Exam 10: Military Carriers

The worldwide healthcare system for the military is currently called:

TRICARE offers supplemental programs to beneficiaries with certain health concerns or conditions.Name three of these programs.

OHI does not include TRICARE supplemental insurance or Medicaid.

Which of TRICARE's program options is similar to a health maintenance organization (HMO)?

CHAMPVA eligibility can be lost in all of the following situations except when a:

All military medical facilities have implemented HIPAA's privacy rules.

None of the TRICARE options will pay for the ADSM's medical care received from a civilian provider.

If Medicare finds a service is not medically necessary or appropriate,CHAMPVA does not provide coverage either.

If there are no problems with the claim,the contractor sends a written notice to both the beneficiary and provider,known as a/an __________.

TRICARE claims must be submitted electronically without exception.

Individuals covered by TRICARE Standard no longer need approval from their MTF to seek inpatient care at civilian hospitals in most situations.

The TRICARE option that is structured similar to a preferred provider organization (PPO)is:

Under ___________ (effective for plan years starting on or after January 1,2014)preexisting condition exclusions are prohibited for all health plan insurance issuers.

The name of the total healthcare infrastructure of the U.S.uniformed services is called the _____ Health System.

TRICARE is administered on a global basis.

A hospital or institutional provider,physician,or other provider of services or supplies specifically allowed to provide benefits under TRICARE is commonly referred to as a:

Providers who accept assignment on CHAMPVA claims must accept the CHAMPVA allowable rate as payment in full and cannot balance bill.

TRICARE offers eligible beneficiaries five basic options to choose from.

An ID card alone is not always sufficient to prove current TRICARE eligibility.

Enrollees are responsible for certain __________ for care that is covered under TRICARE Standard.