319th MDG Third Party Collection Program

  • Published
  • By 319th Medical Group
  • Resource Management Office
The 319th Medical Group is using a new method for updating some beneficiary's health insurance information.

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 health insurance other than, or in addition, to, TRICARE.

The 319th MDG Clinic must comply with this law and needs your help for continued program success.

You are accustomed to being asked by Medical Group personnel for your "yellow card" at each point of service (ex: Family Practice, Lab, Pharmacy, etc.). Under our new system, dependents of active duty members, retirees or family members of a retiree will be asked to verify their address, phone numbers, name of employer and other health insurance information on our new electronic DD Form 2569.

If updates are needed we will make them on the spot, you will be asked to sign on a signature pad verifying your new information, and you're done. It should only take a few minutes. These forms help the Medical Group maintain your most current information. It is our way of ensuring all beneficiaries are informed and active participants in the Third Party Collections Program.

It is important to note if you do have other health insurance, the obligation to pay these medical care costs apply only to the insurance carrier. By law your insurance policy rates cannot be raised or canceled just because a claim was filed. Your insurance company pays the benefits directly to the 319th Medical Group and you will not be billed or responsible for any uncollected charges.

How does this process benefit you?

As a patient, you will have no co-pay, deductible, or any patient 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. For example, let's assume you have a health insurance policy with a $250 deductible for outpatient care. You are treated within the 319th Medical Group Clinic which generates a bill for $230 worth of services. The Clinic will bill your insurance company for the $230. The insurance company does not pay but would credit that $230 towards your deductible. The next time you received a referral for medical treatment downtown you would only owe the remaining $20 of your $250 deductible before your insurance would start to pay.

Remember, the Third Party Collection Program helps our 319th Medical Group help you. Much of the money earned through this program goes directly toward providing medical supplies, patient travel costs and staff training. In fiscal 2011, more than $220,000 was collected to support treatment within our clinic. Our goal is to continue providing service excellence and the highest quality healthcare to you -- the patient.

For further assistance with the Third Party Collections Program, please stop by the Budget Office located on the 1st floor in Room 703 or call our Third Party Collections representatives at (701) 747-5376 or (701) 747-6127.