APEA 3P Exam Prep- Professional Issues/Ethics Questions and Answers with Explanations

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A nurse practitioner has agreed to participate in the Medicare health insurance program. Medicare paid 80% of the charges billed for a clinic visit. What can be done about the other 20% that is owed... ? The NP can bill the patient for a percentage of the remainder. The NP is prohibited from billing the patient. The NP can collect 90% if billed incident to the MD. The NP can resubmit the bill for additional payment. The NP is a “participating” provider because he agreed to accept assignments. An assignment is an agreement between Medicare and the NP to accept the Medicare Approved Amount (MAA) as payment in full and not charge Medicare recipients a higher rate. The NP can bill the patient for a percentage of the remaining bill that was not paid by Medicare. The NP may opt out of participating. The NP can be reimbursed 100% if billed incident to the MD. The name given to subjects in a research study who do not have the disease or condition being studied, but who are included in the study for comparison are: studied subjects. controls. case series. cross sectionals. Studied subjects are those members of a study who have a specific disease or condition of interest or who are receiving a specific treatment. Case series may refer to an observational study in which a group of patients with interesting characteristics are studied. Cross sectional is a type of observational study in which a particular characteristic is studied at one time rather than over time. Controls are commonly employed in many types of research studies. The research design that provides the strongest evidence for concluding causation is: randomized controlled trials. cohort studies. case control studies. prospective studies [Show More]

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