Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Chapter 16
TRICARE
| Question | Answer |
|---|---|
| beneficiary counseling and assistance coordinator (BCAC) | individual available at a military treatment facility (MTF) to answer questions, help solve health care-related problems, and assist beneficiaries in obtaining medical care through TRICARE; was previously called health benefits advisor (HBA). |
| catastrophic cap benefit | protects some TRICARE beneficiaries from devastating financial loss due to serious illness or long-term treatment by establishing limits over which payment is not required; the catastrophic cap is the maximum a sponsor |
| catchment area | the region defined by code boundaries within a 40-mile radius of a military treatment facility. |
| Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) | program that provides health benefits for dependents of veterans rated as 100 percent permanently and totally disabled as a result of service-connected conditions or injuries, veterans who died as a result of service-connected conditions or injuries, and |
| Civilian Health and Medical Program–Uniformed Services (CHAMPUS) | implemented in 1967 as the result of an initiative to provide military medical care for families of active duty members; designed as a benefit for dependents of personnel serving in the armed forces |
| clinical trial | research study that helps find ways to prevent, diagnose, or treat illnesses and improve health care; when enrolled, beneficiaries receive care that is considered the latest medicine or therapy, but is not yet approved as a standard care. |
| common access card (CAC) | identification card issued by the Department of Defense (DoD), which TRICARE enrollees show to receive health care services. |
| Continued Health Care Benefit Program (CHCBP) | premium-based health care program administered by Humana Military; though not a TRICARE program, CHCBP offers continued health coverage (18–36 months) after TRICARE eligibility ends. |
| critical pathway | sequence of activities that can normally be expected to result in the most cost-effective clinical course of treatment. |
| customer service representative (CSR) | employed at a TRICARE Service Center; provides information about using TRICARE and assists with other matters affecting access to health care (e.g., appointment scheduling). |
| debt collection assistance officer (DCAO) | individuals located at military treatment facilities to assist beneficiaries in resolving health care collection-related issues. |
| Defense Enrollment Eligibility Reporting System (DEERS) | computer system that contains up-to-date Defense Department Workforce personnel information. |
| Defense Health Agency (DHA) | under the direction of the Assistant Secretary of Defense (Health Affairs) manages the TRICARE program. |
| demonstration project or pilot | test and establish the feasibility of implementing a new TRICARE program during a trial period, after which the program is evaluated, modified, and/or abandoned. |
| fiscal year | for the federal government, October 1 of one year to September 30 of the next. |
| health care finder (HCF) | facilitates TRICARE administrative activities, such as referrals to appropriate health care services in the military facility and civilian provider network, including preauthorization for procedures and services provided in a military treatment facility o |
| lead agent (LA) | serves as a federal health care team created to work with regional military treatment facility commanders, uniformed service headquarters’ staffs, and Health Affairs (HA) |
| Military Health System (MHS) | entire health care system of the U.S. uniformed services and includes military treatment facilities (MTFs) as well as various programs in the civilian health care market |
| Military Health System (MHS) Nurse Advice Line | allows TRICARE beneficiaries to receive advice from a registered nurse 24/7 when living or traveling in the United States or a country with an established military hospital or clinic. |
| military treatment facility (MTF) | hospital or clinic located on military bases and posts around the world that provides inpatient and/or ambulatory (outpatient and emergency department) care to eligible TRICARE beneficiaries. |
| practice guidelines | decision-making tools used by providers to determine appropriate health care for specific clinical circumstances. |
| primary care manager (PCM) | assigned to provide most of a TRICARE beneficiary’s care and is a military or network provider that is responsible for referring beneficiaries to specialists |
| Program Integrity (PI) Office | responsible for the worldwide surveillance of fraud and abuse activities involving purchased care for beneficiaries in the Military Health System. |
| Supplemental Health Care Program (SHCP) | provides coverage by civilian health care providers to active duty service members and designated non-TRICARE eligible patients; authorizations and claims processing are administered by TRICARE contractors. |
| Transitional Assistance Management Program (TAMP) | provides 180 days of premium-free transitional health care benefits after regular TRICARE benefits end, but it is temporary (similar to COBRA benefits when an employee resigns from a non-military job). |
| TRICARE | health care program for uniformed service members, retirees, and their families around the world; provides comprehensive care coverage to all beneficiaries, including health plans, special programs, prescriptions, and dental plans. |
| TRICARE beneficiary | includes uniformed services sponsors and dependents of sponsors. |
| TRICARE Prime | managed care option similar to a civilian health maintenance organization (HMO), which is available in certain geographic areas of the United States called Prime Service Areas; priority access to care at military treatment facilities is also guaranteed. |
| TRICARE Select | self-managed, preferred provider network plan available in the United States. |
| TRICARE Service Center (TSC) | business offices staffed by one or more customer service representatives and health care finders who assist TRICARE sponsors with health care needs and answer questions about the program. |
| TRICARE sponsors | uniformed service personnel who are active duty, deceased, retired, or members of the National Guard/Reserve. |
| uniformed services | U.S. military branches that include the Army, Navy, Air Force, Marines, Coast Guard, Public Health Service, and the North Atlantic Treaty Organization (NATO). |
Created by:
Amaya122000