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60 Cards in this Set

  • Front
  • Back
1. The manage access to care tools are available in CHCS and…
TRICARE operations center
2. What is composed of timeslots that have been assigned appointment types?
schedule
3. What is a pattern of time slots specific to a provider, but not linked to a date?
template
4. What in CHCS makes it simple to add/delete/cancel/freeze schedule time slots?
maintain/cancel
5. Which CHCS option allows you to cancel existing schedule at the request of the provider?
cancellation by facility
6. What includes all units, organizations and members in the ANG and AFR?
Air Reserve Component
7. The favorable dependency determination must specifically state the individual is eligible for medical care and this eligibility determination is made by the…
MPF
8. The former CHAMPUS option that pays a share of the cost covered by healthcare services is...
TRICARE standard
9. Pregnant female discharged under other then honorable conditions fall within what program?
Secrertary of the AF designee
10. Children retain their eligibility unless they marry before the age of…
21
11. Active duty family not enrolled in TRICARE prime belong in priority group number…
four
12. What priority group includes special provisions to members who aren’t on active duty but entitled to care?
one
13. When creating a personal master schedule, the appointment personnel must coordinate with the…
provider
14. To be cognizant of the information you’re inputting you must remember what?
accuracy and effectivness
15. When you print reports by using the appropriate option then what will happen next?
print on demand
16. For PHA reason, how often are records reviewed?
annually
17. What function ensures preventive individual medical readiness?
MAJCOM SG
18. Who’s required to conduct medical record reviews to id medical history/info that could be disqualifying for deployment/WWD?
PCE/PCM
19. MTF’s use what 2 systems to id and describe the enrolled population?
DOD/ AFMS
20. What is non-electronic, folder-style form documenting immunizations?
2766
21. What process for inpatients begins before or on admission and continues after discharge to include f/u and evaluation?
MTF discharge and disposition planning process
22. What MTF process is a broad-spectrum scope to ID beneficiaries experiencing conditions which may indicate the need for case management?
MTF case Management
23. How often must MTF assess centrally and locally produced performance measures?
Quarterly
24. The federal governments healthcare financing for the elderly is called….
Medicare
25. What legislation enabled managed care plans to increase numbers and expand enrollments through healthcare programs financed by grants, contracts and loans?
Health Care Act 1973
26. If a healthcare system is responsible for both the finance and delivery of a broad range of comprehensive health services to a voluntarily enrolled population, what plan would apply?
HMO
27. If an individual is in a healthcare plan, who is responsible for reimbursing for costs?
Insurance
28. If a patient has routine medical needs, who would be the patients principle provider?
PCM
29. What was formally known as the Public Health Services Hospitals and now operates much like TRICARE?
Uniformed Services Family Health Plan
30. What is the main challenged for most eligible beneficiaries?
Which TRICARE is best
31. The TRICARE program is geographically structured by…
regions
32. How many regions are there?
3
33. Within each local delivery area, how is TRICARE managed?
locally
34. The benefits of TRICARE can’t be realized without information regarding access, utilization and…
costs
35. For at least how many months is enrollment for TRICARE prime?
12
36. TRICARE standard pays what % of approved cost for outpatient care?
80%
37. TRICARE plus enrollment is noted on records in…
DEERS
38. TRICARE standard has the broadest choice of…
providers
39. What document reflects an approach to managing military benefits as a first priority?
governance plan
40. The TRO (TRICARE regional office) operates under the authority of…
regional director
41. One of the most important functions of MCS contractor is the development of in support of TRICARE…
prime/extra
42. What does the TRO use as a baseline to build additional network needs?
primary care systems
43. Which duty is performed by the ACO?
resolving contracteral issues
44. Who is each TRO and MTF required to have available to assist beneficiaries?
DCAO
45. A nonenrolled beneficiary is required to obtain authorization for care from HCF when…
a NAS is required
46. No availability statements are processed through…
DEERS
47. There is no copayment for beneficiaries referred for civilian medical care while…
while on inpatient status
48. Who authorizes non-MTF referred supplemental care for the uniformed services?
HCF
49. TRICARE Management Activity is a field of activity of the…
Undersecretary of defense for personal readiness
50. Who along with the TRO is responsible for conducting provider training on TRICARE?
MCS Contractor
52. TRICARE presentations are most effective when done jointly by…
MSCS Marketing Representatives
53. What should be the first priority in developing marketing material?
enrollment packages
54. Customer Satisfaction Survey attempts to collect in for regarding…
specific appointments
55. When utilizing resource support who may request a task order for equipment?
MTF CC
56. Whose policy requires you to consider resource sharing agreements are the best interest of the gov. and support healthcare?
TRICARE
57. Who determines whether or not resource sharing agreements are in the best interest of the government and are in support of the regional health care plan?
TRO
58. Who establishes the resource sharing agreements with the MCS contractor?
MTF CC
59. Who performs periodic reviews of the MTF facitlity resource sharring agreements?
TRO
60. As a minimum the medical portion of in-and-out processing should include how to…
resolve problems accessing health care
61. Active duty personnel who have family members may or may not elect to enroll in…
TRICARE Prime