Under the Consolidated Omnibus Reconciliation Act of 1986, all military medical treatment facilities are mandated to bill health insurance carriers for the cost of medical care provided to active duty family members, retirees and family members who are covered by other health insurance. The 75th Medical Group (75 MDG) Clinic must comply with this law and needs your help for continued program success.
In most cases, the 75th MDG is no different than civilian health care providers who need insurance information at each clinic visit. To collect benefits covered by your other health insurance, it must have the information that appears on your other health insurance identification card.
The new electronic system streamlined the process of collecting other health insurance (OHI) information for clinic staff and beneficiaries. You will be asked if you have other health insurance at every point of service when you use services at the 75th MDG. If you are covered by other health insurance or have a Medicare supplement, staff will ask for your insurance card to scan into the electronic database.
You no longer have to manually fill out the DD Form 2569, record of other health insurance form, and this eliminates the use of the yellow card. Each point of service has a scanner and signature pad to expedite the process of collection.
The obligation to pay medical care costs applies only to the insurance carrier. Your insurance company will pay benefits directly to the 75th MDG and you will not be billed or responsible for any uncollected charges. Additionally, your insurance premiums cannot increase or be canceled just because a claim is filed.
The benefits for the patient include no copay, deductible or any patient responsibility charges indicated in the Explanation of Benefits received from the insurance company. This means you may pay less out of pocket expense when later seeking health care through a civilian provider.
Monies collected under this program are deposited directly into the 75th MDG Operations and Maintenance account. In fiscal year 2011, $2 million was collected. This accounted for 7 percent of the 75th MDG operations and maintenance budget. The ultimate goal is to provide enhanced health care services for you--the patient.
Your assistance is appreciated in helping the 75th MDG Clinic keep up with these requirements and creating a healthcare environment we can all be proud of.
For further assistance with the Third Party Collections (TPC) Program, please stop by the TPC office located on the first floor near the pharmacy or call the TPC representatives at 586-9847 or 777-6422.