TRICARE Plans
This HMO-style TRICARE plan uses a Primary Care Manager as the gatekeeper.
What is TRICARE Prime?
A beneficiary must be enrolled in this system to be eligible for TRICARE.
Correct Response What is DEERS?
24 hours, 7 days, 28 days, and 28 days are the Prime access standards for these four categories, respectively.
What are acute, future/routine, wellness, and specialty care?
Protection and privacy, including limits on the use andsharing of healthcare information, are the primary purposes of this law.
What is HIPAA?
This Department of Defense process determines whether a service member is fit for normal military duty and deployment needs.
What is the Medical Evaluation Board (MEB)?
This PPO-style TRICARE plan offers more provider choice, uses network discounts, and generally does not require referrals.
What is TRICARE Select?
A beneficiary with TRICARE Prime, an assigned PCM or medical home, and priority access is described by this term rather than merely eligible.
What is an enrolled patient?
This “one-stop shop” assists patients referred by their PCM for specialty care outside the MTF.
What is the Referral Management Center?
Responding to patient complaints is assigned to this HIPAA officer, while conducting EHR audits falls to the Security Officer?
Who is the HIPAA Privacy Officer?
IDES integrates the DoD Disability Evaluation System with this federal department’s disability process and continuity of care.
What is the Veterans Administration (VA)?
This TRICARE Prime payment option allows a beneficiary to see a provider of choice without a referral but carries a heavy deductible and cost-share penalty.
What is Prime Point of Service (POS)?
Marriage, birth of a child, joining active duty, or retiring are examples of this event that can permit a TRICARE
What is a Qualifying Life Event (QLE)?
Work the MTF can perform for its own Prime enrollees but that instead goes to the civilian network is called this.
What is Prime Leakage?
Military health records are the property of this entity rather than the individual patient.
What is the U.S. Government?
This DoD process helps a military service determine whether a member is fit for normal military duty and deployment needs.
What is the Medical Evaluation Board (MEB)?
Lowest cost, least choice, and PCM referrals describe Prime; higher cost, more choice, deductibles/cost- sharing, and no referral requirement describe this other plan.
What is TRICARE Select?
A TRICARE beneficiary can use an MTF’s laboratory, radiology, pharmacy, and immunization services but does not have an assigned PCM or priority access. This term describes the beneficiary’s status.
What is eligible?
Because most MTF care is a fixed cost while purchased care is variable, leadership seeks to maximize this use of existing military treatment capability.
What is MTF utilization?
EHR audits are a responsibility of this HIPAA function, which also safeguards electronic security, monitors compliance, researches violations, and reports breaches.
What is HIPAA Security?
A single-sourced disability rating, a process goal of less than 180 days to active-duty separation, faster transition to VA care, and electronic medical records to the VA within 45 days are goals of this system.
What is IDES?
A retired Reserve member is approaching age 60. This sequence of TRICARE coverage applies as the member moves from the period before age 60, through ages 60–64, and then reaches age 65.
What are TRICARE Retired Reserve, TRICARE Prime/Select, and TRICARE For Life?
An MTF/CC is determining how many beneficiaries should be enrolled to its primary care teams. These two leaders advise the commander on enrollment policy.
Who are the TOPA Officer and Group Practice Manager?
An MTF can provide a service to its Prime enrollees, but that workload is instead going to civilian network providers. Leadership uses this report to identify the potentially recapturable workload and help control purchased-care costs.
What is the Prime Leakage Report?
A beneficiary receives a collection notice and negative credit report related to a TRICARE claim. This TOPA position assists beneficiaries with collection agencies, resolves claims issues, and can intercede with the agency.
Who is the Debt Collection Assistance Officer (DCAO)?
An Airman is expected to remain hospitalized for more than 90 days and is unlikely to return to the home unit. AFPC can assign the member to this organization, which has fixed locations at Andrews, Travis, and Lackland.
What is the Airman Guardian Medical Transition Unit (AGMTU)?