Term
| which medical practice is described as a formal association of three or more health professionals providing services with income from the medical practice pooled and redistributed to the members according to a prearranged plan? |
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Definition
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Term
| The federal government's health care finacing for elderly is called |
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Definition
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Term
| Which act enabled managed care plans to increase in numbers and expand enrollments through healthcare programs financed by grants,contracts, and loans? |
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Definition
| Health Maintenance Organization Act of 1973 |
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Term
| Whis health care system is reponsible for both the financing and delivery of a broad range of comprehensive health services to a voluntarily enrolled population? |
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Definition
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Term
| Who is responsible for reimbursing covered individuals for the cost of their health care? |
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Definition
| Health care insurance companies |
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Term
| A patient's principal provider for routine medical needs is the |
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Definition
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Term
What was formerly known as the public Health Services Hospitals, and now operates much like TRICARE Prime? |
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Definition
| Uniformed Services Family Health Plan |
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Term
| What is the main challenge for most eligible beneficiaries? |
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Definition
| Deciding what TRICARE option is best for their particular situation |
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Term
| The TRICARE program is geographically structure by |
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Definition
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Term
| How many regions are there within TRICARE |
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Definition
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Term
| Within each local delivery area,how is TRICARE health care managed? |
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Definition
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Term
| What is the heart of the military health care delivery system? |
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Definition
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Term
| The benefits of TRICARE cannot be fully realized without timely information regarding access, utilizationn and |
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Definition
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Term
| On of the central features of TRICARE is the |
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Definition
| choice of health care plans |
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Term
| For at least how many months is the enrollment period for TRICARE Prime |
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Definition
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Term
| Currently TRICARE standard pays what percentage of the approved or allowable cost for outpatient care, for active duty families, after the annual deductible is paid? |
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Definition
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Term
| TRICARE plus enrollment is noted on beneficiary records in |
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Definition
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Term
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Definition
| the broadest choiceof providers |
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Term
| Who is respnsible for meeting the health needs of the beneficiaries in their region? |
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Definition
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Term
| Besides LS responsibilities, each LA is also a |
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Definition
| commander of an MTF within their respective region |
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Term
| The LA is responsible for coordinating contractor marketing activities with the |
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Definition
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Term
| One of the most important functions of the MCS contractor is the development of civilian provider networks in support of TRICARE |
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Definition
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Term
| What does the LA use as the baseline to build additional network needs, develop referral policy and measure access standards? |
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Definition
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Term
| Which duty is performed by the ACO? |
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Definition
| Assists with resolving contractual issues |
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Term
| Who are the two entities in the MTF that assist beneficiaries with using and understanding their health benefits? |
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Definition
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Term
| Prior to assisting patients with completing TRICARE claim forms, the BCA officer should ensure the patient is enrooled in DEERS and |
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Definition
| Is eligible for TRICARE benefits |
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Term
| WHo is each lead agency and MTF required to have available to assist beneficiaries in determining the validity of collection agent claims recieved for debts incurred as a result of medical/dental care under the TRICARE Program? |
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Definition
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Term
| A nonenrolled beneficiary is required to obtain authorization for care from the Health Care Finder when |
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Definition
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Term
| A NAS is issued when the MTF cannot provide the |
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Definition
| inpatient medical care needed |
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Term
| NASs are processed through the |
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Definition
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Term
| Claims for MTF referred supplemental care are normally for tests, procedures and |
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Definition
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Term
| Beneficiaries referred by a MTF for civilian health care will be referred to network providers to the extent possible and in all cases referrals will meet TRICARE Prime standards for access, waiting times and |
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Definition
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Term
There is no copayment or deductible for beneficiares referred for civilian medical care |
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Definition
| while in an inpatient status in the MTF |
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Term
| Who authorizes non-MTF referred supplement care for the uniformed services? |
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Definition
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Term
| Which marketing strategy is utilized by TRICARE? |
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Definition
| Position TRICARE Prime enrollment at the MTF as the best choice for most active duty family members |
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Term
| The TMA is field activity of the |
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Definition
| Undersecretry of Defense for Personnel and Readiness |
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Term
| Who along with the LAs, are responsible for conducting provided training on TRICARE and managed care in accordance with contract provisions? |
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Definition
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Term
| Who is responsible for oversight of the MCS contractor's marketing programs? |
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Definition
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Term
| TRICARE presentations are effective when done jointly by a knowledgeable uniformed representative and a |
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Definition
| MCSC marketing representative office |
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Term
| What should be the first priority in developing marketing material for a region? |
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Definition
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Term
| The national TRICARE logo may be regionalized by adding the regions's name |
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Definition
| to the right of the word "TRICARE" |
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Term
| A systematic data collection, using personal or telephone interviews, or self-administered questionnaires, from a sample of 10 or more persons is the definition of a |
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Definition
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Term
| Who sponsors the health Enrollment/Evaluation assessment Review and the Customer Satisfaction Survey? |
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Definition
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Term
| The Customer Satisfaction survey primarily attempts to collect information regarding |
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Definition
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Term
| Resource sharing is based on the assumption that costs associated with the provision of these resorces will be more than offset by decreased |
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Definition
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Term
| When utilizing resorces support, who may request a task order for personnel, equipment, equipment maintenance, and supply? |
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Definition
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Term
| Whose policy requires you to consider resource sharing as the first alternative in initiatives to recapture tricare workload for which the gov and the contractor are jointly at risk? |
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Definition
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Term
| Who determines whether or not resoure sharing agreement are in the best interest of the gov and are in support of the regional health care plan? |
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Definition
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Term
| Who establishes the resource sharing agreement with the MCS contractor? |
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Definition
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Term
Resource sharing allows the MCS contractor to provide personnel, equipment, supplies and |
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Definition
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Term
| Who performs periodic reviews of MTF/VA facility resource sharing agreement to ensure compatibility with agreement including VA facilities as network providers? |
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Definition
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Term
| who is responsible for the supervision of the external resource sharing health care personnel? |
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Definition
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Term
| As a minimum, the medical portion of in- and out-processing should include information on how to access health care at the MTF and in the community, and how to |
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Definition
| resolve problems accessing health care |
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Term
| Active duty personnel who have family members may or may not elect to enroll their family in |
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Definition
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Term
| Which office conducts the required medical out-processing briefing? |
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Definition
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