QUESTION: 321

The ________________ refers to a statement sent to the patient to clarify which services were provided, amount billed, and amount of payments made by the health plan.

Medicare summary notice.
remittance advice.
health care claims transaction.
coordination of benefits.

Answer(s): A

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QUESTION: 322

Currently, payment to the physician for outpatient surgery performed ona Medicare patient is based upon which prospective payment system?

set of categories.
classification system.
medical nomenclature.
diagnosis listing.

Answer(s): C

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QUESTION: 323

Which of the following best describes the situation of a provider who agrees to accept assignment for Medicare Part B services?

The provider is reimbursed at 15% above the allowed charge.
The provide is paid according to the Medicare physician fee schedule (MPFS) plus 10%.
The provider cannot bill the patients for the balance between the MPFs amount and the total charges.
The provider is a nonparticipating provider.

Answer(s): C

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According to the Federal Register, the definition of a "new" patient when assigning a CPT Evaluation and Management (medical visit) code to a Medicare hospital outpatient under the prospective payment system is a patient that has

not seen the physician within the last 3 years.
not seen the physician within the last 5 years.
not already been assigned a medical record number.
never seen the physician before.

Answer(s): C

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QUESTION: 321

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QUESTION: 323

QUESTION: 324

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