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TRICARE and Patient Administration Information

TRICARE and Patient Administration Information

TRICARE is the Department of Defense's triple-option health-care program which replaced the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). TRICARE is a partnership contract between the Department of Defense and a civilian-managed care contractor, with services provided by both military doctors and participating contract doctors and facilities. TRICARE is designed to enhance access, preserve quality and reduce costs for patients and the government.

 

The three options under TRICARE are Prime, Extra and Standard. TRICARE Prime is modeled after civilian health maintenance organizations, or HMOs. Under TRICARE Prime, primary care managers (PCMs) provide or arrange the total spectrum of a military family's health care and encourage use of preventive services. TRICARE Standard is a fee-for-service plan and operates like the old CHAMPUS program. TRICARE Extra provides discounts over TRICARE Standard for beneficiaries who use a network provider.

 

Active-duty personnel and their dependents must enroll in TRICARE at their current medical treatment facility (MTF). After enrollment, active-duty personnel receive TRICARE Prime with no out-of-pocket costs for health care. Active-duty dependents, retirees and retiree dependents may choose from one of the three options. Active duty dependents enroll in TRICARE Prime at no cost, while retirees and their dependents share the cost with the government. TRICARE

 

REGISTRATION AND ENROLLMENT

Keesler Air Force Base is in the TRICARE SOUTH region. If moving from another installation, it is recommended that beneficiaries move their enrollment within 30 days of arriving at Keesler.

 

All TRICARE-eligible beneficiaries who want to be seen at the 81st Medical Group must register in Keesler CHCS (the hospital computer system). All active-duty members assigned to Keesler must enroll in TRICARE Prime at Keesler.

 

Eligible family members may enroll in TRICARE Prime (enrollment required) or choose to use TRICARE Standard and Extra (no enrollment required).

 

Registration - All beneficiaries

To register, report to:

 81st Medical Group Keesler Hospital System

Location at the 81st MDG, Beneficiary Services

 Phone: 376-4742/4743. (DSN: 591)

 Open 7 a.m.-5 p.m. Monday-Thursday and 7 a.m.-4 p.m. Friday

 

Enrollment - Active Duty assigned to KAFB and eligible family members must call

 Phone: 1-800-444-5445 option Enrollment

 Open 7 a.m.-5 p.m. Monday-Thursday and 7 a.m.-4 p.m. Friday

All other beneficiaries, including retirees: must call 1-800-444-5445

 

QUESTIONS, TRICARE BILLING AND CLAIMS PROCESSING

Health Benefits Advisors

Room GH027 or GH028

Keesler Hospital

Phone: 376-4010 /376-4737/376-4752 (DSN: 591)

Open 7 a.m.-5 p.m. Monday-Thursday and 7 a.m.-4 p.m. Friday

 

The health benefits advisors can assist you with any TRICARE question, TRICARE billing and claims processing.

 

LINKS

Keesler Hospital - local MTF information: http://newpreview.afnews.af.mil/keesler/units/81stmedicalgroup.asp

 

TRICARE South - Humana Military Healthcare Services, Inc.

1-800-444-5445

www.humana-military.com

 

Getting Copies of Medical Records

Release of information is located on the Keesler Hospital ground floor in Beneficiary Service front desk. Per AFI 41-210, original medical records are property of the government. You may request a copy of your records with proper identification. Please allow 20 business days to process your request. If the records are needed for a civilian provider, immediately notify Referral Management to ensure the information is available for the appointment. Referral Management is are located on the first floor in room 1A230. They may be reached at 376-0490. NO ONE is allowed to hand-carry records to downtown appointments. Request forms in the TRICARE Office at the Medical Records desk. Be sure to include an accurate phone number and address on the request so you may be contacted it needed. Patients assigned to the Flight Medicine Clinic will obtain a copy of their medical record through Flight Medicine only.

 

Out-Processing

Only active-duty members on flying status or on PRP are allowed to hand-carry their records. All records will be mailed to the gaining MTF. If dependents are remaining in the local area or will be going to a follow-on assignment ahead of the sponsor, please inform the staff to properly transfer the medical record. Active-duty members must out-process through the TRICARE Office and provide a copy of their orders to the Medical Records desk which will then forward them to Outpatient Records in order to transfer the medical record to the gaining base. You will need to provide a copy of your orders to the medical records technician for virtual out-processing.

 

Picking up Medical Records

Only the requester is allowed to pick up a copy of their medical record unless previous authorization has been signed. This rule applies to all patients over the age of 18.

Outpatient Records

Keesler Hospital

GF 400A

301 Fisher St

Keesler AFB, MS, 39534

Phone: 376-4733 (DSN: 591)

Open 7 a.m.-5 p.m. Monday-Thursday and 7 a.m.-4 p.m. Friday.

 

If you have further questions, please contact Outpatient Records at 376-4733