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NEWS | April 16, 2019

Third-party insurance helps improve quality of health care at NHCC

By Capt. Dale P. Barrette, commanding officer Naval Health Clinic Charleston

Like the private health care industry, the cost of providing health care services to Department of Defense’s active-duty personnel, their dependents, retirees and their survivors or dependents, has increased dramatically and will likely continue to rise.

To defray costs, Congress created the Third-Party Collection Program in 1986, requiring all military treatment facilities to recover some of these costs by third-party civilian insurance carriers.

Naval Health Clinic Charleston has been participating in the Third-Party Collection Program and provides all non-active duty beneficiaries a DD Form 2569 to file in order to be issued a Compliance Card.

All DOD beneficiaries, excluding active duty, are required to fill out the DD Form 2569 annually to verify the presence or absence of third-party insurance. This includes, but is not limited to, active-duty family members, retirees and family members of retirees.

The Compliance Card must be presented at the time of check-in at each patient intake area where a patient seeks health care services. The card is valid for one year if the information on it remains the same. A new DD Form 2569 must be completed when the expiration date is reached.

The information provided on the DD Form 2569 is used to properly route a healthcare claim to the DOD beneficiary's private insurance carrier.

Under federal law, Military Treatment Facilities are authorized to collect from third-party payers the reasonable charges for medical services provided to uniform services beneficiaries, excluding active duty.

A third party insurance carrier provides health insurance policies other than TRICARE, TRICARE Supplemental plans, Medicare, Medicaid and certain government-sponsored programs that beneficiaries may carry through an employer or private insurance company. Any third-party health insurance in addition to TRICARE coverage is considered to be the primary health insurance.

Beneficiaries who receive care at a Military Treatment Facility will not be billed except for subsistence costs of an inpatient stay. The third-party insurer may deduct payment for any copay or cost share amounts, but a beneficiary will not be billed for any amounts that cannot be collected from the third party insurance.

At Naval Health Clinic Charleston, we understand that health care is an earned service benefit. Billing third-party insurance carriers will help us offset the costs of care and allow for improvements to the quality of care beneficiaries receive at NHCC.