Question 1

The plan that provides benefits for veterans with 100% service-related disabilities and their families is:
A)TRICARE Standard.
B)TRICARE Extra.
C)TRICARE Prime.
D)CHAMPVA.

Accepted Answer

The plan that provides benefits for veterans with 100% service-related disabilities and their families is CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs). TRICARE Standard, TRICARE Extra, and TRICARE Prime are plans for active duty military and their families, as well as certain retired service members and their families.

Question 2

The TRICARE plan option that provides benefits using a fee-for-service, cost-sharing structure is:
A)TRICARE Standard.
B)TRICARE Extra.
C)TRICARE Prime.
D)CHAMPVA.

Accepted Answer

TRICARE Standard.

Question 3

An individual who qualifies for TRICARE is known as a(n):
A)member.
B)beneficiary.
C)sponsor.
D)enrollee.

Accepted Answer

A beneficiary is an individual who can receive benefits from TRICARE.

Question 4

The TRICARE preferred provider organization (PPO) plan option is:
A)TRICARE Standard.
B)TRICARE Extra.
C)TRICARE Prime.
D)CHAMPVA.

Accepted Answer

The TRICARE preferred provider organization (PPO) plan option is TRICARE Extra. TRICARE Standard is the fee-for-service option, TRICARE Prime is the managed care option, and CHAMPVA is a healthcare benefit program for eligible spouses and dependents of veterans who have a total and permanent disability from a service-related injury or illness.

Question 5

Under TRICARE Standard, the group of beneficiaries that pays 25% cost share for outpatient services includes all of the following EXCEPT:
A)former spouses of active-duty service members.
B)retired service members and their families.
C)families of deceased personnel.
D)families of active-duty service members.

Accepted Answer

Families of active-duty service members do not pay a 25% cost share for outpatient services under TRICARE Standard; instead, they have different cost-sharing arrangements. The other groups listed do pay a 25% cost share for these services.

Question 6

An active-duty service member whose family is covered by a TRICARE plan is known as a(n):
A)member.
B)beneficiary.
C)sponsor.
D)enrollee.

Accepted Answer

The term sponsor is used to refer to the active-duty service member who is enrolled in TRICARE and whose family members are beneficiaries of the plan. Choice A (member) and choice D (enrollee) are not specific enough to indicate that the person is an active-duty service member with family coverage, while choice B (beneficiary) refers only to the family members who are covered by the plan.

Question 7

To be eligible for TRICARE, all sponsors and family members must be enrolled in DEERS, which stands for:
A)Department Electronic Enrollment Reporting System.
B)Department Early Enrollment Reporting System.
C)Defense Electronic Eligibility Reporting System.
D)Defense Enrollment Eligibility Reporting System.

Accepted Answer

DEERS stands for Defense Enrollment Eligibility Reporting System.

Question 8

Authorized TRICARE providers include all of the following EXCEPT:
A)chiropractors.
B)doctors of dental medicine.
C)doctors of optometry.
D)psychologists.

Accepted Answer

Chiropractors are not authorized TRICARE providers.

Question 9

The TRICARE health maintenance organization (HMO) plan option is:
A)TRICARE Standard.
B)TRICARE Extra.
C)TRICARE Prime.
D)CHAMPVA.

Accepted Answer

TRICARE Prime is the HMO plan option offered by TRICARE. The other options listed (TRICARE Standard, TRICARE Extra, and CHAMPVA) are not HMOs.

Question 10

Under TRICARE Standard, the group of beneficiaries that pays 20% cost share for outpatient services includes:
A)former spouses of active-duty service members.
B)families of active-duty service members.
C)families of deceased personnel.
D)retirees from the military.

Accepted Answer

The answer of Under TRICARE Standard, the group of beneficiaries...

Question 11

Authorized nonphysician TRICARE providers include all of the following EXCEPT:
A)acupuncturists.
B)audiologists.
C)clinical social workers.
D)speech therapists.

Accepted Answer

Acupuncturists are not authorized nonphysician TRICARE providers. The other options listed (audiologists, clinical social workers, and speech therapists) are all authorized nonphysician TRICARE providers.

Question 12

Which of the following services is covered under TRICARE Standard?
A)chiropractic care.
B)cosmetic surgery.
C)mental health care.
D)custodial care.

Accepted Answer

TRICARE Standard covers mental healthcare. Chiropractic care may be covered under certain circumstances, but it is not a guaranteed benefit. Cosmetic surgery and custodial care are not covered under TRICARE Standard.

Question 13

The TRICARE Standard annual catastrophic cap (maximum amount beneficiaries are required to pay within 1 year) for retirees is:
A)$1,000.
B)$2,500.
C)$5,000.
D)$7,500.

Accepted Answer

The answer of The TRICARE Standard annual catastrophic cap (maximum...

Question 14

The TRICARE fiscal year begins on:
A)January 1.
B)July 1.
C)September 1.
D)October 1.

Accepted Answer

The TRICARE fiscal year begins on October 1st and ends on September 30th of the following year. This is the same fiscal year used by the federal government, and it is chosen because it aligns with the federal budget cycle.

Question 15

The TRICARE fiscal year ends on:
A)January 31.
B)June 30.
C)September 30.
D)December 31.

Accepted Answer

The TRICARE fiscal year ends on September 30th. This is the date when the Department of Defense (DoD) closes its books on the previous fiscal year and begins the new fiscal year on October 1st.

Question 16

Under TRICARE, what does NAS stand for?
A)Nonavailability statement
B)Nonactive status
C)Nonauthorized service
D)No available surgeons

Accepted Answer

NAS stands for Nonavailability statement, which is a document required to receive care from a provider that is not within the TRICARE network. It certifies that a military treatment facility or TRICARE network provider is not available to provide the necessary care.

Question 17

If a TRICARE beneficiary receives services from a nonauthorized provider, the physician can bill:
A)only the usual, customary, and reasonable amount.
B)only the authorized contracted amount.
C)only the limiting charge.
D)any amount for the services.

Accepted Answer

The answer of If a TRICARE beneficiary receives services from...

Question 18

The TRICARE Standard annual catastrophic cap (maximum amount beneficiaries are required to pay within 1 year) for active-duty families is:
A)$1,000 per beneficiary.
B)$1,000 per family.
C)$7,500 per beneficiary.
D)$7,500 per family.

Accepted Answer

The answer of The TRICARE Standard annual catastrophic cap (maximum...

Question 19

When a TRICARE beneficiary needs treatment that is NOT available from a military treatment facility (MTF), the:
A)beneficiary will have to pay for the services.
B)services will not be covered.
C)beneficiary must obtain a nonavailability statement (NAS) to receive services from a civilian provider.
D)beneficiary can automatically receive services from a civilian provider.

Accepted Answer

When a TRICARE beneficiary needs treatment that is not available from an MTF, they must obtain a Nonavailability Statement (NAS) to receive services from a civilian provider. The NAS is proof that the needed services are not available from an MTF and that it is necessary to seek care from a civilian provider. Without the NAS, the services may not be covered by TRICARE, and the beneficiary may have to pay out of pocket.

Question 20

Services covered under TRICARE Standard include all of the following EXCEPT:
A)podiatry services.
B)durable medical equipment (DME).
C)mental health care.
D)routine physical examinations.

Accepted Answer

The answer of Services covered under TRICARE Standard include all...

Quiz 15: Tricare Medical Billing

The plan that provides benefits for veterans with 100% service-related disabilities and their families is: A)TRICARE Standard. B)TRICARE Extra. C)TRICARE Prime. D)CHAMPVA.

The TRICARE plan option that provides benefits using a fee-for-service, cost-sharing structure is: A)TRICARE Standard. B)TRICARE Extra. C)TRICARE Prime. D)CHAMPVA.

An individual who qualifies for TRICARE is known as a(n): A)member. B)beneficiary. C)sponsor. D)enrollee.

The TRICARE preferred provider organization (PPO) plan option is: A)TRICARE Standard. B)TRICARE Extra. C)TRICARE Prime. D)CHAMPVA.

An active-duty service member whose family is covered by a TRICARE plan is known as a(n): A)member. B)beneficiary. C)sponsor. D)enrollee.

Authorized TRICARE providers include all of the following EXCEPT: A)chiropractors. B)doctors of dental medicine. C)doctors of optometry. D)psychologists.

The TRICARE health maintenance organization (HMO) plan option is: A)TRICARE Standard. B)TRICARE Extra. C)TRICARE Prime. D)CHAMPVA.

Under TRICARE Standard, the group of beneficiaries that pays 20% cost share for outpatient services includes: A)former spouses of active-duty service members. B)families of active-duty service members. C)families of deceased personnel. D)retirees from the military.

Authorized nonphysician TRICARE providers include all of the following EXCEPT: A)acupuncturists. B)audiologists. C)clinical social workers. D)speech therapists.

Which of the following services is covered under TRICARE Standard? A)chiropractic care. B)cosmetic surgery. C)mental health care. D)custodial care.

The TRICARE Standard annual catastrophic cap (maximum amount beneficiaries are required to pay within 1 year) for retirees is: A)$1,000. B)$2,500. C)$5,000. D)$7,500.

The TRICARE fiscal year begins on: A)January 1. B)July 1. C)September 1. D)October 1.

The TRICARE fiscal year ends on: A)January 31. B)June 30. C)September 30. D)December 31.

Under TRICARE, what does NAS stand for? A)Nonavailability statement B)Nonactive status C)Nonauthorized service D)No available surgeons

If a TRICARE beneficiary receives services from a nonauthorized provider, the physician can bill: A)only the usual, customary, and reasonable amount. B)only the authorized contracted amount. C)only the limiting charge. D)any amount for the services.

The TRICARE Standard annual catastrophic cap (maximum amount beneficiaries are required to pay within 1 year) for active-duty families is: A)$1,000 per beneficiary. B)$1,000 per family. C)$7,500 per beneficiary. D)$7,500 per family.

Services covered under TRICARE Standard include all of the following EXCEPT: A)podiatry services. B)durable medical equipment (DME). C)mental health care. D)routine physical examinations.