A Fordney Ch 13
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| Individuals who qualify for TRICARE are known as subscribers | False
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| A person retired from a career in the armed forces is eligible for TRICARE until 65 years of age | True
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| The NAS may be attached to the paper claim for billing an outpatient procedure | False
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| The NAS is required for outpatient service that are within the catchment area | False
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| The NAS is required for outpatient services that are within the catchment area. | False
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| All dependents 10 years of age or older are required to have a military identification card for TRICARE | True
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| A partnership program permits TRICARE-eligible people to receive inpatient treatment from civilian providers of care in a military hospital. | True
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| A certified nurse midwife is an authorized provider of health care for TRICARE beneficiaries. | True
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| Providers may choose to accept TRICARE assignmenton on a case-by-case basis. | True
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| In the TRICARE Extra plan, the individual enrolls yearly and pays an annual fee. | False
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| Enrollment in TRICARE Prime is voluntary. | True
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| Active duty service members are eligible for TRICARE Extra. | False
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| All privacy Act requests from patients must be made in writting. | False
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| TRICARE is subject to state regulatory agencies that control insurance policies. | False
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| TRICARE claims must be billed on a special claim form provided by the closest military facility within the area of treatment. | False
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| For a CHAMPVA beneficiary, if the physician is nonparticipating and does not accept assignment, the patient completes the top portion of the CMS-1500 claim form, attaches an itemized statement from the physician, and submits the claim. | True
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| TRICARE/CHAMPVA is usually the second payer when a beneficiary is enrolled in other health insurance plans. | True
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| TRICARE is considered primary to Medicare for people younger than age 65 who have Medicare Part A as a result of a disability and who have enrolled in Medicare Part B. | False
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| TRICARE, formerly known as CHAMPUS, is funded through___ | Congress
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| The three choices of health care coverage for families of active duty military personel, military retirees, and their dependents are __ | TRICARE Standard, TRICARE Prime, and TRICARE Extra
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| The health maintenance organization provided for dependents of active duty military personnel is called ___ | TRICARE Prime
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| People NOTentitled to benefits under TRICARE are ___ | CHAMPVA beneficiaries
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| What is the system called that TRICARE claims processors use to verify beneficiary eligibility___ | TRI-CHECK
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| An NAS is a/an____ | certification from a military hospital stating that it cannor provide the necessary care.
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| The NAS catchment area is___ | defined by ZIP codes and based on an area of about 40 miles in radius surrounding each USMTF
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| Medical care that is cost-shared by both TRICARE Standard and a civilian source is known as ___ | cooperative care
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| The TRICARE fisical year extends from __ | October 1 to September
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| Health care professionals who may treat a TRICARE patient are ___ | doctors of medicine, doctors of osteopathy, psychologists
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| A physician who chooses not to participate in TRICARE bills ___ | no more than 115% of the TRICARE allowable charge.
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| Enrollment in TRICARE Prime is for ___ | 1 year at a time
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| 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 Primary Care Manager
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| TRICARE Standard and CHAMPVA are ___ | service/health benefit programs
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| The Vetrans Health Care Expansion Act of 1973 authorized the ___ | CHAMPVA program
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| The wife of a veteran with total permanent disability resulting from a service-connected injury is eligible for CHAMPVA benefits | As long as she is not eligible for TRICARE standard or for Medicare Part A
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| The Privacy Act of 1974 establishes an individual's right to review his or her medical records maintained by a __ | Federal medical care facility, a VA hospital, U.S. Public Health Service facility
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| The time limit within which a TRICARE outpatient clain must be filed is ___ | within 1 year from the date a service is provided
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| 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
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| TRICARE Prime and TRICARE Extra claims are ___ | filed by the provider to a TRICARE subcontractor
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| 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
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