RAC-CTA – Consolidated Billing in a SNF for the Advanced Medicare Specialist – Final…

RAC-CTA – Consolidated Billing in a SNF for the Advanced Medicare Specialist – Final Exam Question 23 of 25 Under which of these circumstances could an initial UB-04 billing claim be processed for payment outside of the timely filing window? A. The biller submitted the claim and it was suspended; the provider then fixed the claim issue and resubmitted yet ultimately was denied payment. B. And once the first claim was billed, it was more than a year old. However, the second claim was billed and paid, so an adjustment claim was submitted to correct the first and second claims together. C. The resident was deemed disabled, and the state Medicaid program gave the resident entitlement. D. Extroactive Medicare and Medicaid entitlement and/or Program of All-Inclusive Care for the Elderly (PACE). RAC-CTA – Consolidated Billing in a SNF for the Advanced Medicare Specialist – Final E Question 24 of 25 What does the type of bill 0211 in FL 4 signify? A. SNF inpatient Part A, interim bill, continuing claim B. SNF inpatient Part A, admission through discharge claim C. SNF inpatient Part A, final claim A SNF resident can access benefits for both Medicare hospice and Part A services under which of these circumstances? A. The additional hospice services available are elected by the resident. B. The resident has a diagnosis related to her terminal condition. C. The reason for the SNF stay is unrelated to the resident’s terminal condition. D. The Medicare beneficiary needs rehabilitation services such as physical therapy to maintain mobility during hospice care.