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15 Cards in this Set

  • Front
  • Back
catchment area-
a region which is defined by postal zip code boundaries that fit roughly within a 40 mile radius of the government medical treatment facility and is used to determine the need for preauthorization for any civilian medical care.
nonavailability statement-champus DD form 1251
preauthorization for nonemergency civilian health care issued by the base commander when medical treatment required for a champus-eligible person is not available at a government medical treatment facility within the patient's catchment area.
hba-health benefits advisor-
an individual stationed at uniformed service facilities who has responsibility for advising and assisting champus beneficiaries obtain health care within the military and/or civilian communities.
tricare prime plan-
an HMO option for the enrolled active duty dependents that eliminates the need to file claim forms and greatly reduces the out-of-pocket expenses for medical care.(Also know as champus prime)
limiting charge(champus)-
non-parproviders are limited to charging up to 15 percent above the champus par fee schedule, and may not balance bill. Claims from independent laboratory, diagnostic laboratory companies, durable medical equipment and medical supply companies are not held to the limiting charge rule.
Federal employee health benefit program-
charges on claims submitted for retired federal employees who are not eligible for medicare are limited to the medicare fee schedule rules.
tricare standard plan-
regular champus benefite for service rendered by health care providers who are not enrolled in champus PPO or HMO nework(Also known as standard champus)
tricare extra plan-
a PPO option available to champus active duty dependents that requires no special enrollment and reduces the out-of pocket expenses for medical care when services are obtained from a tricare network provider(Also known as champus extra)
health care finder&participation provider program- a referral program to encourage the use of civilian champus participating providers by champus patients.
civilian health and medical program of the uniformed services-a comprehensive federal civilian medical care program for spouses and dependents of those in the uniformed services.
civiliam health and medical program of the veterans administration- federal program for medical care in civilian communities for the spouses and dependents of veterans with total service connected disabilities or died as a result of service connected disabilities.
non par providers filing non assigned claims are limited
champus sponsor-
uniformed services personnel who are either on active duty, retired, or have died while in service.
office of civilian health and medical program of the uniformed services-the federal department of defense agency located in Aurora, Colorado with administrative responsibility for the champus program.
military treatment facility a clinic and/or hospital located on a United States military base or institution.