MBC01E113 Unit 4 Learning Act. 3 Project

MBC01E113 Unit 4 Learning Act. 3 Project - 12 25 percent...

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MBC01E113 Unit 4 Learning Activity 3: Project Assignment 12-10 1. Box 1a - 45xx9569a 2. Box 2 - Fremont, Harris 3. Box 9 - Fremont, Emily B. 4. Box 9a - 56-10-0020205-0-xx 5. Box 9d - Medicare/Medicaid 6. Box 11 – None 7. Box 11a – 07-10-1923 8. Box 17 - Raymond Skeleton Md 9. Box26 - No. 12-10 10. Box 33 – College Clinic 4567 Broad Avenue Woodland Hills, XY 12345-0001 11. Medicare 12. 54-32-7681533-10x 13. 3821 Ocean Dr. 14. Child 15. C. 16. 05-28-2011 17. Yes 18. 05-28-2011 TO 06-10-2011 19. Yes 20. College Clinic Assignment 13-2 1. No, because the severity, no prior authorization is needed 2. 24CE, Emergency Certification Statement 3. 19 Assignment 14-1 1. Tricare 2. Sponsor, Service retiree or Military retiree 3. Beneficiary 4. Defense Enrollment Eligibility Reporting System (DEERS) 5. No availability Statement (NAS) 6. Dependents 10 yrs of age and older, Front and Back 7. Cooperative Care and Partnership 8. Per patient $50, Per family $100 9. Per patient $150 Per family $300 10. 20 percent and 80 percent 11. Per patient $150, Per family $300
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Unformatted text preview: 12. 25 percent and 75 percent 13. Tricare Prime 14. Cillivan Health and Medical Program of the veterans Department of Veterans Affairs 15. Veterans 16. Service Benefit 17. A. Husband, Wife or unmarried child of a veteran with complete disability, permanent in nature from a service-connected disability. B. Husband, wife, or unmarried child of a veteran who died because of a service connected disability or who, at the time of death, had a total disability permanent in nature, resulting from a service connected disability c. Husband, wife, or unmarried child of an individual who died in the line of duty while on active service 18. Privacy Act of 1974 19. Fiscal Intermediary ( Regional Contractor) 20. Within 1 year from date service is provided – 1 year from patient’s discharge from hospital. Part 2 21. D 22. B 23. A 24. D 25. B Part 3 26. T 27. T 28. F 29. F 30. T...
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This note was uploaded on 11/02/2011 for the course BUS SCI/241 taught by Professor Unknown during the Spring '11 term at University of Phoenix.

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MBC01E113 Unit 4 Learning Act. 3 Project - 12 25 percent...

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