South Region BCAC and Communication Workgroup Partnership Meeting April 15, 2009.
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South Region BCAC and Communication Workgroup Partnership Meeting April 15, 2009
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Transcript of South Region BCAC and Communication Workgroup Partnership Meeting April 15, 2009.
South Region
BCAC and Communication Workgroup Partnership
Meeting
April 15, 2009
Beneficiary Counseling and Assistance Coordinator (BCAC)
andDebt Collection Assistance Officer
(DCAO)
Chief, Customer CommunicationsTMA, C&CS
Objectives
• Discuss Beneficiary Counseling and Assistance Coordinator (BCAC) and Debt Collection Assistance Officer (DCAO)
• Roles• Knowledge and Skills
• Recognize tools to assist in educational and operational responsibilities
BCAC - FY00 Authorization Act
• The SecDef shall require in regulation the establishment of BCAC positions– Each Regional/Area Office designates a full-time BCAC position– MTF Commanders designate a BCAC position as
primary/collateral duty
• Duties outlined in DoD Directive 6015.23– Delivery of Healthcare at Military Treatment Facilities; Foreign
Service Care; Third Party Collection; Beneficiary Counseling and Assistance Coordinators
– http://www.dtic.mil/whs/directives/corres/pdf/161523_103002/1601523p.pdf
• Provide toll-free communication
BCAC Roles and Responsibilities
• Serves as beneficiary advocate and problem-solver• Coordinates with appropriate points of contact throughout the MHS,
including Managed Care Support Contractor (MCSC) points of contact, to best meet beneficiary needs for information or assistance.
• Counsel beneficiaries and clarify information on their TRICARE benefit; consults with others as necessary.
• Work with functional experts to provide enrollment, beneficiary counseling, and claims processing information. BCACs shall describe or seek clarification on eligibility requirements and benefits based on the category of beneficiary seeking assistance.
• Ensures resolution, as often as possible within appropriate timeframe
• Case tracking/trending
DCAO – P&R Memo
• Under Secretary of Defense (Personnel &Readiness) Policy Memorandum, Debt Collection Assistance Officer Program to Assist Service Members with TRICARE Claims Collection Problems, 27 Jun 2000
– Each Regional Office (Lead Agent) designates a full-time BCAC position– MTF Commanders designate a BCAC position as primary/collateral duty– Response to troops is a priority
• Stand-up program world-wide in 30 days• No additional FTEs – utilize available resources
• Duties outlined in DCAO Implementation and Training Guide– http://www.tricare.mil/customerservicecommunity/documents/
DCAOImplementationTrainingGuideV3.pdf
DCAO Roles and Responsibilities - Overview
• To receive services from a DCAO, beneficiaries must present either a:– Letter from a collection agency indicating initiation of
active collection action; and/or– Credit report that reflects a negative credit status due to a
TRICARE payment Issue• Assist beneficiary in determining basis for debt collection• Collect copies of all pertinent documentation; i.e., provider
bills and notices, TRICARE EOBs, letters from providers/credit reporting agencies, etc.
• Obtaining an “Authorization for Disclosure of Medical or Dental Information” form
• Notify provider(s), collection or credit reporting agency that beneficiary’s case is under review.
Knowledge/Skills
• Thorough understanding of TRICARE program and policies– Practical knowledge of TRICARE regional contract– Knowledge of TRICARE special benefit/demonstration Programs (USFHP, CHCBP, etc)
• General understanding of the Military Health System• Skilled in oral/written communication• Experience in handling complex healthcare benefit problems
Operational Elements
• BCAC/DCAO contacted by the beneficiary assumes responsibility for the issue and/or inquiry
• Research and resolve the issue• Notify beneficiary of problem resolution
– Determine beneficiaries satisfaction with case outcome via oral, written, or automated process
• Track case through resolution
Assistance Reporting Tool (ART)
• Address the GAO recommendation to track beneficiary feedback
• Standardize MHS BCAC/DCAO data collection• Support beneficiary satisfaction through systematic issue
collection, tracking, resolution, and evaluation • Address Leadership’s need for location-specific information• Support development and use of marketing and educational
materials • Create a user-friendly system to support dual-hatted
BCACs/DCAOs– Workload management tool
• Capture beneficiary queries• Identify trends and address local/system-wide problems
– Maintain a centralized depository at TMA • Shifts administrative and management costs • Ensures DITSCAP compliance
• Real Time Data, Ad hoc report capabilities
Case Tracking
• Assigns a case identifier• Designate as BCAC/DCAO case • Resolution:
– 30 working days for non-priority BCAC cases– 60 working days for non-priority DCAO cases – 10 working days for congressional/priority inquires
• Response prepared by original BCAC/DCAO• Case categorized in ART; reports as needed
Principles
• Problem solving at the grass roots level• Responsiveness to customer• Maintain customer service focus
Tools
• http://www.tricare.mil/customerservicecommunity/resources.aspx – “Push” email capability– BCAC/DCAO links
• TRICARE University – http://www.tricare.mil/tricareu/TRICARE.mil
• TRICARE Resources– Manuals: http://manuals.tricare.osd.mil – HA Policy/Guidance: http://www.health.mil/HAPolicies.aspx
• Establish POCs– MTF – Regional/Area Office POCs– TMA & Service POCs– Contractor staff
BCAC Directory
• Directory contains names, locations, phone numbers, and email addresses – Public site; hidden site– Think about getting a non-specific email address– Identify if someone is being deleted as someone else is being
added.– Remember to forward phone number and email address
changes• TRICARE web site is updated as soon as the change is entered
QUESTIONS?
WWW.TRICARE.MIL
Site Overview
Tailored beneficiary content Beneficiary Category Location Health Plan Option
Customized applications Plan Wizard Compare Plans Covered Services
Spanish translation
Entering the Profile
Step 1 Select your beneficiary category Select your country
Step 2 If you selected the United States, you’ll
need to enter your ZIP code. Step 3
Select your health plan option
Tailored Home Page
Your profile identified in header Most popular topics based on your
profile Some link directly to external
applications (i.e. Update DEERS) Special messages Announcements
Site Organization: Main Tabs
Overview Medical Dental Vision Prescriptions Mental Health & Behavior Life Events
Quick Tips to Find it Fast
Enter your profile Change the profile to see content for
another family member Click on “TRICARE Contacts” to
quickly find a toll-free number Click on “Forms” to get a form fast Use Google Custom Search
How We’re Doing (ACSI Scores)
ACSI Customer Satisfaction Scores - Apr. 01, 2008-Mar. 31, 2009
60
64
61
62 62
63
65
66
68
69 69 69
54
56
58
60
62
64
66
68
70
Month
Sc
ore
Scores
What’s Changing
Forced Profile New to TRICARE Enhanced tailored home pages Streamlined main tab pages Virtual tour
Forced Profile
New to TRICARE
Enhanced Home Page
Streamlined Main Tab Pages
TRICARE PUBLICATION PRODUCTION SCHEDULE
OVERVIEW
(Please refer to separate attachment.)
