Medicare will award an assigned claim conditional primary payer ...

[bucstennis@aim.com]

Medicare will award an assigned claim conditional primary payer status and process
  the claim when a __________.
 a. patient who is physically or mentally impaired files a claim with the primary payer
  b. plan considered primary to Medicare issues a denial of payment that is under appeal
  c. liability payer responds by processing a submitted claim within 120 days of filing
  d. workers' compensation claim has been approved and the provider reimbursed

Question 2

A Medicare medical necessity denial is a denial of otherwise covered services that were found to be not __________.
 a. cost effective and necessary
  b. in compliance with critical pathways
  c. necessary and frequent
  d. reasonable and necessary

[shaikhs]

Answer to Question 1

b

Answer to Question 2

d