Vol 1 Exam Questions (3) [013-025] Flashcards

1
Q
  1. (013) What year did Congress establish the first hospital?
A

b. 1776.

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2
Q
  1. (013) “TRICARE” originally referred to the three main plan options, which were TRICARE Prime, TRICARE

a. Standard, and TRICARE Extra.
b. Standard, and TRICARE Remote.
c. Remote, and TRICARE Extra.
d. Standard, and TRICARE Reserve.

A

a. Standard, and TRICARE Extra.

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3
Q
  1. (014) The following medical conditions may qualify patients for Medicare before 65 years old, except:

a. end stage renal disease.
b. Amyotrophic lateral sclerosis.
c. Lou Gehrig’s Disease.
d. blood transfusions before 1995.

A

d. blood transfusions before 1995.

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4
Q
  1. (014) What should you first consider when helping a patient narrow down the right TRICARE plan for them?

a. Home of record.
b. Location.
c. Medicare eligible.
d. Status.

A

b. Location.

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5
Q
  1. (015) What two convenient tools can you find on TRICARE.mil?

a. Primary care manager (PCM) finder and plan builder.
b. PCM finder and compare plans.
c. Plan finder and compare plans.
d. Plan finder and plan builder.

A

c. Plan finder and compare plans.

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5
Q
  1. (015) What is the official website for TRICARE?

a. Knowledge Exchange.
b. TRICARE.mil.
c. TRICARE Online.
d. TRICARE.org.

A

b. TRICARE.mil.

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6
Q
  1. (015) Within the MTF, who is the functional champion of TRICARE Online (TOL)?

a. TOL Appointing Subject Matter Expert.
b. TOL Systems Administrator.
c. TOL Project Officer.
d. Provider, Clinics and Marketing point of contacts.

A

c. TOL Project Officer

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7
Q
  1. (016) What is the key to the success of TRICARE?

a. Accurate market analysis.
b. Comprehensive plan.
c. Traditional and social media.
d. Innovative marketing program.

A

d. Innovative marketing program.

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8
Q
  1. (016) Where can you go to get standardized and current marketing materials for TRICARE?

a. Beneficiary Education and Support Division.
b. The marketing office.
c. TRICARE Online.
d. TRICARE Regional Offices.

A

c. TRICARE Online.

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8
Q
  1. (017) What is the primary role of the Beneficiary Counseling Assistance Coordinator (BCAC)? a. Coordinate appropriate issues with Military Health System (MHS) and Defense Health Agency

a. Coordinate appropriate issues with Military Health System (MHS) and Defense Health Agency (DHA).
b. Describe or seek clarification on eligibility.
c. Respond to beneficiary, leadership and congressional inquiries.
d. Serve as a beneficiary advocate and problem solver.

A

d. Serve as a beneficiary advocate and problem solver.

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9
Q
  1. (017) The Beneficiary Counseling Assistance Coordinator (BCAC) does not

a. coordinate appropriate issues with Military Health System (MHS) and Defense Health Agency (DHA).
b. describe or seek clarification on eligibility.
c. respond to beneficiary, leadership and congressional inquiries.
d. file claims for beneficiaries.

A

d. file claims for beneficiaries.

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10
Q
  1. (018) Which of the following is not a responsibility for the Debt Collection Assistance Officer (DCAO)?

a. Work with functional experts to provide enrollment, benefit, and claims processing assistance.
b. Notify, by telephone or in writing, provider(s) and collection or credit reporting agency that the beneficiary’s case is being reviewed by the managed care support contractor (MCSC).
c. Assign a case number and forward beneficiary documentation to the MCSC’s Priority Collections Unit in the region service was rendered.
d. Collect copies of all pertinent documentation available from the beneficiary concerning the case; such as provider bills and notices, TRICARE EOBs, letters from providers or credit agencies.

A

a. Work with functional experts to provide enrollment, benefit, and claims processing assistance.

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10
Q
  1. (020) In the National Defense Authorization Act, how often will the subtitles and sections change?

a. Every year.
b. Every two years.
c. Every five years.
d. They don’t change.

A

a. Every year.

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11
Q
  1. (019) Which of the following steps is not part of in-processing a beneficiary?

a. Collect Records.
b. Obtain documented personal health status information.
c. Recommended preventive services.
d. Print laboratory/radiology results and place in records.

A

d. Print laboratory/radiology results and place in records.

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11
Q
  1. (019) What department level requires all active duty personnel have to attend in- and out- processing programs

a. MAJCOMs.
b. DHA.
c. DOD.
d. USAF.

A

c. DOD.

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12
Q
  1. (020) How often is the National Defense Authorization Act (NDAA) presented to Congress?

a. Three times a year.
b. Twice a year.
c. Once a year.
d. Once every other year.

A

c. Once a year.

13
Q
  1. (021) Which is not an example of a data driven decision?

a. Check the weather before going on a trip.
b. Pull and analyze figures before changing templates.
c. Go with your ‘gut’ when making a decision.
d. Consider movie reviews before going to see one.

A

c. Go with your ‘gut’ when making a decision.

14
Q
  1. (021) The best reason to use data to aid in the decision making process is because it

a. takes the ‘emotion’ out and focuses on the facts.
b. is mandatory across all of the services.
c. guarantees successful outcomes.
d. guarantees standard outcomes.

A

a. takes the ‘emotion’ out and focuses on the facts.

15
Q
  1. (022) Of the reports listed below, what is not a TRICARE Operations Center Report?

a. Access to Care Summary Report.
b. Access to Care Management Report.
c. Daily Outpatient Workload Detailed Report.
d. Detail Code Usage and Summary Report.

A

c. Daily Outpatient Workload Detailed Report.

16
Q
  1. (022) What is a program that aggregates data and measures daily transmission and completeness from source data collection systems?

a. ADM.
b. BDQAS.
c. CHCS ad hoc.
d. TOL.

17
Q
  1. (022) The most simplified description for the TOC entails three basic elements. What is not one of

a. Get Data.
b. Display Data.
c. Print Data.
d. Process Data.

A

c. Print Data.

18
Q
  1. (022) What system produces various standard reports and you can request specific reports be run on demand, nightly, weekly, or on a monthly basis?

a. ADM.
b. BDQAS.
c. CHCS ad hoc.
d. TOL.

A

c. CHCS ad hoc.

19
Q
  1. (023) Resource sharing is based on the assumption that costs associated with the provision of these resources will be more than offset by decreased

a. prime expenses.
b. TRICARE costs.
c. government costs.
d. contractor expenses.

A

b. TRICARE costs.

20
Q
  1. (023) When utilizing resource support, who may request a task order for personnel equipment, equipment maintenance, and supplies?

a. TROs.
b. MTF commander.
c. NCOIC, TRICARE.
d. Health Benefits Advisor.

A

b. MTF commander.

21
Q
  1. (023) Whose policy requires you to consider if resource-sharing agreements are in the best interest of the government and are in support of the regional health care plan?

a. TRICARE.
b. Governmental.
c. MDG/CC.
d. MCS contractor.

A

a. TRICARE.

22
Q
  1. (024) Medical personnel must comply with the Privacy Act, Freedom of Information Act, Health Insurance Portability and Accountability Act, Drug Abuse Offense and Treatment Act, and

a. Insurance Claims Amendments.
b. Disability of Americans Amendments.
c. Comprehensive Alcohol Abuse Amendments.
d. Medical Release of Information Amendments.

A

c. Comprehensive Alcohol Abuse Amendments.

23
Q
  1. (023) Who performs periodic reviews of MTF/VA facility resource sharing agreements to ensure compatibility with agreements including VA facilities as network providers?

a. TRO.
b. Surgeon General.
c. MTF commander.
d. MCS contractor.

24
Q
  1. (024) What are some examples of non-sensitive PII?

a. Name and driver’s license number.
b. Citizenship and gender.
c. Military records and religious preference.
d. Office location and business telephone number.

A

d. Office location and business telephone number.

25
Q
  1. (025) Which of the following is a valid consent authorizing the release of a dependent husband’s medical record information to an insurance company?

a. No consent necessary for member’s own insurance company.
b. Verbal consent from the husband.
c. Written consent from husband.
d. Verbal consent from wife.

A

c. Written consent from husband.

26
Q
  1. (024) What is HIPAA’s training requirement?

a. Initial only.
b. Initial and twice a year refresher.
c. Initial and an annual refresher.
d. Initial and an every other year refresher.

A

c. Initial and an annual refresher.

27
Q
  1. (025) When possible, what is the best way to transfer PHI for routine disclosure of information to insurance companies, attorneys or other legitimate users?

a. Fax machine.
b. Work e-mail.
c. Personal e-mail.
d. Snail mail.

A

d. Snail mail.

27
Q
  1. (025) What action do you take when an incorrect payment is received from an insurance company for copies of medical records?

a. Hold the check, notify the insurance company of the additional charges, and return the check upon receipt of a check for the correct amount.
b. Send the check to the base finance office for deposit and notify the medical service account (MSA. officer that a balance is due and has not been requested.
c. Send the information requested along with a letter to the company specifying the amount owed to the Government.
d. Destroy the check and request that the company issue another check for the correct amount.

A

c. Send the information requested along with a letter to the company specifying the amount owed to the Government.

28
Q
  1. (025) Once a breach investigation is complete, who will assess the results of the risk assessment and recommendations in determining whether affected individuals should be notified of the breach?

a. Leadership.
b. Breach Response Coordinator.
c. Release of information Officer.
d. Installation Privacy Act Official.

A

a. Leadership.

29
Q
  1. (025) Information that may affect a patient’s morale, character, medical progress, or mental health is considered

a. Non-releasable.
b. Classified.
c. Sensitive.
d. Secret.

A

c. Sensitive.