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patient to payment chapter 11#

KEY WORDS TERMS VOCABULARY
STUDY
PLAY
CATASTROPHIC CAP
The maximum annual amount a TRI-CARE beneficiary must pay for deductible and coat share.
CHAMPVA
The Civilian Health and Medical Program of the Veterans Administration (now known as the Department of Veterans Affairs) which shares health care cost for families of veterans with 100 percent service-connected disability the surviving spouse and children of veterans who die from service-connected disabilities.
CHAMPVA for Life
Programs for beneficiaries who are both Medicare and CHAMPVA eligible, extends benefits to spouses of dependents who are age sixty-five and over.
cost share
The term meaning coinsurance for a TRI-CARE or CHAMPVA beneficiary.
Defense Enrollment Eligibility Reporting System (DEERS)
The Worldwide database of TRI-CARE and CHAMPVA beneficiaries.
military treatment facility (MTF)
Government providing facility medical services for members and dependents of the uninformed Services.
nonavailability statement
A formed required for preauthorization when a TRI-CARE member seeks medical services on other than military treatment facility.
Primary Care Manager (PCM)
Provider who coordinates and manages the care of the TRI-CARE beneficiary.
sponsor
The uninformed service member in a family qualifier for TRI-CARE or CHAMPVA.
TRI-CARE
A government health program that services dependents of active-duty serves members military retirees and their families some former spouses and survivors of deceased military member formerly called CAMPUS.
TRI-CARE Extra
TRI-CARE'S managed care health plan that offers a network of civilians providers.
TRI-CARE for Life
Program for beneficiaries who are both Medicare and TRI-CARE eligible.
TRI-CARE Prime
The basic managed care health plan offered by TRI-CARE.
TRI-CARE Prime Remote
A TRI-CARE plan that provides no-cost health care through civilian providers for eligible service members and their families who are on remote assignment.
TRI-CARE Reserved Select (TRS)
TRI-CARE health plan offered to certain members of the National Guard and Reserved activated on or after September 11,2001.
TRI-CARE Standard
The fee-for -service health plan offered by TRI-CARE.