A provider sees a patient who has TRICARE Select. The provider is not contracted with
TRICARE but is certified by the regional TRICARE Managed Care Support Contractor
(MCSC). The provider charges $200 for the office visit. TRICARE allows $160 and pays
$140. How much can the provider bill the patient for? - Answers. $60.00
What organization is responsible in evaluating the medical necessity, appropriateness,
and efficiency of the use of healthcare services and procedures? - AnswersUtilization
Review Organization
Medicaid providers are forbidden by law to: - AnswersBalance bill patients
Which statement is FALSE about Local Coverage Determinations (LCDs)? -
AnswersCMS develops LCDs when there is no National Coverage Determination
When a minor procedure is performed on a Medicare patient, what is the global period
and what time frame is covered? - Answers10-day global period - the day of the
procedure and 10 days following the procedure.
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Question 11
If add-on procedure code 11103 is performed twice during an office visit, how is it
indicated on the CMS-1500 claim form? - AnswersCode 11103 is reported once with the
number 2 in box 24G
Which set of documentation guidelines can be used for E/M services submitted to
Medicare for a physician assistant (PA)? - AnswersEither 1995 or 1997 CMS
documentation guidelines
Select the scenario that meets the incident-to requirements - AnswersCare is delivered
to an established patient by the physician assistant as part of the physician's treatment
plan while the physician is seeing another
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