This plan allows out-of network options to a patient with a higher cost than in-plan services.
What is point -of-services (POS)?
100
MEDICAL CARE OR SERVICES SCHEDULED FOR TRICARE PRIME ENROLLESS WHO HAVE A NON-EMERGENT OR URGENT CARE PROBLEM NEED TO BE BOOKED IN THIS TIME FRAME.
What is 24 HOURS
100
WHAT IS THE DMIS FOR WOMACK ARMY MEDICAL CENTER.
What is 0089
100
TRICARE PRIME COVERAGE FOR ACTIVE DUTY SERVICES MEMBERS HCDP CODE
What is 106
100
A system operated by the Department of Defense and used by TRICARE contractors to determine and confirm the eligibility of beneficiaries. Beneficiaries are responsible for maintaining the accuracy of their records and updating them as necessary in this system.
What is DEERS
200
THIS OPTION IS A FEE-FOR-SERVICE PLAN THAT REPLACED CHAMPUS COVERAGE.
What is TRICARE STANDARD PLAN
200
WELLNESS APPOINTMENTS NEED TO BE BOOKED IN THIS TIME FRAME.
A review by the military treatment facility (MTF) of civilian authorizations and referrals received by Health Net Federal Services, LLC to determine if the MTF is able to provide the services.
What is Right of First Refusal (ROFR)
300
A program for eligible uniformed service members who require medical care that is not available at the military treatment facility (MTF) and must be referred to a civilian provider. Also available on a limited basis for non-TRICARE-eligible individuals when specifically referred by the MTF.
What is Supplemental Health Care Program (SHCP)
300
ROUTINE APPOINMENTS MUST BE MADE WITHIN HOW MANY DAYS.
What is SEVEN
300
WHAT DMIS IS USED FOR JOEL ARMY HEALTH CENTER.
What is 7286
300
TRICARE PRIME COVERAGE HCDP CODES FOR ACTIVE FAMILY MEMBERS
What is 107 AND 108
300
Two types of referrals request sent to specialty providers for initial evaluation, and or required diagnostic services and treatment related to a specific medical condition.
What is Evaluation only and Evaluation and treatment
400
TO BE ENROLLED IN THIS PLAN ALL PARTICIPANTS MUST LIVE AND WORK MORE THAN 50 MILES FROM THE NEAREST MILITARY TREATMENT FACILITY.
What is TRICARE PRIME REMOTE
400
FOR INTIAL SPECIALITY CARE OR PROCEDURES APPOINTMENTS NEED TO BE BOOKED IN THIS TIME FRAME.
What is PROVIDER DIRECTED OR WITHIN FOUR WEEKS
400
7294 IS USED FOR WHAT MEDICAL HEALTH CENTER
What is CLARK
400
TRICARE STANDARD HCDP CODE FOR ACTIVE DUTY FAMILY MEMBERS
What is 003
400
A civilian provider who has completed the credentialing process and signed a contracted agreement to participate in the TRICARE program and accepts the negotiated rate as payment in full for services rendered.
What is network provider
500
TRICARE's Medicare-wraparound coverage available to all Medicare-eligible TRICARE beneficiaries, regardless of age or place of residence, as long as they have Medicare Parts A and B.
What is TRICARE For Life (TFL)
500
FUTURE APPOINTMENTS MUST BE BOOK WITHIN HOW MANY DAYS.
What is THERE ARE NO STANDARDS OR PER PROVIDERS GUIDANCE
500
6034 IS THE DMIS FOR WHAT MEDICAL FOR FACILITY.
What is TROOP AND FAMILY MEDICAL CLINIC
500
TRICARE Prime Family Coverage HCDP Codes for Retired and Medal of Honor Sponsors and Family Members
What is 117
500
This option is used for services that are not considered primary care. An example is when a PCM sends a patient to see a cardiologist to evaluate a possible heart problem.