With a Basic Benefits Only plan, expenses not paid by the Basic Benefits would not be payable at all. With a Basic/Major Medical plan, expenses not paid by the Basic Benefit portion of the contract may be payable under the Major Medical portion
Indicate whether this statement is true or false.
Answer: T
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If an individual has both an employer-sponsored disability plan and a government-sponsored plan:
A) the government plan is primary, and the employer plan would supplement the benefits. B) the employer plan is primary, and the government plan would supplement the benefits. C) only the employer plan would pay benefits. D) only the government plan would pay benefits.
Which modifier is used to indicate that a different provider performed the preoperative procedure management of a patient?
a. 56 b. 46 c. 60 d. 65
Tapping of bone is done in fixation procedures to reduce:
a. number of screws needed b. torque pressure on screws c. size of fixation plate used d. need to strip periosteum first
A Stark violation occurs when _____
A) Billers submit insurance claims twice for the same service to the patients B) Financial payment for patient referrals is requested from healthcare facilities C) Insurance payments for patient services that were not provided are processed D) Providers refer patients to a facility in which the provider holds a financial interest