Question | Answer |
TRICARE, formerly known as CHAMPUS, is funded through | Congress. |
The three choices of health care coverage for families of active duty military personnel, military retirees, and their dependents are | TRICARE Standard, TRICARE Prime, and TRICARE Extra. |
The health maintenance organization provided for dependents of active duty military personnel is called | TRICARE Prime. |
People NOT entitled to benefits under TRICARE are | CHAMPVA beneficiaries. |
What is the system called that TRICARE claims processors use to verify beneficiary eligibility? | TRI-CHECK |
An NAS is a/an | certification from a military hospital stating that it cannot provide the necessary care. |
The NAS catchment area is | Both a and c |
Medical care that is cost-shared by both TRICARE Standard and a civilian source is known as | cooperative care. |
The TRICARE fiscal year extends from | October 1 to September 30. |
Health care professionals who may treat a TRICARE patient are | All of the above. |
A health care professional, usually a registered nurse, who helps the patient work with his or her primary care manager to locate a specialist or obtain a preauthorization for care is referred to as a/an | HCF. |
A physician who chooses not to participate in TRICARE bills | no more than 115% of the TRICARE allowable charge. |
enrollment in TRICARE Prime is for | 1 year at a time. |
The physician who is responsible for coordinating and managing all of the health care for the TRICARE Prime patient is referred to as a/an | PCM. |
TRICARE Standard and CHAMPVA are | service/health benefit prgrams. |
The Veterans Health Care Expansion Act of 1973 authorized the | CHAMPVA program. |
The wife of a veteran with total permanent disability resulting from a service-connected injury is eligible for CHAMPVA benefits | Both a and b |
The Privacy Act of 1974 establishes an individual's right to review his or her medical records maintained by a | All of the above |
The time limit within which a TRICARE outpatient claim must be filed is | within 1 year from the dte a service is provided |
The time limit within which a TRICARE inpatient claim must be filed is within | 1 year from a patient's discharge from an inpatient facility. |
TRICARE Prime and TRICARE Extra claims are | filed by the provider to a TRICARE subcontractor. |
If a TRICARE Extra claim is submitted with several items and several dates of service, the time limit that would apply to the claim for filing would be | individual time limits for each item on the claim. |
A certification from a military hospital stating that it connot provide the care needed is called a ______________________ | nonavailability statement (NAS) |
All dependents _________ years of age or oder are required to have a Uniformed Services (military) identification card. | 10 |
The physician who provides medical care at contracted rates to beneficiaries under the TRICARE Extra program is called a/an ________________ provider. | network. |