- The following are a few important and commonly
used terms associated with military health care
The maximum that
will be paid to a participating provider. The allowable is based upon a CHAMPUS approved
institution, physician or another professional who meets the licensing and certification
requirements of the CHAMPUS regulation and is practicing within the scope of that license.
The practice of
billing the beneficiary for the difference between the CHAMPUS allowable amount and the
full charges of the provider.
An individual who
is entitled to receive care at a medical facility (hospital,clinic)or through a health
Service Representatives are employees of *