Insurance and Reimbursement Flashcards
7 cards from real RMA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Insurance and Reimbursement flashcards as text
What does the Medicare Part A program primarily cover?
Answer: Inpatient hospital care
Medicare Part A covers inpatient hospital, skilled nursing, and related institutional care.
Medicare Part B primarily covers:
Answer: Outpatient and physician services
Part B covers outpatient care, physician visits, and preventive services.
Medicare Part D provides coverage for:
Answer: Prescription drugs
Part D is the prescription drug benefit of Medicare.
TRICARE provides health coverage primarily for which group?
Answer: Active-duty military members and their dependents
TRICARE serves uniformed service members, retirees, and their families.
Workers' compensation insurance covers:
Answer: Job-related injuries and illnesses
Workers' compensation pays for injuries and illnesses that occur on the job.
Within how many days of a clean claim does the timely filing limit typically require submission to most commercial payers?
Answer: Within the payer's stated filing deadline, often 90 to 365 days
Each payer sets a timely filing limit, commonly ranging from 90 to 365 days from the date of service.
A 'fee-for-service' reimbursement model pays providers based on:
Answer: Each individual service or procedure provided
Fee-for-service reimburses separately for every service performed.