MANAGED CARE October 1997. ©1997 Stezzi Communications
INSURANCE WRITTEN TEST ANSWERS
1.A nonparticipating provider for Medicare may charge:
c)his/her limiting fee
2.If a physician is a participating provider for Medicare, he/she may collect :
e)C & D [20% of allowed fees & amount applied to deductible]
3.If a physician is a nonparticipating provider for Medicare, assignment must be accepted on:
c)all lab charges
4.When a physician belongs to a PPO, he/she:
d)none of the above
5.For billing private insurance plans, "accept assignment" means:
b)payment comes to the office, but the balance can be billed to the patient
6.You may never collect money from a Medicaid patient.
7. Medicare is requiring all physicians to accept assignment.
8. An HMO insurance plan often utilizes a gatekeeper. Which definition most closely describes the gatekeeper?
b)the primary care physician