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ERMC Public Affairs Office
DSN 371-3317/3049
Tel. 06221-17-3317/3049
ermc-pao@amedd.army.mil
Release No. 20110228-1


February 28, 2011

Referral process changes for Host nation health care
TRICARE Overseas Program contractor to issue authorizations

HEIDELBERG, Germany – The process for receiving authorizations for health care referrals to a host nation provider will change at Army medical facilities in March as the TRICARE Overseas Program (TOP) contractor assumes full responsibility of authorization and claims processes for TRICARE Prime beneficiaries.

Beginning March 14 and continuing over five weeks, 19 Army medical facilities within the Europe Regional Medical Command will conduct a final transition to International SOS - the TOP contractor since September - that will change how authorizations for care are issued. 

Beneficiaries will no longer hand-carry referral authorizations to their host nation provider. International SOS, contracted to manage host nation healthcare networks, will fax or e-mail referral authorizations and claims forms directly to the designated host nation provider before the patient’s appointment. The patient will receive an appointment and can go without having to worry about the paperwork.  

Beneficiaries still have three choices for making appointments:

  • Army health facility TSCs may book appointments for beneficiaries.
  • Beneficiaries may book their own appointment.
  • Beneficiaries may call the TOP Regional Call Center to request assistance in booking their appointment.

Beneficiaries who have questions about the referral process should contact their local health facility TRICARE Service Center.

"The changeover should not cause delays in receiving care within TRICARE Access to Care standards," said Michelle Jones, ERMC’s TRICARE contract liaison officer.

TRICARE Access to Care standards require that appointments for TRICARE Prime beneficiaries be made according to these guidelines:

Acute care                  24 hours
Routine care                 7 days
Wellness                      28 days
Specialty                     28 days

Emergent (emergency) care requires no authorization.

Non-TRICARE Prime beneficiaries may be seen on a space-available basis.

Enrollment Cards Required
At host nation provider appointments, TRICARE OVERSEAS PRIME beneficiaries should present their TRICARE PRIME Overseas Program Enrollment Card. Enrollment card examples are at
http://www.tricare-overseas.com/Provider01_b02.htm.  In addition to referral authorizations that will be sent directly to the host nation provider by International SOS, the enrollment card validates that the bearer is the TRICARE PRIME beneficiary for whom the referral authorization was written. Each family member enrolled in TRICARE OVERSEAS PRIME should have a card. Beneficiaries who did not receive a card or need a replacement card should contact the TRICARE Overseas Program Regional Call Center and press option 4.
 
Toll-free contact numbers are:

  • Germany, 0800-589-1599
  • Italy, 800-915-994
  • Belgium, 0800-811-18

Jones said Army health facility TRICARE Service Centers will continue to provide Host Nation Patient Liaison services, healthcare finders, beneficiary counseling and assistance, and debt collection assistance.

She encourages all beneficiaries to visit www.tricare.mil for plan and benefit information. Beneficiaries can access country-specific toll free contact numbers and a useful “Find-A-Provider” search tool at the TOP Web site at www.tricare-overseas.com. Forms and links to other TRICARE overseas programs are also available at that site.  

“The TRICARE Overseas Program web site offers information for all TRICARE beneficiaries, such as contact numbers for claims and customer service,” said Jones. “The new TRICARE Overseas Beneficiary Handbook and other literature may also be downloaded.”

In addition to International SOS customer service, Jones said the Europe Regional Medical Command’s treatment facilities are committed to ensuring that beneficiaries have access to the healthcare they need.

SIDEBAR: Stay in the know with DEERS

By keeping their Defense Eligibility and Enrollment System (DEERS) address current, beneficiaries can assure they receive news and information mailed by TRICARE.

Options for updating DEERS information are:

  • In person, find the nearest ID card office at www.dmdc.osd.mil/rsl
  • Online, go to www.dmdc.osd.mil/appj/address/
  • By phone call 1-800-538-9552 (1-866-363-2883 TTY/TDD)
  • By faxing dial 1-831-655-8317
  • Mail address changes to the Defense Manpower Data Center (DMDC) Support Office, 400 Gigling Road, Seaside, CA  93955-6771
For more information about DEERS, go to www.tricare.mil/DEERS