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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