Unit 4.8 Hefense Health Agency

Question 1

DISCUSS the responsibilities of the Defense Health Agency (DHA)

Answer 1

• The Defense Health Agency (DHA) is a field activity of the Undersecretary of Defense for Personnel and Readiness
• Manages the TRICARE program
• It was formally established on October 1, 2013.
• —- Previously known as TRICARE Management Activity (DHA)

Question 2

Military Medical Support Office (MMSO)

Answer 2

directly supports the provision of medical care to remotely located Active Duty and Reserve Component

Question 3

MMSO provides

Answer 3

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 4

MMSO serves the following population

Answer 4

Active Duty Service Members enrolled in TRICARE Prime Remote (TPR)

Question 5

Active Duty Dental Program (ADDP)

Answer 5

The TRICARE Remote Dental Program previously administered by MMSO has been transitioned to the new ADDP administered by United Concordia

Question 6

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

Answer 6

Designated Certifying Official

• Medical Department Representative
• Health Benefits Advisor
• Senior Officer

Question 7

LIST the process for individuals to obtain medical and dental care, at government expense, at non-federal Medical Treatment Facilities

Answer 7

• 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 8

Deceased active duty or retired members

Answer 8

Children

• • Up to age 21
• • Up to age 23 if in college
• • Indefinitely if because of mental or physical capacity

Question 9

Divorcees

Answer 9

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

Question 10

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

Answer 10

CONUS:
- Managed Care Support Center for region in which member is enrolled
OCONUS:
- Tricare Prime: (WPS) Wisconsin Physician Service
- Tricare Standard: Managed Care Support Center in region where care is obtained

Question 11

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

Answer 11

DD Form 2642

Question 12

Describe DD Form 2642

Answer 12

• If payment was made directly to the health care provider by the patient or representative, the patient must submit a DD 2642, Nov 2018
• Include the itemized bill and proof of payment