Defense Health Agency

Question 1

What individuals may be designated as the Certifying Official for the non-federal Medical Health Care Claim Form

Answer 1

• Medical Department Representative
• Health Benefits Advisor
• Senior Officer

Question 2

Eligibility requirements for individuals who can obtain medical and dental care, at government expense, at non-MTF?

Answer 2

Active duty and retired members
Spouses
Children: 
Up to age 21
Up to age 23 if enrolled in college
Indefinitely if because of mental or physical incapacity

Question 3

Eligibility requirements for DECEASED active duty or retired members

Answer 3

Unremarried spouses
Children
Up to age 21
Up to age 23 if in college
Indefinitely if because of mental or physical capacity

Question 4

Eligibility requirements for DIVORCEES

Answer 4

Must not have other health coverage
Unremarried
Former spouse was on active duty for at least 20 years during the marriage

Question 5

STATE the adjudicating authority for payment processing for treatment from non-federal sources for active duty Navy and Marine Corps personnel

Answer 5

CONUS:
Managed Care Support Center (MCSC)

OCONUS:
Tricare Prime: (WPS)

Question 6

Procedures required for reimbursement of health care related expenses while on official business

Answer 6

Submit DD Form 2642 (Original and 2 copies of claim form)

• Include bill
• Across the front of the bill “Medical services rendered were satisfactory”

Question 7

DD Form 2642

Answer 7

Tricare Medical Claim, DoD/CHAMPUS Patient’s Request for Medical Payment

Question 8

MMSO provides:

Answer 8

• pre-authorization for civilian medical care
• authorization for payment of medical claims
• coordinates civilian health care for SM in remote locations
• collaborates line of duty care

Question 9

DISCUSS the responsibilities of the Defense Health Agency

Answer 9

• Provides oversight of regional operations and health plan administration at the regional level
• Manages the contracts with regional contractors
• Supports military treatment facility (MTF) Commanders
• Develops business plans for non-MTF areas (e.g. remote areas)
• Funds regional initiatives to optimize and improve delivery of health care

Question 10

MMSO

Answer 10

Military Medical Support Office

Question 11

Active Duty Dental Program (ADDP)

Answer 11

The TRICARE Remote Dental Program administered by United Concordia

Question 12

MMSO serves the following population:

Answer 12

• Active Duty Service Members enrolled in TRICARE Prime Remote (TPR)
• Non-enrolled ADSMs not managed by a Military Treatment Facility (MTF)
• Reserve Component service members in remote areas with Service approved Line of Duty (LOD) injuries, illnesses or diseases

Question 13

Who are the Designated Certifying Officials?

Answer 13

• Medical Department Representative
• Health Benefits Advisor
• Senior Officer

Question 14

Adjudicating authority for CONUS payment?

Answer 14

CONUS:

Managed Care Support Center for region in which member is enrolled

Question 15

Responsibilities of the Defense Health Agency (DHA)

Answer 15

• Manages the TRICARE program

- Undersecretary of Defense for Personnel and Readiness

Question 16

What are the 3 separate regions:

Answer 16

U.S. East, U.S. West, and Overseas

Question 17

Overseas Region is dispersed among:

Answer 17

Eurasia-Africa Area
Latin America and Canada Area
Pacific Area

Question 18

Each region/area provides what?

Answer 18

• oversight of regional operations and health plan administration
• Manages regional contractors
• Supports MTF Commanders
• Develops business plans for remote areas
• optimize and improve delivery of health care

Question 19

Who has responsibility for management of remote active duty Navy and Marine Corps personnel?

Answer 19

Military Medical Support Office (MMSO)

Question 20

TRICARE reimbursement form while on official business

Answer 20

DD Form 2642

Question 21

Active Duty Dental Program (ADDP) administered by

Answer 21

United Concordia

Question 22

What needs to be written on the bill for reimbursement?

Answer 22

“Medical services rendered were satisfactory”

Question 23

How many copies do you need of the DD 2642?

Answer 23

Original and 2 copies

Question 24

Who is responsible for TRICARE Prime Remote?

Answer 24

Military Medical Support Office (MMSO)

Question 25

TRICARE Prime

Answer 25

Wisconsin Physician Service

Question 26

TRICARE Standard

Answer 26

Managed Care Support Center

Question 27

Who is the adjudicating authority for OCONUS payment?

Answer 27

OCONUS:
Tricare Prime: (WPS) Wisconsin Physician Service
Tricare Standard: (MCSC) Managed Care Support Center

Question 28

What instructions govern DHA?

Answer 28

• NAVMEDCOMINST 6320.3
• BUMEDINST 6320.103
• DoD Directive 5136.13

Question 29

Responsibilities of the DHA?

Answer 29

• Provides oversight of regional operations and health plan administration
• Manages regional contractors
• Supports MTF Commanders
• Develops business plans for remote areas
• Funds regional initiatives to improve delivery of health care

Question 30

Who has responsibility for management of remote Medical/Dental Treatment Program of active duty Navy and Marine Corps personnel?

Answer 30

Military Medical Support Office (MMSO)

Question 31

Military Medical Support Office (MMSO) provides:

Answer 31

• Pre-authorization for civilian medical care.
• Authorizations for payment of civilian medical claims.
• Coordinates civilian health care services for remotely located service members
• Collaborates with unit representatives regarding line-of duty (LOD) care for remotely located service members

Question 32

Active Duty Dental Program (ADDP):

Answer 32

The TRICARE Remote Dental Program administered by United Concordia

Question 33

LIST the individuals that may be designated as the Certifying Official for the non-federal Medical Health Care Claim Form:

Answer 33

Medical Department Representative
Health Benefits Advisor
Senior Officer