Third party collection, other health insurance

  • Published
  • By 66th Medical Squadron Resource Management Operations
HANSCOM AIR FORCE BASE, Mass. – The Hanscom clinic is required to determine if patient care is covered under other health policies and, if so, to seek reimbursement.

The Consolidated Omnibus Reconciliation Act of 1986 established the Third Party Collection Program, which mandates all military medical treatment facilities bill to other health insurance carriers, such as Blue Cross/Blue Shield, for medical care furnished to retirees and family members covered by other health insurance.

The Third Party Collection Program will not bill TRICARE.

The clinic must comply with the law by ensuring each non-active duty patient completes an insurance information sheet annually. In addition, the patient must provide a copy of Department of Defense Form 2569, Record of Other Health Insurance.

Upon check-in, all patients are required to show a military ID card, their current DD 2569 and a copy of any other insurance cards. This documentation is required and serves as proof of eligibility for care.

When a patient has another health insurance policy, or a Medicare supplement, the obligation to pay medical care costs applies only to the insurance carrier and not to the patient.

The clinic is entitled to, and required by law, to bill health care services provided by Hanscom but covered under a separate policy.

All transactions to recover medical services provided by Hanscom that are covered under separate insurance will be processed by the clinic and all recovered costs are paid directly to them.

The patient will not be billed for unrecovered expenses and this process will not increase insurance costs because these services have already been paid for in the insurance premium. This is considered a reimbursement for services covered and not an additional expenditure.

The Third Party Collection program ensures that the insurance premiums paid for coverage are collected by the provider of that service.

For further information about third party collections and other health insurance, contact Lisa Uku at 781-225-6228.