Question 1

Which are decision-making tools used by providers to determine appropriate health care for specific clinical circumstances?

Accepted Answer

A)   critical pathways
B)   living wills
C)   practice guidelines
D)   revenue managementE) B) and C)
F) None of the above

Question 2

Which is responsible for the surveillance of fraud and abuse activities worldwide involving purchased care for beneficiaries in the Military Health Care System?

Accepted Answer

A)   Department of Defense
B)   Office of Inspector General
C)   Program Integrity Office
D)   TRICARE management activityE) B) and C)
F) A) and C)

Question 3

When a patient seeks health care under the TRICARE program, sponsor information is verified in the __________ computer system, which contains up-to-date workforce personnel information.

Accepted Answer

A)   CMS
B)   DEERS
C)   DOD
D)   MTFE) C) and D)
F) B) and D)

Question 4

Which is the name of the entire health care system of the U.S. uniformed services and includes military treatment facilities as well as various programs in the civilian health care market, such as TRICARE?

Accepted Answer

A)   Defense Enrollment Eligibility Reporting System
B)   Military Health Services System
C)   TRICARE Program Management Organization
D)   TRICARE Service CenterE) A) and B)
F) A) and C)

Question 5

TRICARE Prime beneficiaries can receive care if they reside and work outside a military treatment facility __________ area, which is the region defined by code boundaries within a 40-mile radius of a military treatment facility.

Accepted Answer

A)   catchment
B)   local
C)   regional
D)   stateE) None of the above
F) C) and D)

Question 6

Which is a health care program for (1)  active duty members of the military and their qualified family members, (2)  CHAMPUS-eligible retirees and their qualified family members, and (3)  eligible survivors of members of the uniformed services?

Accepted Answer

A)   CHAMPUS
B)   CHAMPVA
C)   MEDICARE
D)   TRICAREE) C) and D)
F) A) and B)

Question 7

Which is the former name for TRICARE Standard?

Accepted Answer

A)   CHAMPUS
B)   CHAMPVA
C)   DOD-MTF
D)   TRIWESTE) A) and D)
F) A) and C)

Question 8

TRICARE __________ are uniformed service personnel who are either active duty, retired, or deceased.

Accepted Answer

A)   beneficiaries
B)   patients
C)   providers
D)   sponsorsE) A) and B)
F) B) and C)

Question 9

Which include sponsors and dependents of sponsors?

Accepted Answer

A)   beneficiaries
B)   coordinators
C)   finders
D)   representativesE) B) and D)
F) B) and C)

Question 10

TRICARE enrollees use their uniformed services __________, which can be scanned each time they receive health care services.

Accepted Answer

A)   common access card
B)   driver's license
C)   insurance ID
D)   military badgeE) A) and C)
F) None of the above

Question 11

Health Affairs (HA)  refers to the Office of the Assistant Secretary of Defense for Health Affairs, which is responsible for __________.

Accepted Answer

A)   military readiness and peacetime health care
B)   the military health care system in their region
C)   various programs in the civilian health care market
D)   working with uniformed service headquarters' staffsE) C) and D)
F) A) and D)

Question 12

A TRICARE __________ assists primary care providers with preauthorizations and referrals to health care services in a military treatment facility or civilian provider network.

Accepted Answer

A)   beneficiary services representative
B)   health care finder
C)   nurse advisor
D)   primary care managerE) B) and C)
F) A) and D)

Question 13

Which is assigned to a TRICARE Prime sponsor and is part of the TRICARE provider network?

Accepted Answer

A)   beneficiary services representative
B)   health care finder
C)   nurse advisor
D)   primary care managerE) A) and B)
F) B) and D)

Question 14

TRICARE __________ are available 24/7 for advice and assistance with treatment alternatives and to discuss whether a sponsor should see a provider based on a discussion of symptoms, and they will also discuss preventive care and ways to improve a family's health.

Accepted Answer

A)   beneficiary services representatives
B)   health care finders
C)   nurse advisors
D)   primary care managersE) A) and B)
F) A) and C) C

Question 15

The TRICARE Management Activity (TMA)  coordinates and administers the TRICARE program and is accountable for __________ health care provided to members of the uniformed services and their families.

Accepted Answer

A)   affordable
B)   efficient
C)   pathway
D)   qualityE) B) and C)
F) All of the above D

Question 16

A TRICARE __________ provides information about using TRICARE and assists with other matters affecting access to health care (e.g., appointment scheduling) .

Accepted Answer

A)   beneficiary services representative
B)   health care finder
C)   nurse advisor
D)   primary care managerE) C) and D)
F) A) and C) A

Question 17

A military treatment facility (MTF)  is a health care facility operated by the military that provides inpatient and ambulatory care to eligible TRICARE beneficiaries. Which is an example of ambulatory care?

Accepted Answer

A)   acute care hospital stay
B)   emergency department treatment
C)   overnight psychiatric evaluation
D)   rehabilitation requiring 30-day admissionE) A) and B)
F) All of the above

Question 18

Which is the TRICARE managed care option similar to a civilian health maintenance organization?

Accepted Answer

A)   TRICARE
B)   TRICARE Extra
C)   TRICARE Prime
D)   TRICARE StandardE) A) and B)
F) A) and C)

Question 19

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?

Accepted Answer

A)   CHAMPUS
B)   CHAMPVA
C)   Medicare
D)   TRICAREE) A) and D)
F) C) and D)

Question 20

TRICARE regions are served by one or more __________ who assist TRICARE sponsors with health care needs and answer questions about the program.

Accepted Answer

A)   military treatment facilities
B)   nurse advisors
C)   primary care managers
D)   service centersE) A) and B)
F) A) and C)

Exam 16: Tricare

Which are decision-making tools used by providers to determine appropriate health care for specific clinical circumstances?

Correct AnswerverifiedShow Answer

Which is responsible for the surveillance of fraud and abuse activities worldwide involving purchased care for beneficiaries in the Military Health Care System?

Correct AnswerverifiedShow Answer

When a patient seeks health care under the TRICARE program, sponsor information is verified in the __________ computer system, which contains up-to-date workforce personnel information.

Correct AnswerverifiedShow Answer

Which is the name of the entire health care system of the U.S. uniformed services and includes military treatment facilities as well as various programs in the civilian health care market, such as TRICARE?

Correct AnswerverifiedShow Answer

TRICARE Prime beneficiaries can receive care if they reside and work outside a military treatment facility __________ area, which is the region defined by code boundaries within a 40-mile radius of a military treatment facility.

Correct AnswerverifiedShow Answer

Which is a health care program for (1) active duty members of the military and their qualified family members, (2) CHAMPUS-eligible retirees and their qualified family members, and (3) eligible survivors of members of the uniformed services?

Correct AnswerverifiedShow Answer

Which is the former name for TRICARE Standard?

Correct AnswerverifiedShow Answer

TRICARE __________ are uniformed service personnel who are either active duty, retired, or deceased.

Correct AnswerverifiedShow Answer

Which include sponsors and dependents of sponsors?

Correct AnswerverifiedShow Answer

TRICARE enrollees use their uniformed services __________, which can be scanned each time they receive health care services.

Correct AnswerverifiedShow Answer

Health Affairs (HA) refers to the Office of the Assistant Secretary of Defense for Health Affairs, which is responsible for __________.

Correct AnswerverifiedShow Answer

A TRICARE __________ assists primary care providers with preauthorizations and referrals to health care services in a military treatment facility or civilian provider network.

Correct AnswerverifiedShow Answer

Which is assigned to a TRICARE Prime sponsor and is part of the TRICARE provider network?

Correct AnswerverifiedShow Answer

TRICARE __________ are available 24/7 for advice and assistance with treatment alternatives and to discuss whether a sponsor should see a provider based on a discussion of symptoms, and they will also discuss preventive care and ways to improve a family's health.

Correct AnswerverifiedC

The TRICARE Management Activity (TMA) coordinates and administers the TRICARE program and is accountable for __________ health care provided to members of the uniformed services and their families.

Correct AnswerverifiedD

A TRICARE __________ provides information about using TRICARE and assists with other matters affecting access to health care (e.g., appointment scheduling) .

Correct AnswerverifiedA

A military treatment facility (MTF) is a health care facility operated by the military that provides inpatient and ambulatory care to eligible TRICARE beneficiaries. Which is an example of ambulatory care?

Correct AnswerverifiedShow Answer

Which is the TRICARE managed care option similar to a civilian health maintenance organization?

Correct AnswerverifiedShow Answer

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?

Correct AnswerverifiedShow Answer

TRICARE regions are served by one or more __________ who assist TRICARE sponsors with health care needs and answer questions about the program.

Correct AnswerverifiedShow Answer

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