Medical Management Guide, 2009, Version 3.0 - Tricare

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Page 182Appendix C - DefinitionsVersion 3.0Medical Management GuideSupplemental Security Income (SSI)SSI is a federal income supplement program funded by general tax revenues (not Social Security taxes). It isdesigned to help aged, blind, and disabled people who have little or no income. It provides cash to meet basicneeds for food, clothing, and shelter.Resources:Social Security Administration (SSA): http://www.socialsecurity.gov/ssi/.Temporary Disability Retirement List (TDRL)See also Permanent Disability Retirement List (PDRL)If, as the result of a Physical Evaluation Board finding, a Service member is found unfit to perform his/her dutiesby reason of a disability which may not be of a permanent nature, that Service member may be placed on theTemporary Disability Retired List under the authority of Title 10 of the U.S. Code, Section 1202 or 1205.Resources:Defense Finance and Accounting Service (DFAS): http://www.dfas.mil/retiredpay/disabilityretirements.html.Temporary Limited Duty (TLD)See Limited Duty (LIMDU)Tertiary Prevention(see also Primary Prevention, Secondary Prevention)A stage of Medical Management that occurs when the goal is to prevent further suffering at end the stage ofthe disease.Resources:2001 DoD Population Health Improvement Plan and Guide: http://www.tricare.mil/ocmo/download/mhs_phi_guide.pdf.See Executive Summary, CD-ROM Resource ES-1.Wilson, W., Carneal, G., Newman, M.B. Documenting Case Management Outcomes, Case in Point, 15. CaseManagement Society of America, February/March 2008: http://www.schoonerhealth.com/files/32736223.pdf.Transitional Assistance Management Program (TAMP)TAMP offers transitional TRICARE coverage to certain separating ADSMs and their eligible family members.Care is available for a limited time. Under the National Defense Authorization Act for Fiscal Year 2005, effectiveOct. 28, 2004, TRICARE eligibility under the TAMP has been permanently extended from 60 or 120 days to 180days.The four categories for TAMP are:• Members involuntarily separated from active duty and their eligible family members.• National Guard and Reserve members, collectively known as the Reserve Component (RC), separated from
Medical Management Guide Version 3.0 Appendix C - DefinitionsPage 183Active Duty after being called up or ordered in support of a contingency operation for an Active Dutyperiod of more than 30 days, and their family members.• Members separated from Active Duty after being involuntarily retained in support of a contingencyoperation, and their family members.• Members separated from Active Duty following a voluntary agreement to stay on Active Duty for less thanone year in support of a contingency mission, and their family members.Resources:TRICARE: http://www.tricare.mil/factsheets/viewfactsheet.cfm?id=317.Traumatic Injury Protection under Service members' Group Life Insurance (TSGLI)A traumatic injury protection rider under Service members’ Group Life Insurance (SGLI) that provides forpayment to any member of the Uniformed Services covered by SGLI who sustains a traumatic injury resulting incertain severe losses. Effective Dec. 1, 2005, every member who has SGLI also has TSGLI. This coverage appliesto ADSMs, Reservists, National Guard members, funeral honors duty, and one-day muster duty. This benefit isalso provided retroactively for members who incur severe losses as a result of traumatic injury between Oct. 7,2001 and Dec. 1, 2005 if the loss was the direct result of injuries incurred in Operation Enduring Freedom (OEF)or Operation Iraqi Freedom (OIF).Resources:Department of Veterans Affairs (VA): http://www.insurance.va.gov/SGLISITE/legislation/TSGLIFacts.htm.Utilization Management (UM)A methodology that addresses the issue of managing use of resources in the delivery of health care, while alsomeasuring the quality associated with the delivery of that care.Resources:McKesson Certified Professional in Healthcare Management (CPHM) Study Guide 2, 148. September 2009.Utilization Review (UR)The process of determining whether all aspects of a patient’s care, at every level, are medically necessary andappropriate.Resources:McKesson Certified Professional in Healthcare Management (CPHM) Study Guide 2, 148. September 2009.
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Medical Management Guide, 2009, Version 3.0 - Tricare

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