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27 Cards in this Set
- Front
- Back
TRICARE Standard |
fee-for-service, replacing champus |
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TRICARE Prime |
Managed Care Plan similar to HMO |
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TRICARE Extra |
alternative plan other than military facility, more expensive |
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TRICARE program was formally called CHAMPUS? T or F |
TRUE |
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PCM is abbreviation for Primary Care Manager? T or F |
TRUE |
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NAS is abbrevation for Nonavailibility Statement? T or F |
TRUE |
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TRICARE is the secondary payer to almost all other plans, except Medicaid? T or F |
TRUE |
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TRICARE'S managed care plans will not pay for services to beneficiaries provided by non-network providers? T or F |
TRUE |
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TRICARE participating provider charges generally follow the Medicare Fee Schedule? T or F |
TRUE |
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Beneficiaries enrolled in a Medicare HMO are eligible for TRICARE Senior Prime? T or F |
FALSE |
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TRICARE program serves families of Veterans with 100% service-connected disability? T or F |
FALSE, its CHAMPVA |
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In TRICARE program, providers who do not participate may charge up to 150% of the TRICARE allowed charge? T or F |
False, non-participating can charge up to 115% |
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The TRICARE catastrophic cap is an annual amount? T or F |
TRUE |
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Military Treatment Facilities (MTF) are government hospitals & clinics whose first priority is to serve active-duty military personnel? T or F |
TRUE |
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DEER |
Defense Enrollment Eligibility Reporting |
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CHAMPUS |
Civilian Health & Medical Program of Uniformed Services |
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CHAMPVA |
Civilian Health & Medical Program Department of Veterans Affairs |
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CMS-1500 claim form |
paper claim for physicians services |
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DEERS |
worldwide database of TRICARE & CHAMPVA beneficiaries |
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Catastrophic Cap |
Maximum annual amount TRICARE beneficiaries must pay |
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PCM ( primary care Manager) |
provider who coordinates & manages the care of TRICARE Beneficiaries |
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Cost Share |
amount of provider's charges the patient is responsible for |
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Sponsor |
Uniform Service Member in family qualified for TRICARE or CHAMPVA |
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Nonavailibility statement |
Form requested for preauthorization from TRICARE member seeking other treatment facility |
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CHAMPVA def. |
government Health insurance for family of veterans (100%) service-related disabilities. |
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MTF stands for |
military treatment facility |
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Age to qualify on TRICARE for Life? |
over 65 yrs |