Plans
This plan requires a referral
Prime
They have signed an agreement and agreed to follow Tricare's policies and procedures.
Network Provider
This manages and administers all MTF worldwide, organized into nine DHNs. Intergrated networks of military hospitals, clinics and dental facilities, operates as a coordinated system to improve the deliver and continuity of health services.
Defense Health Network
When the PCM send the beneficiary to another provider for specialty care. What's this called
Referral
This program is available to beneficiaries diagnosed with moderate or severe intellectual disability, a serious physical disability, or an extraordinary physical or psychological condition.
ECHO
This plan does not require a referral.
Select
Have not joined the network beneficiaries may pay more to visit
Non Network Provider
What group of people does Tricare provider healthcare services to.
Uniformed Service members, retirees and their families.
What does OHI stand for
Other Health Insurance
This program provides services for qualifying ADFM, retirees, and certain National Guard and Reserve members.
Autism Care Demonstration
This plan is the supplement for Medicare
Tricare for Life
True or False:
The T-5 Contract requires Triwest to provider a comprehensive network of providers and facilities.
True
Hospitals and clinis operated by the dod are called?
MTF
One hundred percent of these must be processed within one business day.
Urgent Authorizations
TRICARE now covers some services provided by certified labor doulas, lactation consultants, and lactation counselors. What is this coverage called
Childbirth and Breastfeeding Support Demonstration
This plan is for people in the national guard and reservists.
Tricare Reserve Select
True or False:
The TriWest Tricare provider network is built entirely from scratch for each new contract.
False
What are the core components of Tricares Medical Management program.
Utilization management, referral management, case management, behavioral health, population health,
True or False:
Select plans do not requires a referral for most specialist care.
True
Health care provided during a time of transition
TAMP
This plan is for retired reservists.
Tricare Retired Reserve.
Care provided at military hospital and clinics
Direct Care
What is the primary goal of medical management in Tricare
To ensure the highest quality care for eligible beneficiaries
Why might certain tabs and features not be visible to a user in the system?
They are not visible due to role based permissions tailored to the users security access and departmental role.
TRICARE covers participation in National Cancer Institute (NCI)-sponsored Phase IEvaluates the safety of a new treatment on patients with advanced cancer not effectively treated with standard care. There are specific requirements for phase I trials. Participation may be approved on a case-by-case basis., Phase IIFocuses on learning whether a new therapy has an anticancer effect. and Phase IIICompares a promising new treatment to the standard approach. studies for all beneficiaries who are selected to participate
Cancer Clinical Trial