coverages

Question 1

What is the ERISA and what coverage does it regulate under Federal law?

Answer 1

ERISA - Employee Retirement Income Security Act

Question 2

Are the following Part of the Medicare Advantage Plans?
Health Maintenance Plan
Handicap Needs Plans
Medicare Savings Accounts MSA
Preferred Physician Organizations PPO’s
Personal Fee -fee-Service Plans

Answer 2

None are correct
Health Maintenance ORGANIZATION HMO
SPECIAL Needs Plans
MEDICAID Savings Accounts MSA
Preferred PROVIDER Organization PPO
PRIVATE Fee-for-Services Plans

Question 3

What 2 factors are determinates for whether the Medicare Advantage organization is liable for the payments?

Answer 3

1 - Is the provider included in the inpatient hospital or home health Prospective Payment System PPS

2 Date of enrollment

Question 4

What is examples of Medicare Advantage Organization not being responsible for payment?

Answer 4

The patient changes Medicare Advantage Status during the stay

(Patient’s status at admission or start of care determines liability, beneficiary must be enrolled upon admission)