| Question | Answer |
| Individuals who qualify for TRICARE are known as subscribers | False |
| A person retired from a career in the armed forces is eligible for TRICARE until 65 years of age | True |
| The NAS may be attached to the paper claim for billing an outpatient procedure | False |
| The NAS is required for outpatient service that are within the catchment area | False |
| The NAS is required for outpatient services that are within the catchment area. | False |
| All dependents 10 years of age or older are required to have a military identification card for TRICARE | True |
| A partnership program permits TRICARE-eligible people to receive inpatient treatment from civilian providers of care in a military hospital. | True |
| A certified nurse midwife is an authorized provider of health care for TRICARE beneficiaries. | True |
| Providers may choose to accept TRICARE assignmenton on a case-by-case basis. | True |
| In the TRICARE Extra plan, the individual enrolls yearly and pays an annual fee. | False |
| Enrollment in TRICARE Prime is voluntary. | True |
| Active duty service members are eligible for TRICARE Extra. | False |
| All privacy Act requests from patients must be made in writting. | False |
| TRICARE is subject to state regulatory agencies that control insurance policies. | False |
| TRICARE claims must be billed on a special claim form provided by the closest military facility within the area of treatment. | False |
| 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 |
| TRICARE/CHAMPVA is usually the second payer when a beneficiary is enrolled in other health insurance plans. | True |
| 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 |
| TRICARE, formerly known as CHAMPUS, is funded through___ | Congress |
| 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 |
| The health maintenance organization provided for dependents of active duty military personnel is called ___ | TRICARE Prime |
| People NOTentitled 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 cannor provide the necessary care. |
| The NAS catchment area is___ | defined by ZIP codes and based on an area of about 40 miles in radius surrounding each USMTF |
| Medical care that is cost-shared by both TRICARE Standard and a civilian source is known as ___ | cooperative care |
| The TRICARE fisical year extends from __ | October 1 to September |
| Health care professionals who may treat a TRICARE patient are ___ | doctors of medicine, doctors of osteopathy, psychologists |
| 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 Primary Care Manager |
| TRICARE Standard and CHAMPVA are ___ | service/health benefit programs |
| The Vetrans 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 | As long as she is not eligible for TRICARE standard or for Medicare Part A |
| 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 |
| The time limit within which a TRICARE outpatient clain must be filed is ___ | within 1 year from the date 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 |
