Question 1

The primary care manager (PCM) under TRICARE Prime may be a single military or civilian provider or a group of providers.

Accepted Answer

A) True 
 B)False

Question 2

What are some of the advantages of submitting TRICARE claims electronically?

Accepted Answer

Advantages of electronic submi

Question 3

To be eligible for TRICARE, all sponsors and family members must be enrolled in DEERS, which stands for:
A)Department Electronic Enrollment Reporting System.
B)Department Early Enrollment Reporting System.
C)Defense Electronic Eligibility Reporting System.
D)Defense Enrollment Eligibility Reporting System.

Accepted Answer

Defense En

Question 4

Under the access standards for TRICARE Prime enrollees, appointment wait time for wellness/preventive care should NOT exceed:
A)48 hours.
B)1 week.
C)2 weeks.
D)4 weeks.

Accepted Answer

The answer of Under the access standards for TRICARE Prime...

Question 5

Under TRICARE, what does MTF stand for?
A)Medical treatment for forces
B)Military treatment facility
C)Military training families
D)Medical training facility

Accepted Answer

Military t

Question 6

The TRICARE Prime annual enrollment fee for retired service members is:
A)$0.
B)$260 for an individual or $520 for a family.
C)$300 for an individual or $600 for a family.
D)$520 for an individual or $1,040 for a family.

Accepted Answer

$260 for a

Question 7

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

Accepted Answer

beneficiary must obtain a nona

Question 8

Form Locator 1a, Insured's ID Number, should include the:
A)patient's Social Security number.
B)patient's TRICARE-issued ID number.
C)sponsor's Social Security number.
D)sponsor's military rank and number.

Accepted Answer

sponsor's

Question 9

What are the seven health plans available to individuals who are eligible for TRICARE benefits?

Accepted Answer

The choices are TRICARE Standa

Question 10

Match between columns
                        Premises: The TRICARE plan that provides benefits to individuals older than age 65
The TRICARE plan that provides benefits similar to a preferred provider organization (PPO) plan
The TRICARE plan that provides benefits to active-duty service members assigned to permanent duty in a location that is at a distance from sources of military healthcare
An individual who is eligible to receive TRICARE benefits
The provider who coordinates and manages a patient’s medical care under TRICARE Prime.
The form required to obtain services NOT available through a military treatment facility (MTF)
Term used by TRICARE to describe the active-duty service member whose status qualifies family members for coverage
The TRICARE plan option that provides coverage under a fee-for-service, cost-sharing structure
The program that provides healthcare coverage to veterans with 100% service-related disabilities
The TRICARE plan that provides benefits similar to a health maintenance organization (HMO) plan

Accepted Answer

The Answer of TRICARE Extra and CHAMPVA and sponsor and is...

Question 11

The Department of Defense (DoD) medical entitlement program for uniformed services beneficiaries is __________ .

Accepted Answer

The answer of The Department of Defense (DoD) medical entitlement...

Question 12

Penalties or interest charges can be billed to a beneficiary by a physician due to TRICARE's failure to make payment on a timely basis.

Accepted Answer

A) True 
 B)False

Question 13

Contractors who process TRICARE claims do NOT provide information to parents of minors when the healthcare services provided are related to drug abuse.

Accepted Answer

A) True 
 B)False

Question 14

Which of the following services is covered under TRICARE Standard?
A)chiropractic care.
B)cosmetic surgery.
C)mental health care.
D)custodial care.

Accepted Answer

The answer of Which of the following services is covered...

Question 15

When is the TRICARE fiscal year?

Accepted Answer

The TRICARE fiscal y

Question 16

TRICARE
Prime is a managed care plan that differs from TRICARE Standard in that:
A)beneficiaries are assigned a primary care manager (PCM).
B)more preventive services are covered.
C)fewer out-of-pocket costs must be paid by beneficiaries.
D)beneficiaries receive priority treatment at MTFs.

Accepted Answer

beneficiaries are assigned a primary car

Question 17

The TRICARE plan option that provides benefits using a fee-for-service, cost-sharing structure is:
A)TRICARE Standard.
B)TRICARE Extra.
C)TRICARE Prime.
D)CHAMPVA.

Accepted Answer

The answer of The TRICARE plan option that provides benefits...

Question 18

The TRICARE plan that offers a higher-cost, point-of-service option for care received from out-of-network providers is:
A)TRICARE Standard.
B)TRICARE Extra.
C)TRICARE Prime.
D)CHAMPVA.

Accepted Answer

The answer of The TRICARE plan that offers a higher-cost,...

Question 19

The TRICARE claims processor for the northern region of the United States is:
A)Blue Cross/Blue Shield.
B)Health Net Federal Services, Inc.
C)the Veteran's Administration (VA) Health Administration Center.
D)the Wisconsin Physicians Service (WPS).

Accepted Answer

Health Net

Question 20

Enrollment is NOT required for:
A)TRICARE Standard.
B)TRICARE Prime.
C)TRICARE Prime Remote.
D)CHAMPVA.

Accepted Answer

The answer of Enrollment is NOT required for:
A)TRICARE Standard.
B)TRICARE Prime.
C)TRICARE...

The primary care manager (PCM) under TRICARE Prime may be a single military or civilian provider or a group of providers.

What are some of the advantages of submitting TRICARE claims electronically?

Under the access standards for TRICARE Prime enrollees, appointment wait time for wellness/preventive care should NOT exceed: A)48 hours. B)1 week. C)2 weeks. D)4 weeks.

Under TRICARE, what does MTF stand for? A)Medical treatment for forces B)Military treatment facility C)Military training families D)Medical training facility

The TRICARE Prime annual enrollment fee for retired service members is: A)$0. B)$260 for an individual or $520 for a family. C)$300 for an individual or $600 for a family. D)$520 for an individual or $1,040 for a family.

Form Locator 1a, Insured's ID Number, should include the: A)patient's Social Security number. B)patient's TRICARE-issued ID number. C)sponsor's Social Security number. D)sponsor's military rank and number.

What are the seven health plans available to individuals who are eligible for TRICARE benefits?

The Department of Defense (DoD) medical entitlement program for uniformed services beneficiaries is __________ .

Penalties or interest charges can be billed to a beneficiary by a physician due to TRICARE's failure to make payment on a timely basis.

Contractors who process TRICARE claims do NOT provide information to parents of minors when the healthcare services provided are related to drug abuse.

Which of the following services is covered under TRICARE Standard? A)chiropractic care. B)cosmetic surgery. C)mental health care. D)custodial care.

When is the TRICARE fiscal year?

TRICARE Prime is a managed care plan that differs from TRICARE Standard in that: A)beneficiaries are assigned a primary care manager (PCM). B)more preventive services are covered. C)fewer out-of-pocket costs must be paid by beneficiaries. D)beneficiaries receive priority treatment at MTFs.

The TRICARE plan option that provides benefits using a fee-for-service, cost-sharing structure is: A)TRICARE Standard. B)TRICARE Extra. C)TRICARE Prime. D)CHAMPVA.

The TRICARE plan that offers a higher-cost, point-of-service option for care received from out-of-network providers is: A)TRICARE Standard. B)TRICARE Extra. C)TRICARE Prime. D)CHAMPVA.

The TRICARE claims processor for the northern region of the United States is: A)Blue Cross/Blue Shield. B)Health Net Federal Services, Inc. C)the Veteran's Administration (VA) Health Administration Center. D)the Wisconsin Physicians Service (WPS).

Enrollment is NOT required for: A)TRICARE Standard. B)TRICARE Prime. C)TRICARE Prime Remote. D)CHAMPVA.

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Hipaa: Health Insurance Portability and Accountability Act of 1996

ICD-9-CM Medical Coding

ICD-10-CM Medical Coding

Introduction to Cpt and Place of Service Coding

Coding Procedures and Services

Hcpcs and Coding 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

Electronic Medical Claims Processing

Filters

Exam 15: Tricare Medical Billing

The primary care manager (PCM) under TRICARE Prime may be a single military or civilian provider or a group of providers.

What are some of the advantages of submitting TRICARE claims electronically?

Under the access standards for TRICARE Prime enrollees, appointment wait time for wellness/preventive care should NOT exceed: A)48 hours. B)1 week. C)2 weeks. D)4 weeks.

Under TRICARE, what does MTF stand for? A)Medical treatment for forces B)Military treatment facility C)Military training families D)Medical training facility

The TRICARE Prime annual enrollment fee for retired service members is: A)$0. B)$260 for an individual or $520 for a family. C)$300 for an individual or $600 for a family. D)$520 for an individual or $1,040 for a family.

Form Locator 1a, Insured's ID Number, should include the: A)patient's Social Security number. B)patient's TRICARE-issued ID number. C)sponsor's Social Security number. D)sponsor's military rank and number.

What are the seven health plans available to individuals who are eligible for TRICARE benefits?

The Department of Defense (DoD) medical entitlement program for uniformed services beneficiaries is __________ .

Penalties or interest charges can be billed to a beneficiary by a physician due to TRICARE's failure to make payment on a timely basis.

Contractors who process TRICARE claims do NOT provide information to parents of minors when the healthcare services provided are related to drug abuse.

Which of the following services is covered under TRICARE Standard? A)chiropractic care. B)cosmetic surgery. C)mental health care. D)custodial care.

When is the TRICARE fiscal year?

TRICARE Prime is a managed care plan that differs from TRICARE Standard in that: A)beneficiaries are assigned a primary care manager (PCM). B)more preventive services are covered. C)fewer out-of-pocket costs must be paid by beneficiaries. D)beneficiaries receive priority treatment at MTFs.

The TRICARE plan option that provides benefits using a fee-for-service, cost-sharing structure is: A)TRICARE Standard. B)TRICARE Extra. C)TRICARE Prime. D)CHAMPVA.

The TRICARE plan that offers a higher-cost, point-of-service option for care received from out-of-network providers is: A)TRICARE Standard. B)TRICARE Extra. C)TRICARE Prime. D)CHAMPVA.

The TRICARE claims processor for the northern region of the United States is: A)Blue Cross/Blue Shield. B)Health Net Federal Services, Inc. C)the Veteran's Administration (VA) Health Administration Center. D)the Wisconsin Physicians Service (WPS).

Enrollment is NOT required for: A)TRICARE Standard. B)TRICARE Prime. C)TRICARE Prime Remote. D)CHAMPVA.

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Hipaa: Health Insurance Portability and Accountability Act of 1996

ICD-9-CM Medical Coding

ICD-10-CM Medical Coding

Introduction to Cpt and Place of Service Coding

Coding Procedures and Services

Hcpcs and Coding 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

Electronic Medical Claims Processing

Filters