4A051 Cdc Volume 3

Front 1

1. The manage access to care tools are available in CHCS and…

Back 1

TRICARE operations center

Front 2

2. What is composed of timeslots that have been assigned appointment types?

Back 2

schedule

Front 3

3. What is a pattern of time slots specific to a provider, but not linked to a date?

Back 3

template

Front 4

4. What in CHCS makes it simple to add/delete/cancel/freeze schedule time slots?

Back 4

maintain/cancel

Front 5

5. Which CHCS option allows you to cancel existing schedule at the request of the provider?

Back 5

cancellation by facility

Front 6

6. What includes all units, organizations and members in the ANG and AFR?

Back 6

Air Reserve Component

Front 7

7. The favorable dependency determination must specifically state the individual is eligible for medical care and this eligibility determination is made by the…

Back 7

MPF

Front 8

8. The former CHAMPUS option that pays a share of the cost covered by healthcare services is...

Back 8

TRICARE standard

Front 9

9. Pregnant female discharged under other then honorable conditions fall within what program?

Back 9

Secrertary of the AF designee

Front 10

10. Children retain their eligibility unless they marry before the age of…

Back 10

21

Front 11

11. Active duty family not enrolled in TRICARE prime belong in priority group number…

Back 11

four

Front 12

12. What priority group includes special provisions to members who aren’t on active duty but entitled to care?

Back 12

one

Front 13

13. When creating a personal master schedule, the appointment personnel must coordinate with the…

Back 13

provider

Front 14

14. To be cognizant of the information you’re inputting you must remember what?

Back 14

accuracy and effectivness

Front 15

15. When you print reports by using the appropriate option then what will happen next?

Back 15

print on demand

Front 16

16. For PHA reason, how often are records reviewed?

Back 16

annually

Front 17

17. What function ensures preventive individual medical readiness?

Back 17

MAJCOM SG

Front 18

18. Who’s required to conduct medical record reviews to id medical history/info that could be disqualifying for deployment/WWD?

Back 18

PCE/PCM

Front 19

19. MTF’s use what 2 systems to id and describe the enrolled population?

Back 19

DOD/ AFMS

Front 20

20. What is non-electronic, folder-style form documenting immunizations?

Back 20

2766

Front 21

21. What process for inpatients begins before or on admission and continues after discharge to include f/u and evaluation?

Back 21

MTF discharge and disposition planning process

Front 22

22. What MTF process is a broad-spectrum scope to ID beneficiaries experiencing conditions which may indicate the need for case management?

Back 22

MTF case Management

Front 23

23. How often must MTF assess centrally and locally produced performance measures?

Back 23

Quarterly

Front 24

24. The federal governments healthcare financing for the elderly is called….

Back 24

Medicare

Front 25

25. What legislation enabled managed care plans to increase numbers and expand enrollments through healthcare programs financed by grants, contracts and loans?

Back 25

Health Care Act 1973

Front 26

26. If a healthcare system is responsible for both the finance and delivery of a broad range of comprehensive health services to a voluntarily enrolled population, what plan would apply?

Back 26

HMO

Front 27

27. If an individual is in a healthcare plan, who is responsible for reimbursing for costs?

Back 27

Insurance

Front 28

28. If a patient has routine medical needs, who would be the patients principle provider?

Back 28

PCM

Front 29

29. What was formally known as the Public Health Services Hospitals and now operates much like TRICARE?

Back 29

Uniformed Services Family Health Plan

Front 30

30. What is the main challenged for most eligible beneficiaries?

Back 30

Which TRICARE is best

Front 31

31. The TRICARE program is geographically structured by…

Back 31

regions

Front 32

32. How many regions are there?

Back 32

3

Front 33

33. Within each local delivery area, how is TRICARE managed?

Back 33

locally

Front 34

34. The benefits of TRICARE can’t be realized without information regarding access, utilization and…

Back 34

costs

Front 35

35. For at least how many months is enrollment for TRICARE prime?

Back 35

12

Front 36

36. TRICARE standard pays what % of approved cost for outpatient care?

Back 36

80%

Front 37

37. TRICARE plus enrollment is noted on records in…

Back 37

DEERS

Front 38

38. TRICARE standard has the broadest choice of…

Back 38

providers

Front 39

39. What document reflects an approach to managing military benefits as a first priority?

Back 39

governance plan

Front 40

40. The TRO (TRICARE regional office) operates under the authority of…

Back 40

regional director

Front 41

41. One of the most important functions of MCS contractor is the development of in support of TRICARE…

Back 41

prime/extra

Front 42

42. What does the TRO use as a baseline to build additional network needs?

Back 42

primary care systems

Front 43

43. Which duty is performed by the ACO?

Back 43

resolving contracteral issues

Front 44

44. Who is each TRO and MTF required to have available to assist beneficiaries?

Back 44

DCAO

Front 45

45. A nonenrolled beneficiary is required to obtain authorization for care from HCF when…

Back 45

a NAS is required

Front 46

46. No availability statements are processed through…

Back 46

DEERS

Front 47

47. There is no copayment for beneficiaries referred for civilian medical care while…

Back 47

while on inpatient status

Front 48

48. Who authorizes non-MTF referred supplemental care for the uniformed services?

Back 48

HCF

Front 49

49. TRICARE Management Activity is a field of activity of the…

Back 49

Undersecretary of defense for personal readiness

Front 50

50. Who along with the TRO is responsible for conducting provider training on TRICARE?

Back 50

MCS Contractor

Front 51

52. TRICARE presentations are most effective when done jointly by…

Back 51

MSCS Marketing Representatives

Front 52

53. What should be the first priority in developing marketing material?

Back 52

enrollment packages

Front 53

54. Customer Satisfaction Survey attempts to collect in for regarding…

Back 53

specific appointments

Front 54

55. When utilizing resource support who may request a task order for equipment?

Back 54

MTF CC

Front 55

56. Whose policy requires you to consider resource sharing agreements are the best interest of the gov. and support healthcare?

Back 55

TRICARE

Front 56

57. Who determines whether or not resource sharing agreements are in the best interest of the government and are in support of the regional health care plan?

Back 56

TRO

Front 57

58. Who establishes the resource sharing agreements with the MCS contractor?

Back 57

MTF CC

Front 58

59. Who performs periodic reviews of the MTF facitlity resource sharring agreements?

Back 58

TRO

Front 59

60. As a minimum the medical portion of in-and-out processing should include how to…

Back 59

resolve problems accessing health care

Front 60

61. Active duty personnel who have family members may or may not elect to enroll in…

Back 60

TRICARE Prime