Question 1

If a beneficiary has both TRICARE Senior Prime/TFL and Medicare, which plan is primary?

Accepted Answer

A)  TRICARE is primary. 
B)  Medicare is primary. 
C)  The patient can select which is primary. 
D)  The provider can select which is primary. 
A)  TRICARE is primary. 
B)  Medicare is primary. 
C)  The patient can select which is primary. 
D)  The provider can select which is primary.

Question 2

Under the access standards for TRICARE Prime enrollees, appointment wait time for wellness/preventive care should NOT exceed:

Accepted Answer

A)  48 hours. 
B)  1 week. 
C)  2 weeks. 
D)  4 weeks. 
A)  48 hours. 
B)  1 week. 
C)  2 weeks. 
D)  4 weeks.

Question 3

The TRICARE regional healthcare finder (HCF) provides preventive services and care for routine illnesses or injuries.

Accepted Answer

A) True 
 B)False

Question 4

The TRICARE health maintenance organization (HMO) plan option is:

Accepted Answer

A)  TRICARE Standard. 
B)  TRICARE Extra. 
C)  TRICARE Prime. 
D)  CHAMPVA. 
A)  TRICARE Standard. 
B)  TRICARE Extra. 
C)  TRICARE Prime. 
D)  CHAMPVA.

Question 5

If a TRICARE Standard beneficiary receives care from a provider who is a nonparticipating provider, he or she is responsible for the provider's additional charges up to 115% of the allowable charge.

Accepted Answer

A) True 
 B)False

Question 6

Match the following
-The form required to obtain services NOT available through a military treatment facility (MTF)

Accepted Answer

A)  TRICARE Prime Remote 
B)  TRICARE Senior Prime/TRICARE for Life 
C)  beneficiary 
D)  nonavailability statement (NAS) 
E)  CHAMPVA
F) TRICARE Prime
G) TRICARE Standard
H) sponsor
I) TRICARE Extra
J) primary care manager (PCM) 
A)  TRICARE Prime Remote 
B)  TRICARE Senior Prime/TRICARE for Life 
C)  beneficiary 
D)  nonavailability statement (NAS) 
E)  CHAMPVA
F) TRICARE Prime
G) TRICARE Standard
H) sponsor
I) TRICARE Extra
J) primary care manager (PCM)

Question 7

TRICARE claims must be submitted no later than:

Accepted Answer

A)  30 days from the date of service. 
B)  90 days from the date of service. 
C)  6 months from the date of service. 
D)  1 year from the date of service. 
A)  30 days from the date of service. 
B)  90 days from the date of service. 
C)  6 months from the date of service. 
D)  1 year from the date of service.

Question 8

Which claim form must physician offices use to submit claims to TRICARE?

Accepted Answer

A)  CMS-1450 
B)  CMS-1500 
C)  UB-04 
D)  CMS-5100 
A)  CMS-1450 
B)  CMS-1500 
C)  UB-04 
D)  CMS-5100

Question 9

An individual who qualifies for TRICARE coverage is known as a sponsor.

Accepted Answer

A) True 
 B)False

Question 10

An active-duty service member whose family is covered by a TRICARE plan is known as a(n):

Accepted Answer

A)  member. 
B)  beneficiary. 
C)  sponsor. 
D)  enrollee. 
A)  member. 
B)  beneficiary. 
C)  sponsor. 
D)  enrollee.

Question 11

What groups of people are eligible for TRICARE coverage?

Accepted Answer

The categories of eligibility

Question 12

The TRICARE fiscal year begins on:

Accepted Answer

A)  January 1. 
B)  July 1. 
C)  September 1. 
D)  October 1. 
A)  January 1. 
B)  July 1. 
C)  September 1. 
D)  October 1.

Question 13

Match the following
-The provider who coordinates and manages a patient's medical care under TRICARE Prime.

Accepted Answer

A)  TRICARE Prime Remote 
B)  TRICARE Senior Prime/TRICARE for Life 
C)  beneficiary 
D)  nonavailability statement (NAS) 
E)  CHAMPVA
F) TRICARE Prime
G) TRICARE Standard
H) sponsor
I) TRICARE Extra
J) primary care manager (PCM) 
A)  TRICARE Prime Remote 
B)  TRICARE Senior Prime/TRICARE for Life 
C)  beneficiary 
D)  nonavailability statement (NAS) 
E)  CHAMPVA
F) TRICARE Prime
G) TRICARE Standard
H) sponsor
I) TRICARE Extra
J) primary care manager (PCM)

Question 14

The TRICARE plan with the lowest out-of-pocket costs is:

Accepted Answer

A)  TRICARE Standard. 
B)  TRICARE Extra. 
C)  TRICARE Prime. 
D)  CHAMPVA. 
A)  TRICARE Standard. 
B)  TRICARE Extra. 
C)  TRICARE Prime. 
D)  CHAMPVA.

Question 15

The copay for visits to civilian providers under TRICARE Prime is based on the:

Accepted Answer

A)  type of service required. 
B)  type of physician providing services. 
C)  military rank of the sponsor. 
D)  number of dependent family members. 
A)  type of service required. 
B)  type of physician providing services. 
C)  military rank of the sponsor. 
D)  number of dependent family members.

Question 16

When a TRICARE beneficiary needs treatment that is NOT available from a military treatment facility (MTF), the:

Accepted Answer

A)  beneficiary will have to pay for the services. 
B)  services will not be covered. 
C)  beneficiary must obtain a nonavailability statement (NAS) to receive services from a civilian provider. 
D)  beneficiary can automatically receive services from a civilian provider. 
A)  beneficiary will have to pay for the services. 
B)  services will not be covered. 
C)  beneficiary must obtain a nonavailability statement (NAS) to receive services from a civilian provider. 
D)  beneficiary can automatically receive services from a civilian provider.

Question 17

In 1994, the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) program name was changed to:

Accepted Answer

A)  the Defense Enrollment Eligibility Reporting System (DEERS). 
B)  the Veterans Administration (V
A)  Health Administration Center. 
C)  TRICARE. 
D)  CHAMPVA. 
A)  the Defense Enrollment Eligibility Reporting System (DEERS). 
B)  the Veterans Administration (V
A)  Health Administration Center. 
C)  TRICARE. 
D)  CHAMPVA.

Question 18

TRICARE beneficiaries who use nonauthorized providers may be responsible for paying their entire bill.

Accepted Answer

A) True 
 B)False

Question 19

Services covered under TRICARE Standard include all of the following EXCEPT:

Accepted Answer

A)  chemotherapy 
B)  durable medical equipment (DM
E) . 
C)  mental healthcare. 
D)  routine physical examinations. 
A)  chemotherapy 
B)  durable medical equipment (DM
E) . 
C)  mental healthcare. 
D)  routine physical examinations.

Question 20

Match the following
-The TRICARE plan that is a preferred provider organization (PPO) option

Accepted Answer

A)  TRICARE Prime Remote 
B)  TRICARE Senior Prime/TRICARE for Life 
C)  beneficiary 
D)  nonavailability statement (NAS) 
E)  CHAMPVA
F) TRICARE Prime
G) TRICARE Standard
H) sponsor
I) TRICARE Extra
J) primary care manager (PCM) 
A)  TRICARE Prime Remote 
B)  TRICARE Senior Prime/TRICARE for Life 
C)  beneficiary 
D)  nonavailability statement (NAS) 
E)  CHAMPVA
F) TRICARE Prime
G) TRICARE Standard
H) sponsor
I) TRICARE Extra
J) primary care manager (PCM)

If a beneficiary has both TRICARE Senior Prime/TFL and Medicare, which plan is primary?

Under the access standards for TRICARE Prime enrollees, appointment wait time for wellness/preventive care should NOT exceed:

The TRICARE regional healthcare finder (HCF) provides preventive services and care for routine illnesses or injuries.

The TRICARE health maintenance organization (HMO) plan option is:

If a TRICARE Standard beneficiary receives care from a provider who is a nonparticipating provider, he or she is responsible for the provider's additional charges up to 115% of the allowable charge.

Match the following -The form required to obtain services NOT available through a military treatment facility (MTF)

TRICARE claims must be submitted no later than:

Which claim form must physician offices use to submit claims to TRICARE?

An individual who qualifies for TRICARE coverage is known as a sponsor.

An active-duty service member whose family is covered by a TRICARE plan is known as a(n):

What groups of people are eligible for TRICARE coverage?

The TRICARE fiscal year begins on:

Match the following -The provider who coordinates and manages a patient's medical care under TRICARE Prime.

The TRICARE plan with the lowest out-of-pocket costs is:

The copay for visits to civilian providers under TRICARE Prime is based on the:

When a TRICARE beneficiary needs treatment that is NOT available from a military treatment facility (MTF), the:

In 1994, the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) program name was changed to:

TRICARE beneficiaries who use nonauthorized providers may be responsible for paying their entire bill.

Services covered under TRICARE Standard include all of the following EXCEPT:

Match the following -The TRICARE plan that is a preferred provider organization (PPO) option

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Hcpcs Coding and Compliance

Auditing

Physician Medical Billing

Hospital Medical Billing

Medicare Medical Billing

Medicaid Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Workers Compensation

Filters

Exam 14: Tricare Medical Billing

If a beneficiary has both TRICARE Senior Prime/TFL and Medicare, which plan is primary?

Under the access standards for TRICARE Prime enrollees, appointment wait time for wellness/preventive care should NOT exceed:

The TRICARE regional healthcare finder (HCF) provides preventive services and care for routine illnesses or injuries.

The TRICARE health maintenance organization (HMO) plan option is:

If a TRICARE Standard beneficiary receives care from a provider who is a nonparticipating provider, he or she is responsible for the provider's additional charges up to 115% of the allowable charge.

Match the following -The form required to obtain services NOT available through a military treatment facility (MTF)

TRICARE claims must be submitted no later than:

Which claim form must physician offices use to submit claims to TRICARE?

An individual who qualifies for TRICARE coverage is known as a sponsor.

An active-duty service member whose family is covered by a TRICARE plan is known as a(n):

What groups of people are eligible for TRICARE coverage?

The TRICARE fiscal year begins on:

Match the following -The provider who coordinates and manages a patient's medical care under TRICARE Prime.

The TRICARE plan with the lowest out-of-pocket costs is:

The copay for visits to civilian providers under TRICARE Prime is based on the:

When a TRICARE beneficiary needs treatment that is NOT available from a military treatment facility (MTF), the:

In 1994, the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) program name was changed to:

TRICARE beneficiaries who use nonauthorized providers may be responsible for paying their entire bill.

Services covered under TRICARE Standard include all of the following EXCEPT:

Match the following -The TRICARE plan that is a preferred provider organization (PPO) option

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Hcpcs Coding and Compliance

Auditing

Physician Medical Billing

Hospital Medical Billing

Medicare Medical Billing

Medicaid Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Workers Compensation

Filters