Defense Health Agency Flashcards
what instructions governs the DHA program
DoDD 5136.13
DHA is a field activity of whom
undersecretary of defense for personnel and readiness
what does DHA manage
TRICARE
who assist DHA in offering services and support to TRICARE beneficiaries
Health Net Federal Services, LLC
TRICARE was formally est. on what date
October 1 2013
TRICARE is broken down into what 3 regions
West region
East region
Overseas region
Overseas region is broken down into what sub regions
Eurasia-Africa
Latin America and Canada (TLAC) area
Pacific Area
what are the responsibilities of each region
Provide oversight at the regional level
Manage Contracts
Support MTF Commanders
Develop business plans for non-MTF areas
Fund optimization initiatives and improve delivery of health care
MMSO directly supports the provision of medical care through
TRICARE Prime Remote and the supplemental health Care program
MMSO provides
pre authorization for civilian medical care
authorizes for payment of civilian medical claims
Coordinates civilian healthcare services for remote SM
MMSO serves what population
AD service members enrolled in TRICARE PRIME REMOTE
Non enrolled ADSM not managed by MTFs
RC Service members in remote areas with service approved line of duty injuries illnesses or diseases
TRICARE remote dental program previously administered by MMSO has transitioned to what
Active Duty Dental Program
who administers the Active Duty Dental Program
United Concordia Companies, Inc
Who is designated as the certifying official for non federal medical health care claim
SMDR
Health Benefits Advisor
Senior Officer
who can obtain medical and dental care at the governments expense at non-federal MTFs
AD and retired members
Spouses
Children
unmarried spouses and children of diseased AD or retired members
Divorcees
what is the criteria for Children to obtain medical and dental care at the governments expense at non-federal MTFs
up to age 21
up to 23 if in college
Indefinitely if they have a mental or physical incapacity
For spouses of deceased active duty or retired members what is the criteria to obtain medical and dental care at the governments expense at non-federal MTFs
unremarried
For divorcees of deceased active duty or retired members what is the criteria to obtain medical and dental care at the governments expense at non-federal MTFs
Must not have have other health coverage
Unremarried
Former spouse was on active duty for at least 20 years during marriage
who is the adjudicating authority for payment processing for treatment CONUS
Managed care support center for the region in which member is enrolled
if a payment was made directly to the health care provider and wants to be reimbursed what steps must be taken
submit the original DD 2642 and 2 copies
Include itemized bill and proof of payment
what should be written Across the front of the bill submitted for reimbursement
“Medical services rendered were satisfactory”
what is the Medical and Dental Care for Eligible Persons at Navy Medical Department Facilities instruction
NAVMEDCOMINST 6320.3
