beneficiary counseling and assistance coordinator (BCAC)
individuals available at a military treatment facility (MTF) to answer questions, help solve healthcare related problems, and assist beneficiaries in obtaining medical care through TRICARE; were previously called health benefits advisors (HBA).
beneficiary services representative (BSR)
employed at a TRICARE Service Center; provides information about using TRICARE and assists with other matters affecting
access to health care (e.g., appointment scheduling).
catastrophic cap benefit
protects TRICARE beneficiaries
from devastating financial loss due to serious illness or long-term treatment by establishing limits over which payment is not required.
the region defined by code boundaries
within a 40-mile radius of a military treatment facility
CHAMPUS Reform Initiative (CRI)
conducted in 1988; resulted in a new health program called TRICARE,
which includes three options: TRICARE Prime,TRICARE Extra, and TRICARE Standard.
common access card (CAC)
identification card issued
by the Department of Defense (DoD), which TRICARE enrollees show to receive healthcare services.
sequence of activities that can normally
be expected to result in the most cost-effective clinical course of treatment.
debt collection assistance officer (DCAO)
individuals located at military treatment facilities to assist beneficiaries in resolving healthcare collection-related
Defense Enrollment Eligibility Reporting System (DEERS)
computer system that contains up-to-date Defense Department Workforce personnel information.
tests and establishes the feasibility
of implementing a new program during a trial period, after which the program is evaluated, modified,and/or abandoned
DSM (Diagnostic and Statistical Manual)
classifies mental health disorders and is based on ICD; published by the American Psychiatric Association
care for the sudden and unexpected
onset of a medical or mental health condition that is threatening to life, limb, or sight
for the federal government, October 1 of
one year to September 30 of the next.
Health Affairs (HA)
refers to the Office of the Assistant
Secretary of Defense for Health Affairs, which is responsible for both military readiness and peacetime
health care finder (HCF)
registered nurse or physician
assistant who assists primary care providers with preauthorizations and referrals to healthcare services in a military treatment facility or civilian provider network.
lead agent (LA)
serves as a federal healthcare team
created to work with regional military treatment facility commanders, uniformed service headquarters' staffs, and Health Affairs (HA) to support the mission of the Military Health Services System (MHSS).
Military Health Services System (MHSS)
entire healthcare system of the U.S. uniformed services and includes military treatment facilities (MTFs) as well as various programs in the civilian healthcare market, such as TRICARE.
military treatment facility (MTF)
healthcare facility operated by the military that provides inpatient and/or ambulatory (outpatient and emergency department)
care to eligible TRICARE beneficiaries; capabilities of MTFs vary from limited acute care clinics to teaching and tertiary care medical centers.
nonavailability statement (NAS)
certificate issued by a military treatment facility that cannot provide needed
care to TRICARE Standard beneficiaries.