By law, all military treatment facilities must bill private insurance companies--third party insurers--for the care of military family members, retirees and their family members. The Third Party Collection Program was established to seek reimbursement of care provided at Darnall, and all Department of Defense medical treatment facilities. You will need to verify your insurance during clinic visits and pre-admission interviews to meet your insurance company's requirements before you receive care. The insurance company will pay the hospital directly and patients are not responsible for any uncollected charges. All funds collected through this program are retained by Darnall, and are used to enhance and expand medical services. For the benefit of everyone, it is important to report your private insurance to the clinics or pharmacies you visit. For more information, call 288-8693 or 288-8378, Monday through Friday 8:00am-4:00pm.
THIRD PARTY COLLECTION PROGRAM
The Third Party Collection Program was established by Public Law 101-510 (10 U.S. Code 1095). The program directs military hospitals to bill private insurance companies for the cost of care provided by the military facility.
When a patient has commercial insurance, the government must bill the insurance company for outpatient and inpatient care. The government determines the cost of an outpatient clinic visit and bills this amount to the insurance company. The cost for inpatient stays are determined by Diagnosis Related Groups (DRG). Your insurance company cannot charge you for the deductible or co-payment for care received through the military facility. The government will absorb these costs. Therefore, claims filed by the government for care you received may count toward meeting your deductible. This may result in a significant savings to you if you later seek civilian medical care.
Allowing Carl R. Darnall Army Medical Center to bill your third party insurance company for care you receive will help you and your hospital.
The money collected will:
- Help meet your policy’s deductible and will not require any out of pocket expense
- Enhance the quality of care at Darnall
- Allow Darnall to provide you with essential equipment and Health Care staff
- Not effect your policy premiums
MEDICAL CARE RECOVERY PROGRAM (Medical Affirmative Claims) (MAC)
The Medical Recovery Program provides the statutory and regulatory authority to recover the reasonable value of medical care rendered for injuries or illnesses provided at Government expense.
MAC provides the statutory and regulatory authority to recover the reasonable value of medical care rendered for injuries or illnesses provided at Government expense to active duty members, dependents (as defined at 10 U.S. Code 1072), and retirees (as defined at 10 U.S. Code 1074), under circumstances creating third party tort liability.
The Medical Affirmation Claims (MAC) Program (42 U.S. Code 2651-1653 and CFR 43), the Federal Claims Collection Act (31 U.S. Code 3711-3720 A and 4 CFR 101-105), and the Third Party Collection Program (10 U.S. Code 1095 and 32 CFR 220), apply to these claims.
If you are involved in an accident of any type and have liability insurance, please provide that information to your Health Care Provider at the time of treatment. Please inform the Health Care provider if your visit is related to a Worker’s Compensation injury.
Promptly notify the Medical Care Recovery Office, at 288-8624 or 286-7614, of your accident and sign a Release of Information form. All accident related information must be released through the Medical Care Recovery Office.
Carl R. Darnall Army Medical Center will be reimbursed.
WHAT IS YOUR RESPONSIBILITY?
- Please bring your insurance identification card each time you visit the hospital or clinic.
- You will be asked to update the information every twelve months or when your coverage changes.
- All patients will be asked to complete and sign a DD FORM 2569.
- Completion of the DD Form 2569 will be annotated in the hospital computer so it can be easily verified on your next visit. This serves as a reference to remind you when to fill out a new DD Form 2569, which is due every 12 months or sooner if you have changes in your coverage.
|Third Party Collection Program Office
288-8378 or 288-8693
|Medical Care Recovery Program Office
288-8624 or 286-7614
page last modified on: 5/17/2013