Post on 18-Dec-2015
2010 UBO/UBU Conference
Title: Foreign Military Billing
Session: T-3-1430
Objectives
Better understanding of billing foreign military members and their dependents – UBO MSA perspective
Reciprocal Healthcare Agreements– DoD Reference page
Invitational Travel Orders Identify and discuss some important issues Provide ideas for improved performance Share helpful references for future use
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Foreign Military Programs
The programs are numerous:– International Military Education and Training (IMET)– Foreign Military Sales (FMS) – TW-P-TAX
FMS – Paid for by host country– 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)
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Training Programs
Counterterrorism Fellows Program (CTFP) – JO-B-B05 Counter-Narcotics – MX-B-INL or POT
– IMET, CTFP, and Counter-Narcotics– Primarily funded by U.S. government– Only covers student’s care– Dependents should be covered by insurance or an
international agreement
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Non-Students
Not issued an ITO – Embassy employees– Personnel Exchange Program (PEP) – Reciprocal– Liaison Officer program (LNO) – Country funds– Foreign Visitor Program– Coalition Exercises in CONUS– WHINSEC guest instructors
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Process Changes
Past – Foreign military were not enrolled in DEERS Present – Foreign Military Members and dependents
automatically enrolled in DEERS on 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– Billing rules do not account for those with insurance– Foreign language documents
Future – No idea, but the programs continue to evolve
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Collection Process
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 (ITOs)– Tells you where they’re from, what they’re authorized,
and financial responsibility for health care of family members
Communicating with;– Schools– FLO Coordinators– Foreign Members
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Foreign Military Registration Card
DeWitt Health Care Network card
Identification to billing office can come in various forms
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Benefit Sheet
Example of Beneficiaries Svs. sheet
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Reciprocal Health Care Agreements
Provide care at no charge for military members and dependents in DoD facilities only
Each agreement is unique, and some have restrictions All expired agreements are under renewal (with the exception
of Venezuela) https://fhp.osd.mil/portal/rhas.jsp
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Reciprocal Health Care Agreements
https://private.fhp.osd.mil/portal/rhas.jsp
DoD Reference Sheets
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DoD Reference Sheets
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Reference Sheet Codes
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Invitational Travel Order
Important items on ITO– Home Country– Funding– Invitation– Authorized Training– Dependents– Medical Services– Special Conditions
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Invitational Travel Order
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Invitational Travel Order
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Country Code, Case ID, and Case Line
Important for deposits When using sales code 73 address cannot be built without country,
case, and 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:
Netherlands, Country Code: NZ Pseudo Country Code: S4 Case ID: NZS989 Case Line: D111158
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#: NZS989D111158S4)
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Invitational Travel Order
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Invitational Travel Orders
ITO contains billing information
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Example of Address Line Request
Invalid charge//aar
aarCountry/Case/Line code is available on the ITO or is obtained from the Foreign Liaison Officer
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Authorizations for Care
ITOs for students and dependents ID card Invitational letter DEERS Agreements
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Submitting Bills
Documentation– SF 1080– Bill (DD7, DD7A, etc…)– ITO/copy of ID card– Amendment to ITO (if applicable)– Insurance Info
I&R: Invoice and Receipt– IMET Students– FMS – Dependents– Embassies
UB-04: – Prepared for whomever requests billing on this form
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Submitting Bills
US Air Force AFSAT/FMF ATTN: FMS Claims 315 J Street West Randolph AFB, TX 78150
US Army USAMEDCOM ATTN: MCRM-F 2050 Worth Rd, Ste 9 Ft Sam Houston, TX 78324
US Navy Commanding Officer Naval Ed & Security Assistance Field Activity Code-N5 Naval Air Station Pensacola, FL 32508
Embassies in DChttp://embassy.org/embassies
References:
Joint Security Assistance Training (JSAT)AR 12-15SECNAVINST 4950.4AAFI 16-105
DoD 5105.38-M (Security Assistance Management Manual)
Chapter 4 - FMS General Information
Chapter 10 - International Training
DFAS 37-100-2007
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Contact Information
Foreign Military Student (FMS) and IMET Billing
Air Force Security Assistance Training (AFSAT)
Mailing Address:
AFSAT/FMF
315 J Street West
Randolph AFB TX 78150-4349
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Challenges
Inconsistent training in Foreign Military Billing– 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 Over 60 counties currently covered by some type of
healthcare agreements with DoD– Agreements expiring and being renegotiated– The program is in constant motion
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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– Active Duty subsistence rate not updated since
Congress stopped charges for U.S. active duty– Travelers Insurance– Patients do not understand medical billing in the U.S.– Embassies are moving away from paper checks
Daily Challenges – Make CHCS Work for You
DEERS TRICARE Standard issues
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Rates
http://www.tricare.mil/ocfo/_docs/FY_2011_DC_Inpt_Rate_dtd_9_28_10.pdf
Rates
Know your rates
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Rates
International Military Education and Training (IMET) and Inter-Agency Outpatient Rate (IOR) rate tables
2010 Government Discount Calculation Rate Factor
PATCATIMET 0.64IOR 0.94IOR 0.94 K611IOR 0.90 K612
http://www.tricare.mil/ocfo/mcfs/ubo/mhs_rates/imet_ior.cfm30
Sample SF 1080
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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)– 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
Helpful Hints cont…
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 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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Web Sites
https://fhp.osd.mil/portal/rhas/dependentsmatrix.jsp http://www.armymedicine.army.mil/hc/ip/medical-eligibility.ht
m#spain https://fhp.osd.mil/portal/rhas.jsp http://www.embassiesabroad.com/ International Military Students & Medical Care Desk Top
Guide http://www.disam.dsca.mil/DR/14%20Chapter.pdf http://www.cs.amedd.army.mil/imso/Medical.htm (Ft. Sam
Houston site, but good explanations)
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Summary
Better understanding of billing foreign military members and their dependents – UBO MSA perspective
Reciprocal Healthcare Agreements– DoD Reference page
Invitational Travel Orders Identify and discuss some important issues Provide ideas for improved performance Share helpful references for future use
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Questions