Tricare and Champva
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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 personnel, 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 NOT entitled 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 cannot provide the necessary care.
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| The NAS catchment area is | Both a and c
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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 fiscal year extends from | October 1 to September 30.
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| Health care professionals who may treat a TRICARE patient are | All of the above.
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| 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.
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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.
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| TRICARE Standard and CHAMPVA are | service/health benefit prgrams.
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| The Veterans 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 | Both a and b
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| The Privacy Act of 1974 establishes an individual's right to review his or her medical records maintained by a | All of the above
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| The time limit within which a TRICARE outpatient claim must be filed is | within 1 year from the dte 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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| A certification from a military hospital stating that it connot provide the care needed is called a ______________________ | nonavailability statement (NAS)
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| All dependents _________ years of age or oder are required to have a Uniformed Services (military) identification card. | 10
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| The physician who provides medical care at contracted rates to beneficiaries under the TRICARE Extra program is called a/an ________________ provider. | network.
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Created by:
bunnyfinley