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Fordney 14

Tricare and Champva

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.
Created by: bunnyfinley