question 6

Claims filed by a hospital for inpatient services must be received by Medicaid within 95 days of the discharge date.

Accepted Answer

Medicaid requires that claims for inpatient services be received within 95 days of the discharge date.

Question 7

The federal-state program that provides medical benefits to specific groups of low-income people is __________ .

Accepted Answer

The answer of The federal-state program that provides medical benefits...

Question 8

The category of individuals who would be eligible for Medicaid services but have too much money is known as the __________ .

Accepted Answer

The answer of The category of individuals who would be...

Question 9

The cost of Medicaid benefits has been decreasing rapidly since the 1990s.

Accepted Answer

The cost of Medicaid benefits has actually been increasing since the 1990s due to factors such as rising healthcare costs, an aging population, and the expansion of Medicaid under the Affordable Care Act.

Question 10

The form signed by a patient that states the amount and reason why a procedure is NOT covered by Medicaid is a(n) __________ notice.

Accepted Answer

The answer of The form signed by a patient that...

Question 11

If a Medicaid patient is on restricted status, the patient is required to see a specific physician and/or to use a specific pharmacy.

Accepted Answer

If a Medicaid patient is on restricted status, they are required to see a specific physician and/or use a specific pharmacy. This is often due to cost savings measures or to ensure proper management of their medical conditions.

Question 12

A type of noncapitated Medicaid managed care plan in which participants must select a primary care physician is known as primary care __________ .

Accepted Answer

The answer of A type of noncapitated Medicaid managed care...

Question 13

Medicaid patients enrolled in managed care plans must select a primary care provider.

Accepted Answer

Medicaid patients enrolled in managed care plans are required to select a primary care provider (PCP) to coordinate their healthcare services. The PCP is the first point of contact for the patient and is responsible for managing and coordinating all of their healthcare needs, including referrals to specialists if needed.

Question 14

A type of Medicaid managed care plan can involve a health maintenance organization that contracts with Medicaid and is paid a monthly fee for each enrolled beneficiary; this payment arrangement is known as __________ .

Accepted Answer

The answer of A type of Medicaid managed care plan...

Question 15

Healthcare Common Procedure Coding System (HCPCS) codes are required on both Medicaid physician and hospital claim forms.

Accepted Answer

HCPCS codes are a required component of Medicaid claim forms for physicians and hospitals.

Question 16

The federal government matches state expenditures for medical assistance with no set limit or cap.

Accepted Answer

This is known as the Medicaid matching formula, where the federal government matches state expenditures for medical assistance with a percentage based on the state's per capita income. There is no set limit or cap on the federal matching funds.

Question 17

To be considered for payment, a denied Medicaid claim must be appealed within 60 days of the date of denial notification.

Accepted Answer

The specific time frame for appealing a denied Medicaid claim can vary by state, but it is commonly 90 days from the date of the denial notification, not 60 days.

Question 18

The program that provides states with grants to be spent on time-limited cash assistance to low-income families is called __________ .

Accepted Answer

The answer of The program that provides states with grants...

Question 19

If a Medicaid claim was NOT filed within the required time limits because of an error or neglect on the part of the medical office staff, the physician can appeal the denial and seek payment.

Accepted Answer

The answer of If a Medicaid claim was NOT filed...

Question 20

A low-income individual age 65 or older may be eligible for both Medicare and __________ health insurance coverage.

Accepted Answer

The answer of A low-income individual age 65 or older...

Quiz 14: Medicaid Medical Billing