the world's leading medical assistance company

the world’s leading medical assistance company

“Your Passport to Quality Health”

Overview

• Program purpose• SOS London/tricare functional

organizational structure• Routine care • Urgent / emergent care• Authorization process• Air evacuation

EUCOM

CENTCOM

•Expansive area•Difficult to reach locations•Many command structures with multiple and varied missions•Complex inter-governmental relationships

Program Purpose

30oW 17

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Atlantic Ocean

Arctic Ocean

Indian OceanAtlantic Ocean

CENTCOM

EUCOM

42oE30

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Atlantic Ocean

Arctic Ocean

Indian OceanAtlantic Ocean

CENTCOM

EUCOM

42oE

• As of 1st July 2001 As of 1st August 2002– Egypt - Djibouti– Ethiopia - Eritrea– Kenya– Kuwait– Pakistan– Saudi Arabia

• As of 1st June 2002 As of 1st October 2002– Jordan - Kazakhstan (Almaty)– Oman - Kyrgyzstan (Bishkek)– Qatar - Turkmenistan (Ashgabat)– UAE - Uzbekistan (Tashkent)

CENTCOM

EUCOM and outside of Continental United States Start Date:

1 SEPTEMBER 03

the world’s leading medical assistance company

“Your Passport to Quality Health”

Global Remote Program

GOALS

•Provide Cashless Access to Care

•Ensure Quality of providers and facilities

•Manage Costs

International SOS

International SOS

International SOS

– Worlds leading medical assistance company– More than 20 years experience– Offices in 39 countries– Over 200 full time physicians– Medical referral network in more than 150

countries

International SOS

Provides active duty and their families assigned to remote locations the following:

– “Credentialed” provider network– PCM concept of operations/advice line, self care– 24/7 call center– Referral/Utilization Management– Emergency air evacuation if military assets are not

available/feasible– Cashless and claimless services

International SOSFacts & Figures

3,000 professionals 24 call centers Offices in 43 countries 300 full-time medical staff Over 40 in-house languages

Network of credentialed medical providers Handles thousands of cases every day Perform one evacuation every hour Provide healthcare to 180,000 each year through

international SOS clinics

Hospital Evaluation Criteria• Physical plant• Hygiene• Medical staff• Nursing staff• Diagnostic capabilities• Surgical and intensive care capabilities• Emergency services• Administrative organization• Financial considerations

Physician Evaluation Criteria • Minimum criteria:

– graduate of an accredited medical school– licensed

• Office location and hygiene• Experience treating foreign patients• English language proficiency• Hospital affiliation • Overseas training• Local reputation• Availability

TRICARE Program

Service Delivery Receipt of new request

– By e-mail– By fax – By phone

•From POC•From Provider•From Member•From TEO

Routine Care• For Active Duty (AD)and Active Duty

Family Members(ADFM)

• Primary Care Providers– Mainly seen by HU / MTF for GP– Dental and OB-GYN– Wellness Program investigations

• Specialist care Providers– Referral from HU / MTF– Notification to SOS through local POC– Orthopedist, Ophthalmologist and

Dermatologist

Urgent / Emergent Care

Urgent / Emergent Care

• For AD / ADFM and TDY/TAD personnel

• Urgent Care– Requiring medical intervention within 24

hours

• Emergent Care – Requiring medical intervention within 4

hours

• Hospitalization and Patient movement

Authorization Process

Medical Authorization

• Member’s eligibility– Verification through DEERS– Confirmation from POC/TEO on patient’s

status

• Medical information– Patient’s problem identified– Services required

• Referral Letter for Specialist care provided

Medical Authorization

• Approval– Medical Department to review

request and provides approval within the parameters of the TRICARE program

• Guarantee Letter (GOP)– Issue Guarantee Letter to provider,

copy to POC as appropriate

Dental Care

AD Dental Authorization

• Member’s eligibility – Active duty (permanent party)– Network dentist– Cashless claimless

• Dental information– Patient’s problem identified– Services required

• GOP (guaranteed letter of payment AD only)– For current/approved treatment

– “Other” treatment must be approved prior

ADFM Dental Authorization

– Referral services only– Same network dentist– Family Member must file claim

with UCCI (United Concordia Companies inc.)

– No GOP

Evacuation Process

Medical (Air) Evacuation

• Emergency Only

• SOS Responsibilities– Contact Theatre Patient Movement

Requirements Center (TPMRC) all EVAC’s

– Contact TRICARE Europe (TEO) update on patient’s status

SOS Dedicated Air Ambulance

Locations

30oW

Europe: Europe: Baden Baden (Lear 55)Baden Baden (Lear 55)

Africa:Africa: Johannesburg (Falcon 10, Lear 25 & Beechcraft Johannesburg (Falcon 10, Lear 25 & Beechcraft C90)C90)

Gaborone (Cessna 402)Gaborone (Cessna 402)

Windhoek – (Cessna Citation II)Windhoek – (Cessna Citation II)

CIS: CIS: Moscow (Hawker 125-1A)Moscow (Hawker 125-1A)

Far East:Far East: Singapore (Falcon 200)Singapore (Falcon 200)

Beijing (Hawker 800XP)Beijing (Hawker 800XP)

Australasia:Australasia: Port Moresby – (Citation II)Port Moresby – (Citation II)

SOS Dedicated Air Ambulances

30oW 17

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5oS, 68°E

Indian Ocean

Atlantic Ocean

Pacific Ocean

42oE

Your Role

Review local provider list

Provide International SOS with a preferred provider list (you will be contacted)

the world’s leading medical assistance company

“Your Passport to Quality Health”

Your Role as a:•TRICARE POC •Healthcare/Health Unit Provider

Educate military and family members about the TRICARE -International SOS Global Remote program

Coordinate w/TRICARE Europe

the world’s leading medical assistance company

“Your Passport to Quality Health”

Your Role as a:•TRICARE POC •Healthcare Provider

EUCOM and outside of Continental United States Start Date:

1 SEPTEMBER 03

the world’s leading medical assistance company

“Your Passport to Quality Health”

Global Remote Program

the world’s leading medical assistance company

“Your Passport to Quality Health”