Exam Preview for 12945: Show Me the Money: Therapy Reimbursement (P

Show Me the Money: Therapy Reimbursement (Professionals, Parents, Adults)

Please note: exam questions are subject to change.

1. Insurance coverage post cochlear implantation Only covers children Sometimes covers adults Must provide coverage for whatever an adult or child needs to maximize outcomes Varies considerably by private carrier and by policies within a given carrier A and B
2. Coverage policies by private carriers Are largely set and cannot be changed May be changed but are generally most easily changed by working with the individual's employer to request changes Are determined according to federal guidelines May be mandated by individual states B and D
3. Fees paid to therapists are Standardized across private carriers for each type of therapy Based entirely on amount of time spent providing services Are sometimes negotiable with individual carriers Set by the individual carrier and may not be negotiated Pegged to an inflation index and adjusted each year accordingly
4. Medicaid coverage for therapy Is identical to Medicare policies though the beneficiaries are largely children Varies greatly state by state May place limits on the number of therapy sessions a child may receive B and C All of the above
5. Vocational Rehabilitation Programs will cover aural rehabilitation services For all adults over age 18 If services can be linked to employment outcomes for the client If services are deemed medically necessary All of the above
6. Health Savings Accounts can be used to pay for post-CI rehabilitation costs That are not covered by primary insurance or other 3rd party payors. With pre-tax dollars. Both a and b Neither a nor b
7. Speech language pathologists in private practice will be eligible to bill Medicare directly for aural rehabilitation services as of July 1, 2009 as of January 1, 2009 once they have obtained a National Provider Identification (NPI) number a and c b and c
8. Particular insurance plans may refer to covered services following cochlear implantation as Speech therapy Aural rehabilitation services Post-CI rehabilitation any of these
9. The possibility to use a provider that is not "in-network" is available through HMO plans PPO plans Medicare Vocational Rehab
10. Insurance coverage for aural rehabilitation post cochlear implantation is limited to therapy provided by a professional within a CI clinic setting who is a speech language pathologist certified as LSLS Cert. AVT who has special training in therapy post cochlear implantation none of the above