DECEMBER FLU DRIVE DATE - 6 DEC!
Flu vaccines will be available at McGill Dec. 6 from 10 AM to 6 PM for active duty and TRICARE beneficiaries enrolled at a military facility (not enrolled in US Family Health or Johns Hopkins).

Patient Resources

Forms

Kimbrough Ambulatory Care Center Forms

Defense Health Agency Forms

TRICARE Forms

Third Party Collection Program

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    Third Party Collection Program DD Form 2569
     
    The Third Party Collection Program (TPCP) requires Military Treatment facilities (MTF) to bill your Other Health Insurance (OHI) for Outpatient visits or Inpatient stays. If you have Tricare AND other health insurance coverage, the government requires that we attempt to collect payment from your third party insurance. In addition to fling claims for office visit and inpatient stays we also bill your insurance for all ancillary services provided such as Pharmacy, Laboratory and Radiology services.

    The key to the Third Party Collection Program’s success is you and the OHI coverage that you or your spouse may be paying for, but are not using. We require that you fill out and submit your OHI information on a DD2569 for processing. This should be done annually or upon any change to your coverage. We will then bill your insurance company directly for the cost of your visit.

    Who must participate in the Third Party Collection Program?

    Tricare members who have Other Health Insurance:
    • Family Members of Active Duty
    • Retired Military Members
    • Family Members of Retired Members
    Collectively these categories of patients are called "DoD Beneficiaries"
     
    Where does the money go?
    Payments from your healthcare insurer go directly to our Medical Treatment Facility's operating budget. The money is then used to enhance the total healthcare services offered to you.
     
    How can you help us?
    • Complete DD Form 2569
    • Turn the form in to the Patient Administration Division (PAD) office or drop off at the front desk during your next PCM visit.
    • Update your information with PAD or your clinic whenever there is a change to your insurance coverage (e.g. carriers, policy, address or phone number).
Don't forget to keep your family's information up-to-date in DEERS.