Insurance program yields vital savings Published Aug. 14, 2012 GRAND FORKS AIR FORCE BASE, N.D. -- The Third Party Collection Program (TPCP) was legislated by Congress in 1986. It obligates Department of Defense Military Treatment Facilities to bill private health insurance carriers for the cost of medical care furnished to retirees and family members covered by their own health insurance policies, including all medical benefits and ancillary services such as pharmacy items. It is important to note the TPCP only works with current and accurate information for Other Health Insurance (OHI) policies carried by patients. When visiting military treatment facilities, patients will be asked to verify their OHI information regardless of if they have insurance. The 319th Medical Group has an automated system for gathering and updating OHI information. Using this system, active duty dependents, retirees and their family members are asked to verify their address, phone number, name of employer, and OHI information. Any informational changes are made on-the-spot during check in, only taking a few minutes. This process helps the Medical Group maintain the most current information. It is our way of ensuring all beneficiaries are informed and active participants in the program. If patients have OHI the obligation to pay medical care costs apply only to the insurance carrier. By law insurance policy rates cannot be raised or canceled just because a claim was filed. The insurance company pays the benefits directly to the 319th Medical Group and patients will not be billed or responsible for any uncollected charges. Beneficiaries will have no co-pay, deductible, or any patient charges indicated in the Explanation of Benefits received from the insurance company. This means patients may pay less out-of-pocket expense when later seeking health care through a civilian provider. For example, a person holds a health insurance policy with a $250 deductible for outpatient care is treated within the 319th Medical Group Clinic which generates a bill for $230 worth of services. The Clinic will bill the insurance company for the $230. The insurance company does not pay but would credit that $230 towards the deductible. The next time a patient receives a referral for civilian medical treatment the patient would only owe the remaining $20 of the $250 deductible before the insurance would start to pay. Much of the money earned through this program goes directly towards providing patient care. In fiscal year 2011 more than $220,000 was recovered to support treatment within our clinic. Our goal is to continue providing service excellence and the highest quality healthcare. For further assistance with the Third Party Collections Program, visit the Budget Office located on the first floor in room 703 or call a Third Party Collections representative at (701) 747-5376 or (701) 747-6127. Courtesy of the 319th Medical Group Resource Management Office