Chapter 14 TRICARE and CHAMPVA
questions well answered already passed
The conversion of CHAMPUS to TRICARE was the result of - correct answer ✔✔reorganization of
each branch of the United States uniformed services.
Lead Agent of selected military treatment facilities (MTFs) hold what rank? - correct answer
✔✔Commander
MTF - correct answer ✔✔Military Treatment Facility
The organization responsible for coordinating and administering the TRICARE program is the.... -
correct answer ✔✔TRICARE Management Activity
The entire healthcare system of the U.S. uniform services is known as the... - correct answer
✔✔Military Health Services System (MHSS)
MHSS - correct answer ✔✔Military Health Services System
The term sponsor is used to describe.... - correct answer ✔✔active duty, retired or deceased
military personnel
Claims are submitted to the TRICARE - correct answer ✔✔Regional contractors
TRICARE plans are primary to what other insurance? - correct answer ✔✔Medicaid
,TRICARE nurse advisors are available 24/7 to assist with - correct answer ✔✔Treatment
alternatives and recommendations for care.
The entity responsible for the prevention, detection,investigation,and control of TRICARE
fraud,waste.and abuse is the... - correct answer ✔✔Program Integrity Office
Which TRICARE option is a fee-for-service plan? - correct answer ✔✔TRICARE standard
In which TRICARE option are active military personnel required to enroll? - correct answer
✔✔TRICARE Prime
A military treatment facility (MTF) catchment area is - correct answer ✔✔Defined by code
boundaries within a 40-mile radius of an MTF.
If a TRICARE Prime beneficiary seeks care from a facility outside of the treatment area without
prior approval, the point-of-service option is activated. This will result in what cost(s) to the
beneficiary? - correct answer ✔✔An annual deductible plus 50% or more of visit or treatment
fees.
Which TRICARE option has the highest out-of-pocket costs of all the TRICARE plans? - correct
answer ✔✔TRICARE standard
TRICARE outpatient claims will be denied if they are filed more than..... - correct answer
✔✔One year after the date of service.
If the physician charges $500 or higher for care of a TRICARE beneficiary as the result of an
accidental injury, , the insurance specialist must submit a... - correct answer ✔✔DD Form 2527
that was completed by the patient.
, TRICARE has established a good-faith policy for assigned claims to protect the provider when -
correct answer ✔✔A patient presents an invalid ID card when treatment was rendered and
billed.
What special handling is required for TRICARE hospice claims? - correct answer ✔✔Enter the
words HOSPICES CLAIMS on the envelope.
What information is entered in Block 13 of the TRICARE CMS-1500 claim form? - correct answer
✔✔SIGNATURE ON FILE
When the TRICARE patient has been referred by a military treatment facility, attach what form?
- correct answer ✔✔DD form 2161
What are the TRICARE Regions? - correct answer ✔✔Three in the United States
(North,West, South)
TRICARE Overseas
Military Treatment facilities are the principal source of health care under this option. - correct
answer ✔✔TRICARE Prime
Preferred provider organization option - correct answer ✔✔TRICARE Extra
Fee-for-service option - correct answer ✔✔TRICARE Standard
CHAMPVA - correct answer ✔✔Civilian Health and Medical Program of the Department of
Veterans Affairs
questions well answered already passed
The conversion of CHAMPUS to TRICARE was the result of - correct answer ✔✔reorganization of
each branch of the United States uniformed services.
Lead Agent of selected military treatment facilities (MTFs) hold what rank? - correct answer
✔✔Commander
MTF - correct answer ✔✔Military Treatment Facility
The organization responsible for coordinating and administering the TRICARE program is the.... -
correct answer ✔✔TRICARE Management Activity
The entire healthcare system of the U.S. uniform services is known as the... - correct answer
✔✔Military Health Services System (MHSS)
MHSS - correct answer ✔✔Military Health Services System
The term sponsor is used to describe.... - correct answer ✔✔active duty, retired or deceased
military personnel
Claims are submitted to the TRICARE - correct answer ✔✔Regional contractors
TRICARE plans are primary to what other insurance? - correct answer ✔✔Medicaid
,TRICARE nurse advisors are available 24/7 to assist with - correct answer ✔✔Treatment
alternatives and recommendations for care.
The entity responsible for the prevention, detection,investigation,and control of TRICARE
fraud,waste.and abuse is the... - correct answer ✔✔Program Integrity Office
Which TRICARE option is a fee-for-service plan? - correct answer ✔✔TRICARE standard
In which TRICARE option are active military personnel required to enroll? - correct answer
✔✔TRICARE Prime
A military treatment facility (MTF) catchment area is - correct answer ✔✔Defined by code
boundaries within a 40-mile radius of an MTF.
If a TRICARE Prime beneficiary seeks care from a facility outside of the treatment area without
prior approval, the point-of-service option is activated. This will result in what cost(s) to the
beneficiary? - correct answer ✔✔An annual deductible plus 50% or more of visit or treatment
fees.
Which TRICARE option has the highest out-of-pocket costs of all the TRICARE plans? - correct
answer ✔✔TRICARE standard
TRICARE outpatient claims will be denied if they are filed more than..... - correct answer
✔✔One year after the date of service.
If the physician charges $500 or higher for care of a TRICARE beneficiary as the result of an
accidental injury, , the insurance specialist must submit a... - correct answer ✔✔DD Form 2527
that was completed by the patient.
, TRICARE has established a good-faith policy for assigned claims to protect the provider when -
correct answer ✔✔A patient presents an invalid ID card when treatment was rendered and
billed.
What special handling is required for TRICARE hospice claims? - correct answer ✔✔Enter the
words HOSPICES CLAIMS on the envelope.
What information is entered in Block 13 of the TRICARE CMS-1500 claim form? - correct answer
✔✔SIGNATURE ON FILE
When the TRICARE patient has been referred by a military treatment facility, attach what form?
- correct answer ✔✔DD form 2161
What are the TRICARE Regions? - correct answer ✔✔Three in the United States
(North,West, South)
TRICARE Overseas
Military Treatment facilities are the principal source of health care under this option. - correct
answer ✔✔TRICARE Prime
Preferred provider organization option - correct answer ✔✔TRICARE Extra
Fee-for-service option - correct answer ✔✔TRICARE Standard
CHAMPVA - correct answer ✔✔Civilian Health and Medical Program of the Department of
Veterans Affairs
