Volume 1 Unit 3 Part 2

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What is the primary role of the beneficiary counseling and assistance coordinator?

They are a beneficiary advocate and problem solver, providing dedicated service to all MFT beneficiaries.

They are a beneficiary advocate and problem solver, providing dedicated service to all Military Health System (MHS) beneficiaries. (correct)

They are a beneficiary advocate but not a problem solver.

They are a beneficiary advocate and problem solver, providing dedicated service to some MHS beneficiaries.

Who should the BCAC work with to provide enrollment, benefit, and claims processing?

Functional experts. (correct)

Functional beneficiaries

MHS beneficiaries

MAJCOM

What is the primary purpose of the DCAO?

To calculate debt

To determine the validity of collection agent claims and negative credit reports received for debts incurred because of medical and dental care under the Obama CARE program.

To determine the validity of collection agent claims and negative credit reports received for debts incurred because of medical and dental care under the TRICARE program. (correct)

To determine the validity of payments.

For a case to qualify as a debt collection case, what must be presented to the DCAO?

Letter from a Collection Agency indicating that the beneficiary has been sent to collection for non-payment partial payment or denial of claim for services of a TRICARE-associated claim, and/or a negative credit report secondary to the above. Signup and view all the answers

The _______ requires that all active duty personnel attend in-and out-processing programs and that these programs include information on TRICARE benefits.

Signup and view all the answers

A ____________ brief ensures that all members departing PCS obtain the most up-to-date information regarding the TRICARE benefit.

Signup and view all the answers

What are some things that should be passed on to the gaining MTF?

Recent identification and/or clinical management efforts to control chronic disease condition, poorly controlled chronic disease conditions requiring regular, uninterrupted follow-up, current pregnancy or medical diagnoses requiring obstetrics follow-up, newborns with follow-up requirements, pending radiographic, laboratory, and pathologic specimens, and pending/incomplete referrals or referrals where a result has not been obtained Signup and view all the answers

What is the National Defense Authorization Act?

The Senate and House “instructions" to the DOD to change, add, or eliminate programs. Signup and view all the answers

In the NDAA, what Title addresses health concerns?

Title VII, Healthcare Provision Signup and view all the answers

What are some factors that may affect implementation dates?

Funding, public reviews/comments, contract awards, and additional policy. Signup and view all the answers

From the text, what is an example of data driven decisions?

Checking the weather in the morning to see if you need a jacket or umbrella, or going to see movies by considering the reviews and finding out what time a specific movie is playing. Signup and view all the answers

What does the MHS use to assist with day-to-day activities?

Real time, or near real time, operational systems. Signup and view all the answers

What is health informatics?

It is the study of resources and methods for managing health information. Signup and view all the answers

What three basic elements describe the TRICARE Operations Center (TOC)?

Get data, process data, and display data Signup and view all the answers

What report answers “how many appointments were left unbooked?”

The Access to Care Appointment Utilization Report. Signup and view all the answers

What are the categories the data metrics website is divided in to?

Ambulatory metrics, inpatient metric, clinical coding reports, DQ reports, World Wide Report metrics, and Online help Documents Ambulatory Data Management Signup and view all the answers

What reports are available within the Ambulatory Data Management (ADM) module in Composite Health Care System (CHCS)?

Appointments with no ADM records by clinic, ADM patients with third party insurance, ADM compliance, ADM records with unresolved coding issues and interface transmission status of ADM record Signup and view all the answers

______________ is a system that produces various non-standard reports that are not necessarily run on a consistent basis.

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MTF commanders establish resource-sharing agreements with ____________.

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What can the Manage Care Support (MCS) contractor provide through resource sharing?

Personnel, equipment, equipment maintenance, and supplies Signup and view all the answers

What allows the MCS contractor, through agreements with MTF commanders, to provide personnel, equipment, equipment maintenance, and supplies necessary to enhance the capability of the MTF to provide healthcare to TRICARE beneficiaries?

Resource sharing. Signup and view all the answers

_____________ is an alternative to resource sharing which provides additional flexibility to MTF commanders.

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_______________ make a good faith effort to work with the contractor to execute sound resource sharing agreements.

Signup and view all the answers

Why does the TRICARE regional offices (TRO) perform periodic reviews of MTF and VA facility resource sharing agreements?

To ensure compatibility with agreements including VA facilities as network providers Signup and view all the answers

What acts and amendments must medical personnel comply with?

The Privacy Act, FOIA, HIPAA, Drug Abuse Offense and Treatment act, and Comprehensive Alcohol Abuse amendments. Signup and view all the answers

What is PII the acronym for?

PII is Personally Identifiable Information Signup and view all the answers

Medical records are maintained within a system of records protected by which act?

The Privacy Act Signup and view all the answers

___________ eliminates the need for a separate privacy act statement for each medical or dental document?

Signup and view all the answers

Relative to the release of medical information, what is the purpose of the DD Form 2005?

It serves as evidence that, as prescribed by the privacy act, the individual was informed of the purpose and uses of the information collected and was advised of his/her rights and obligations when providing their data. Signup and view all the answers

What must a Freedom of Information Act (FOIA) request contain?

It must be in writing and must reasonably describe the record(s) the individual is looking for and it must indicate a willingness to pay fees associated with processing. Signup and view all the answers

The _______________ laws take precedence over other directives pertaining to access and release of medical information.

Signup and view all the answers

Whenever you release information under the guidelines of the drug and alcohol abuse acts, what statement must accompany the disclosure?

“Prohibition on Redisclosure: This information has been disclosed to you from records whose Confidentiality is protected by federal law. Federal regulations prohibit you from making any further Disclosure of this information without the specific written consent of the person to whom it pertains. A General authorization for the release of the medical or other information is not sufficient for this purpose.” Signup and view all the answers

To improve the portability and continuity of health insurance coverage, improve access to long-term care services and coverage, and simplify the administration of healthcare is the purpose of _______

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List the six requirements of the HIPPA Privacy Rule.

(1) Use of information, (2) acknowledgement of notice of privacy practices, (3) disclosure or release, (4) patient rights to access,(5) accounting of disclosure, and (6) restrictions on information. Signup and view all the answers

Volume 1 Unit 3 Part 2

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Questions and Answers

What is the primary role of the beneficiary counseling and assistance coordinator?

Who should the BCAC work with to provide enrollment, benefit, and claims processing?

What is the primary purpose of the DCAO?

For a case to qualify as a debt collection case, what must be presented to the DCAO?

The _______ requires that all active duty personnel attend in-and out-processing programs and that these programs include information on TRICARE benefits.

A ____________ brief ensures that all members departing PCS obtain the most up-to-date information regarding the TRICARE benefit.

What are some things that should be passed on to the gaining MTF?

What is the National Defense Authorization Act?

In the NDAA, what Title addresses health concerns?

What are some factors that may affect implementation dates?

From the text, what is an example of data driven decisions?

What does the MHS use to assist with day-to-day activities?

What is health informatics?

What three basic elements describe the TRICARE Operations Center (TOC)?

What report answers “how many appointments were left unbooked?”

What are the categories the data metrics website is divided in to?

What reports are available within the Ambulatory Data Management (ADM) module in Composite Health Care System (CHCS)?

______________ is a system that produces various non-standard reports that are not necessarily run on a consistent basis.

MTF commanders establish resource-sharing agreements with ____________.

What can the Manage Care Support (MCS) contractor provide through resource sharing?

What allows the MCS contractor, through agreements with MTF commanders, to provide personnel, equipment, equipment maintenance, and supplies necessary to enhance the capability of the MTF to provide healthcare to TRICARE beneficiaries?

_____________ is an alternative to resource sharing which provides additional flexibility to MTF commanders.

_______________ make a good faith effort to work with the contractor to execute sound resource sharing agreements.

Why does the TRICARE regional offices (TRO) perform periodic reviews of MTF and VA facility resource sharing agreements?

What acts and amendments must medical personnel comply with?

What is PII the acronym for?

Medical records are maintained within a system of records protected by which act?

___________ eliminates the need for a separate privacy act statement for each medical or dental document?

Relative to the release of medical information, what is the purpose of the DD Form 2005?

What must a Freedom of Information Act (FOIA) request contain?

The _______________ laws take precedence over other directives pertaining to access and release of medical information.

Whenever you release information under the guidelines of the drug and alcohol abuse acts, what statement must accompany the disclosure?

To improve the portability and continuity of health insurance coverage, improve access to long-term care services and coverage, and simplify the administration of healthcare is the purpose of _______

List the six requirements of the HIPPA Privacy Rule.

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