Benefits Breakout Game

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BenefitsBreakout

Use your health insurance knowledge to complete the mission and breakout.

Solve the clue to unlock each round at the base. Answer each question correctly and complete all rounds to BREAKOUT! Headphones MUST be used with mission. Good Luck!

THE MISSION

THE base

Find the key to DirectRx patient care/customer experience.

QUESTION 1/3

False

True

Traditionally medications are billed through a patient's pharmacy drug plan. However, nebulized medications can be billed through the medical (Part B) portion of Medicare which typically means lower, more cost effective options for patients.

QUESTION 2/3

True

False

Medicare Advantage and Medigap both refer to the same optional plan that Medicare patients can select.

QUESTION 3/3

True

False

Tricare is the uniformed service health care program for active duty service members, active duty family members as well as retirees and retiree family members.

THE base

This is strongly encouraged to help prevent COPD.

All of the above

QUESTION 1/3

Which of the following is determined during a Benefit Investigation (BI)?

The primary insurance

If insurance is active

If the patient has secondary coverage

QUESTION 2/3

Qualified Medicare Beneficiary (QMB) is a Medicare Savings Program administered by each state's Medicaid program. It helps people with Medicare who have limited income and assets pay ______________.

Deductibles and coinsurances

Premiums, deductibles, and coinsurances

Premiums and deductibles

QUESTION 3/3

Which of the following parts of Medicare does DirectRx normally bill to?

Part D: Pharmacy

Part B: Medical

Part A: Hospital

the base

DirectRx Difference: Average pick up is less than 12 seconds.

QUESTION 1/3

Traditional Medicare covers ____% of health care costs.

90%

80%

75%

QUESTION 2/3

Medicare Part C is also known as.....

Medicare Advantage

Medicaid

Medicare Secondary

QUESTION 3/3

When does a benefit year run to and from?

January 30th to December 1st

January 1 to December 31st

December 31st to January 1st

the base

DirectRx ensures lowest possible costs for patients

QUESTION 1/3

This transaction is used to verify Medicare eligibility.

270/271

Coordination of Benefits

Benefit Investigation

20/20

QUESTION 2/3

What is the most commonly billed health insurance policy at DirectRx?

Funding Programs

Commercial / Private

Medicaid

Medicare

QUESTION 3/3

Medicare started in ____ and Medicare Advantage started in ____

1995 / 2003

2000 / 2010

1965 / 2003

2004 / 1991

the base

Approximate percentage of DirectRx patients with Medicare/Medicare Advantage.

QUESTION 1/3

This health insurance option is jointly funded by the federal government and individual states; it is operated at the state level which means that coverage and administration may vary greatly from state to state.

Medicare Advantage

Traditional Medicare

Medicaid-Medicare

Medicaid

QUESTION 2/3

DirectRx is the only specialty pharmacy in the United States that focuses on __________.

Breathing Medications & Equipment

Nebulized Medications

Lung Health

COPD Medications

All of the Above

QUESTION 3/3

Which of the following is a DirectRx difference?

We have a dedicated team for completing Prior Authorizations.

We work with non-profit funding programs such as PAN, PAF, and HealthWell to assist with copays.

We proactively apply copay cards for commercial insurance.

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