Federal agency of the Department of Veterans Affairs that administers federal health benefit programs for veterans and their family members. These benefit programs include the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) including the CHAMPVA In House Treatment Initiative (CITI) and the CHAMPVA Meds by Mail program. HAC also administers the Spina Bifida Health Care Program, the Children of Women Vietnam Veterans Health Care Program, and the Persian Gulf Examination Program for Dependents. HAC also runs two programs specifically designed to cater to veterans: (1) the Foreign Medical Program, which provides service to veterans living or traveling throughout the world, and (2) the Fee program, which provides services to veterans who need care outside a Veterans Affairs medical center. HAC’s responsibilities are benefits management, eligibility determination, customer service, outreach and education, claims processing, appeals and grievances and fraud, and waste and abuse prevention.

Government employee (primary care coordinator) responsible for helping all military health system beneficiaries in the TRICARE program obtain medical care.

1. Attention given to individuals or communities by representatives of the health services for the purpose of promoting, maintaining, monitoring, or restoring health. The phrase health care has the intent of a broader scope of meaning when compared with the phrase medical care . When one hears medical care, it infers treatment by or under the supervision of a physician. 2. Under the Health Insurance Portability and Accountability Act (HIPAA), care, services, or supplies related to the health of an individual. This includes preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care, and counseling, service, assessment, or procedure involving physical or mental conditions, or functional status. It also involves the sale or dispensing of a drug, device, equipment, or other item relating to a prescription.

Central location in which medical services are provided to group model health maintenance organization (HMO) members.

Under the Health Insurance Portability and Accountability Act (HIPAA), a third-party administrator (TPA) who receives insurance claims from the physician’s office in a nonstandard format or with nonstandard data and puts it into standard data elements or a standard transaction, or that receives a standard transaction and processes or assists processing the data into nonstandard format for a receiving entity. The TPA performs software edits and redistributes the claims electronically to various insurance carriers.

Unified body of health care providers, purchasers of care, industry, labor, and insurance companies to try to solve medical costs and problems.