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NEWS | Oct. 6, 2011

Medical care reimbursements continue to rise

By Robert Goetz 502nd Air Base Wing OL-B Public Affairs

The 359th Medical Group's third-party collection program, a Department of Defense-mandated practice of billing private health insurance companies for services provided in military treatment facilities, has completed its most successful fiscal year.

The 359th MDG collected nearly $1,052,000 in reimbursements from private insurance companies in fiscal 2011 - funds that allow the Randolph Medical Clinic to buy supplies, new equipment and furniture, add personnel and renovate the facility.

"We're able to use that money to benefit the clinic," Staff Sgt. John Dicks, 359th Medical Support Squadron uniformed business office manager, said. "We're being paid for the services we provide."

He said the 359th MDG also uses the funds to buy equipment for the Randolph Health and Wellness Center and support the clinic's and the HAWC's education classes and programs, such as monthly awareness topics.

Dicks said Public Law 101-510 established the right to bill private health insurance companies and DoD Instruction 6010.15 mandates MTFs to collect from private insurers. The third-party collection program includes all active-duty dependents, retirees and dependents of retirees who have private insurance, but it does not include active-duty members.

"We're mandated to ask everybody who comes in the clinic if they have private insurance coverage or just TRICARE," he said. "The private insurance companies pay first."

Dicks said the eligible population - more than 21,000 Randolph clinic enrollees - must fill out DD Form 2569, which requests demographic information and asks if the patient has health insurance other than TRICARE, Medicare and Medicaid. Each patient receives a third-party verification card, which is good for one year and must be renewed.

Billable services are pediatrics, cardiology, pharmacy, radiology, physical therapy, optometry, primary care, immunizations, laboratory and flight medicine.

Dicks said beneficiaries incur no out-of-pocket expenses, including uncollected charges and the deductible. Each patient's insurance carrier pays the benefits directly to the 359th MDG, which applies charges toward the deductible and helps satisfy the deductible.

In addition, patients do not have to make co-payments, he said.

"We don't accept any payments at the facility," Dicks added.

But he also said it's important patients provide the information requested on DD Form 2569.

"We're able to get most people to fill out the forms," Dicks said. "However, some people are afraid of disclosing their private health insurance."

Education efforts are proving successful, because the amount of money collected since fiscal 2007 has doubled, steadily increasing each year, he said. Third-party collections totaled $419,808 in fiscal 2007, rising to $664,841 in 2008, $864,366 in 2009, $907,081 in 2010 and $1,051, 940 in 2011.

Jackie Fletcher, 359th MDSS third-party collections specialist, believes the upward trend will continue.

"More people want to come on base to use the facility," she said. "This program benefits the patient with the facility, services, supplies and medical staff we have."

For more information on the third-party collection program, call 652-2420, option 7. For the most up-to-date information at the Randolph clinic, visit or search for the 359th Medical Group on Facebook.