Question

1. How are network and non-network providers paid ?

2. List six services typically covered under Tricare standard

3. List three services generally not covered by Tricare standard

Answer 1

1.) How are network and non-network providers paid ?

Anetwork provider is a civilian provider who has completed the credentialing process and signed a contracted agreement to be part of the network of providers who participate in the TRICARE program.A network provider accepts the negotiated rate as payment in full for services rendered.Non-network providers,they help pay for care you get from providers who don't take your plan.But you usually pay more of the cost.For example,your plan may pay 80 percent and you pay 20 percent if you go to an in -network doctor.Out of network,your plan may 60 percent and you pay 40 percent.

2) List six services typically covered under Tricare standard

Answer-Tricare covers medically and psychologically necessary mental health,Substance use disorder care,this includes both inpatient and out patient care,Applied Behavior Analysis,Autism Spectrum Disorder,Congnitive Rehabilitation Therapy.

3). List six services typically covered under Tricare standard

Answer-There are certain services that are not covered by TRICARE plan at all.This includes Acupuncture,Alternative treatments...for example ,the tricare health care program will not cover treatments such as augmentation mamoplasty,laser hair removal or LASIK surgery.