2010 UBO/UBU Conference

Health Budgets & Financial Policy

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Briefing: Foreign Military Billing

Date: 23 March 2010

Time: 1400 – 1450

2010 UBO/UBU ConferenceTurning Knowledge Into Action Objectives

Help UBO MSA staff better understand how to bill foreign military members and their dependents – UBO MSA perspective

Identify and discuss some important issues

Provide ideas for improved performance

Share helpful references for future use

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2010 UBO/UBU ConferenceTurning Knowledge Into Action Overview

Presentation limited to the billing of care provided to foreign military and their dependents at DoD Military Treatment Facilities (MTFs)

Excludes the issue of access to care at MTFs

Does not include the issue of care provided at civilian treatment facilities

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2010 UBO/UBU ConferenceTurning Knowledge Into Action

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Foreign Military Programs/Agreements

Programs Include: – International Military Education and Training (IMET)– Foreign Military Sales (FMS)– NATO Status of Forces Agreements (NATO SOFA)– Partnership for Peace (PFP) with a Status Of Forces

Agreement (PFP SOFA)– Reciprocal Health Care Agreements (RHCA)– Acquisition & Cross Servicing Agreements (ACSA)

2010 UBO/UBU ConferenceTurning Knowledge Into Action Getting Started

In the not so distant past, foreign military were not enrolled in DEERS

Now…Foreign Military Members and dependents automatically enrolled in DEERS upon application and/or receipt of New ID Card – DEERS assigns Foreign Identification Number (FIN)

in lieu of a Social Security Number– FIN used for foreign military, foreign nationals, and

their eligible family members

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2010 UBO/UBU ConferenceTurning Knowledge Into Action Administrative Practices

Coordinating with TRICARE Office or assigned office at your facility– Foreign Military Registration Card

Verifying country of foreign military member Notation of Country in CHCS

Collecting Invitational Travel Orders (ITO)– Tells you where they’re from, what they’re authorized,

& financial responsibility for health care of dependents

Communicating with Schools

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2010 UBO/UBU ConferenceTurning Knowledge Into Action Foreign Military Registration Card

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2010 UBO/UBU ConferenceTurning Knowledge Into Action Challenges

Perceived inconsistency of training in Foreign Military Billing throughout the Military Healthcare System– No guidance on reading ITOs

Billing for reimbursement of care provided difficult due to

lack of appropriate PATCAT information– Often difficult in getting appropriate personnel to

make appropriate PATCAT corrections

Some 60 counties currently covered by healthcare agreements with DoD– Agreements expiring and being renegotiated

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2010 UBO/UBU ConferenceTurning Knowledge Into Action Points to Acknowledge on ITO

Country

Program type

Demographic Information

Beginning/End date of reporting time

Conditions: IMS, FMS, IMET

Family Member Information and Amendments

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2010 UBO/UBU ConferenceTurning Knowledge Into Action

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Billing Form Options

I&R: Invoice and Receipt IMET Students FMS Dependents Embassies

UB-04: Prepared for whomever requests billing on this form

2010 UBO/UBU ConferenceTurning Knowledge Into Action

Reciprocal Health Care Agreements

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Country Termination StatusArgentina January 24, 2010 CurrentBolivia September 13, 2007 ExpiredCanada May 03, 2007 ExpiredChile October 03, 2010 CurrentColombia April 08, 2005 ExpiredDominican Republic June 30, 2012 CurrentEcuador September 18, 2009 CurrentEl Salvador March 16, 2011 CurrentGeorgia February 20, 2011 CurrentGermany July 07, 2007 ExpiredGuatemala March 20, 2010 CurrentHonduras February 10, 2012 CurrentMexico March 26, 2011 CurrentPeru August 31, 2012 CurrentRomania April 25, 2007 ExpiredTunisia July 31, 2012 CurrentUkraine July 08, 2012 CurrentUnited Kingdom October 31, 2014 CurrentUruguay September 18, 2012 CurrentVenezuela September 22, 2003 Expired - no renewal in progress*

References

DoD Dental Care for Foreign Force Members Quick Reference Guide (as of 22 July 2009)

DoD Dental Care for Dependents of Foreign Force Members Quick Reference Guide (as of 22 July 2009)

DoD Medical Care for Foreign Force Members Quick Reference Guide (as of 06 Jan 2009)

DoD Medical Care for Dependents of Foreign Force Members Quick Reference Guide (as of 06 Jan 2009)

NATO Member Countries

Euro-Atlantic Partnership Council (EAPC) Member Countries

References Relating to Health Care for Foreign Force Members

References

2010 UBO/UBU ConferenceTurning Knowledge Into Action

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References

2010 UBO/UBU ConferenceTurning Knowledge Into Action Lessons Learned Along the Way

DOD Reference sheet and CHCS PATCATs not in alignment– CHCS does not always generate FRR bills and Ins

co. does not accept DD7 billings More foreign military now carry health insurance

– CHCS does not allow the input of insurance for this category of patient

– Collect a DD2569 on patient regardless of duty status– Subsistence rate has not been updated for active duty

since Congress stopped charges for U.S. Active Duty– Traveler’s Insurance– Patients do not understand medical billing in the U.S.– Embassies are moving away from paper checks

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2010 UBO/UBU ConferenceTurning Knowledge Into Action Daily Challenges – Make CHCS Work for You

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DEERS TRICARE Standard issuesDEERS TRICARE Standard issues

2010 UBO/UBU ConferenceTurning Knowledge Into Action Country Code, Case ID, and Case Line

When using sales code 73 address cannot be built without country, case & line. Reference DFAS--DE 7077.2-M 13.6 & 13.8

Country Code Criteria: Main country code (i.e., for Italy, use IT for the Country Code criteria)

Case ID and Case Line: The Case ID and Case Line is a programmed number for the training

– Example: Italy, Country Code: IT Pseudo Country Code: S4 Case ID: TEY Case Line: 001

The ITO number will have the 2 character main country code at the beginning of the ITO Number and the 2 character country code at the end of the ITO Number. (i.e. ITO#: ITPTEY0012000S4)

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2010 UBO/UBU ConferenceTurning Knowledge Into Action Example of Address Line Request

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Country/Case/Line code is available on the ITO or is obtained from the Foreign Liaison Officer

2010 UBO/UBU ConferenceTurning Knowledge Into Action Helpful Hints

Know who gets the bill and how you get your money– Air Force Security Assistance Center (AFSAC) (pays

the MTF directly)

– Air Force Security Training (AFSAT) (pays Air Staff…but does not notify MTF when they have processed the bill for payment)

– Embassy (pays by check or electronic method) Herschel Hughes (Indianapolis DFAS) at DSN 699-8821.

Herschel.hughes@dfas.mil (establishing electronic account)

– Insurance company (how to get the bills to the Hub since encounters do not flow to TPOCS)

Work with GSUs to obtain listing of their foreign military Keep track of when member is leaving the country Establish working relationship with FLO-Coordinators

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2010 UBO/UBU ConferenceTurning Knowledge Into Action Helpful Hints (Cont’d)

Recommendation: Pull M2 query and perform 100%

audit on foreign military being seen in your facility– Validate billing requirements

Work with Beneficiary Services to clarify PATCATS and billable services (they are human too and mistakes can easily happen)

Identify billing issues to your service representative

Audit at least quarterly!

Work MSA accounts monthly to stay on top of open foreign military accounts

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2010 UBO/UBU ConferenceTurning Knowledge Into Action Web Sites/References

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http://www.armymedicine.army.mil/hc/ip/medical-eligibility.htm

https://private.fhp.osd.mil/portal/rhas.jsp http://www.armymedicine.army.mil/hc/ip/reciprocal.htm http://www.embassiesabroad.com/ International Military Students & Medical Care Desk Top

Guide

2010 UBO/UBU ConferenceTurning Knowledge Into Action

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Questions & Answers

Thank you for attending our presentation today.

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