FREE AND STUDY GAMES ABOUT CHAPTER 16 INSURANCE

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FREE AND STUDY GAMES ABOUT CHAPTER 16 INSURANCE

EXAM QUESTIONS

Actual Qs and Ans Expert-Verified Explanation

This Exam contains:

-Guarantee passing score -20 Questions and Answers -format set of multiple-choice -Expert-Verified Explanation Question 1: The managed care option that is similar to a civilian HMO is called TRICARE

Answer:

Prime Question 2: Who assists TRICARE sponsors with information about the health program, along with other matters affecting access to health care (e.g., appointment scheduling)?

Answer:

customer service representative Question 3: The health care program for active duty members of the military and their qualified dependents is called

Answer:

TRICARE

Question 4: Beneficiary Services Representative

Answer:

Provide information about using TRICARE and assist with other administrative matters

Question 5: Preauthorization

Answer:

is formal approval obtained from a health care finder before certain specialty procedures and inpatient care services are rendered

Question 6: Which TRICARE option requires annual enrollment?

Answer:

TRICARE Prime Question 7: Which is a comprehensive health care program for which the Department of Veterans Affairs shares costs of covered health care services and supplies with eligible beneficiaries?

Answer:

CHAMPVA

Question 8: Which office coordinates and administers the TRICARE program and is accountable for the quality of health care provided to members of the uniformed services and their eligible dependents?

Answer:

TRICARE Management Activity (TMA)

Question 9: What is the limit for filing TRICARE claism

Answer:

one year Question 10: The office that provides policies and procedures for prevention and detection of fraud and abuse is

Answer:

Program Integrity Office

Question 11: TRICARE

Answer:

is a health care program for uniformed service members and their families, National Guard/Reserve members and their families, survivors, former spouses, Medal of Honor recipients and their families,

Question 12: Health care finder

Answer:

a RN or PA who assists primary care providers with preauthorization and referrals

Question 13: TRICARE Standard and Extra were combined to create TRICARE

Answer:

Select

Question 14: TRICARE coverage includes options

Answer:

special programs, and supplemental programs, and TRICARE is the primary payer to Medicaid and TRICARE supplemental plans.Question 15: The number of TRICARE regions has _____ since originally established.

Answer:

decreased Question 16: TRICARE nonparticipating providers are subject to a limiting charge of _____ above the TRICARE fee schedule for participating providers.

Answer:

15 percent

Question 17: A critical pathway is the

Answer:

sequence of activities that can normally be expected to result in the most cost-effective clinical course of treatment.Question 18: Commanders of selected military treatment facilities for TRICARE regions are called

Answer:

lead agents.Question 19: CHAMPVA- The Civilian Health and Medical Program of the Department of Veterans Affairs

Answer:

is a comprehensive health care program for which the Department of Veterans Affairs (VA) shares costs of covered health care services and supplies with eligible beneficiaries.

Question 20: The CHAMPVA sponsor is a

Answer:

veteran who's permanently & totally disabled from a service-connected condition, died as a result of a service-connected condition, was rated permanently and totally disabled from a service-connected condition at the time of death, or died on active duty