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Medical Billing & Coding Module 9 Flashcards

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3641122483Military Health Services System (MHSS)is the entire health care system of the U.S. uniformed services and includes MTFs as well as various programs in the civilian health care market, such as TRICARE.0
3641125225Transitional Assistance Management Program (TAMP)provides 180 days of premium-free transitional health care benefits after regular TRICARE benefits end1
3641134125Continued Health Care Benefit Program (CHCBP)is a premium-based health care program administered by Humana Military.2
3641140208Beneficiary Services Representative (BSR)is employed at a TRICARE Service Cen- ter, provides information about using TRICARE, and assists with other matters affecting access to health care3
3641144857Health Care Finder (HCF)is a registered nurse or physician assistant who assists primary care providers with preauthorizations and referrals to health care services in a military treatment facility or civilian provider network.4
3641148248Military Treatment Facility (MTF)is a health care facility operated by the military that provides inpatient and/or ambulatory (outpatient and emergency department) care to eligible TRICARE beneficiaries.5
3641151838Critical Pathwayis the sequence of activities that can normally be expected to result in the most cost-effective clinical course of treatment.6
3641153892Practice Guidelinesdecision-making tools used by providers to determine appropriate health care for specific clinical circumstances.7
3641157320TRICARE Primeis a managed care option similar to a civilian health maintenance organization (HMO)8
3641158867Primary Care Manageris a doctor assigned to a sponsor and is part of the TRICARE provider network.9
3641181495TRICARE Extrais a preferred provider option in areas with established TRICARE networks, which does not require enrollment and is not available overseas10
3641184027Emergency Caredefined by TRICARE as the sudden and unexpected onset of a medical or mental health condition that is threatening to life, limb, or sight.11
3641187888Clinical Trialis a research study that helps find ways to prevent, diagnose, or treat illnesses and improve health care; when enrolled, beneficiaries receive care that is considered the latest medicine or therapy, but is not yet approved as a standard care.12
3641199558Material Safety Data Sheets (MSDS)contain information about chemical and hazardous substances used on site.13
3641201389Merchant Marine Act (Jones Act)is not a workers' compensation statute; how- ever, it provides seamen with the same protection from employer negligence as FELA provides railroad workers.14
3641207991Workers' Board (Workers' Compensation Commission)a state agency responsible for administering workers' compensation laws and handling appeals for denied claims or cases in which a worker feels compensation was too low.15
3641212518Temporary Claimsclaims cover health care treatment for illness and injuries, as well as payment for lost wages.16
3641214002Permanent Disabilityrefers to an ill or injured employee's diminished capacity to return to work.17
3641218530Vocational RehabilitationClaims that cover expenses for vocational retraining for both temporary and permanent disability cases.18
3641230033Survivor Benefitsare claims that provide death benefits to eligible dependents.19
3641232283First Report of Injuryforms are completed by the provider (e.g., physician) when the patient first seeks treatment for a work-related illness or injury20
3641254440Federal Black Lung Programprovides medical treatment and other benefits for respiratory conditions related to former employment in the nation's coal mines.21
3641257512Longshore and Harbor Workers' Compensation Programadministered by the U.S. Department of Labor, provides medical benefits, compensation for lost wages, and rehabilitation services to longshoremen, harbor workers, and other maritime workers who are injured during the course of employment or suffer from diseases caused or worsened by conditions of employment.22
3641261242Mine Safety and Health Administration (MSHA)helps to reduce deaths, injuries, and illnesses in U.S. mines through a variety of activities and programs.23
3641264503Merchant Marine Act (Jones Act)is not a workers' compensation statute; how- ever, it provides seamen with the same protection from employer negligence as FELA provides railroad workers.24
3641267311State Insurance Fund (State Compensation Fund)a quasi-public agency that provides workers' compensation insurance coverage to private and public employers and acts as an agent in state workers' compensation cases involving state employees.25
3641270734On-the-Job InjuryExample: a medical assistant who is injured while picking up reports for the office at the local hospital or a worker who is making a trip to the bank to deposit checks26
3641274078Permanent Partial Disabilityin which part of the employee's wage-earning capacity has been permanently lost.27
3641280039Arbitrationa dispute resolution process in which a final determination is made by an impartial person who may not have judicial powers28
3641305921Uniformed ServicesU.S. military branches that include the Army, Navy, Air Force, Marines, and Coast Guard29

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