Froggy Jumps MedicareOnline version Medicare by julie felix 1 Which part of MCR do we deal with? a Part B b Part A c Part D 2 A MCR Advantage plan is a coverage for hospital expenses only. b An alternative to Original MCR c required for pt's over 70 years of age. 3 Which of these is NOT a name for MCR Advantage? a MCR Part C b MCR Supplement plan c MCR Risk 4 The website that contains a wealth of info concerning MCR policies, fee schedules and more is a CMS.gov b WPS c Palmetto 5 NGS processes MCR claims when a services are rendered in Illinois b services are rendered in Missouri c services are for Railroad Retirees 6 MBI stands for a Medicare Beneficiary Identifier b Must Bill Insurance c Medicare Beneficiary Information 7 WPS processes MCR claims when a when services are rendered in Illinois b when services are rendered in Missouri c when services are for Railroad Retirees 8 WPS may also be referred to as a MBI b CONNEX c CSNAP 9 Palmetto GBA processes MCR claims when a When services are rendered in Illinois b Services are for Railroad Retirees c When services are rendered in Missouri 10 When calling MCR, you will need to have a the AWV, IPPES & ABN b the MAC, WPS & NGS c the Group NPI, TIN & PTAN 11 MCR Timely filing for original and corrected claims is a 12 months from the DOS b 2 years from the DOS c 180 days from the DOS 12 MCR timely filing for a redetermination is a 90 days from the date if initial determination b 120 days from date of initial determination c 180 days from the date of initial determination 13 MCR reconsideration timely filing is a 90 days from receipt of redetermination b 120 days from the date of receipt of redetermination c 180 days from the date of receipt of redetermination 14 After a redetermination & reconsideration have been sent, a you should get with your supervisor before proceeding to the next appeal level. b You should send a written appeal to the ALJ. c You should send a written appeal to the DAB. 15 What are the 3 Rs of MCR? a Reconsider, Resubmit, Redetermination b Resubmit, Reopen, Redetermination c Reprocess, Review, Repeat 16 A rejected claim should be a sent to coding for review b resubmitted in Epic c re opened on WPS 17 A re-opening is used to a have a rejected claim re-processed. b appeal a redetermination. c fix minor mistakes such as inaccurate data entry. 18 A corrected claim for MCR should a include all charges. b only include the line or lines that need to be corrected. c be faxed to MCR. 19 Once the MCR corrected claim has been submitted in Epic, a it should be printed to the null printer and a re opening done on MCR website. b it should be deferred for 45 days. c nothing, corrected claim should not be done in Epic for MCR. 20 Redeterminations are a the 2nd step in the MCR appeals process b the first step in the MCR appeals process. c appeals that go before an Administrative Law Judge. 21 MSP stands for a Medically Specific Payor b Medicare Secondary Payor c Medicare Support Person 22 Which of these is NOT true about IPPE? a is known as the Welcome to MCR preventative visit b is paid once per lifetime and only within 12 months of Part B enrollment c Is covered once every 12 months AFTER the 1st 12 months of MCR enrollment. 23 The AWV a is known as the "Welcome to Medicare" visit b is paid once per lifetime c is the Annual Wellness Visit 24 Where can you look to find when a patient is eligible for a preventative visit? a on CMS.gov b on WPS website c in pt's chart 25 MCR Part B does NOT cover a Flu vaccine b Covid 19 vaccine c Shingles vaccine 26 Where can you look to find the CBO policy regarding Part D vaccines? a in the Teams file b CMS.gov c WPS 27 For MCR, Rural practices apply to a Illinois MCR only b Managed MCR plans only c Missouri MCR and RR MCR only
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