Patient Administration - Army Publishing Directorate - U.S. Army

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Point-of-service option The freedom to obtain services from civilian providers on a case-by-case basis. Such freedom is retained by TRICARE Prime enrollees. In such cases, all requirements applicable to standard CHAMPUS apply, except that there are higher deductible and cost sharing requirements. Under Prime, for care not authorized by the PCM or health care finder, deductibles and cost sharing requirements apply. Practical military training Any training activity which is part of the Army ROTC education and training program. Practical military training also includes the Advanced Training Program, Field Training, and other ROTC-sponsored and supervised activities which enhance the program by focusing on specific training goals and objectives and prepare the cadet for service as an Army officer. The Army ROTC will not sponsor potentially hazardous activities. Examples of these activities include but are not limited to rapelling, hang gliding, parasailing, parachute jumping, paint ball wars, and other activities where substantial liability is possible. Legitimate intramural or similar activities are permissible. Primary care manager The first echelon provider that exercises primary decision authority regarding diagnosis and treatment of an individual patient. The primary care manager may be an individual physician, or group practice within a specific clinic or treatment site, or other designation. The primary care manager may be part of the MTF or the Prime civilian provider/ practitioner network. The enrollees will be given the opportunity to register a preference for primary care manager from a list of choices provided by the MTF commander. Preference requests will be honored subject to availability under the MTF beneficiary category priority system and other operational requirements established by the commander (or other authorized person). Quarters Disposition of a military patient when the patient is returned to his or her unit or home for medically directed selftreatment and is not to perform military duty until a medical officer indicates that he or she may perform such duties. Responsible individual An individual who is responsible for transactions relative to deposits in the patients’ trust fund when the patient is unable to deposit directly with the custodian or assistant custodian. Retired member A member or former member of a Uniformed Service who is entitled to retired or retainer pay, or equivalent pay, as a result of service. Routine care a. Routine dental care. All dental care necessary to maintain dental health and function other than care of an emergency or elective nature. b. Routine medical care. Nonemergency care that is required and medically indicated. Subsistence rate charges A flat, per diem, hospitalization charge which applies to enlisted and officers. No credit is given for meals not consumed. Subsisting out The nonleave status of an inpatient who is no longer assigned to an operating bed and whose days become sick days, not occupied bed days. Inpatients authorized to subsist out are not medically able to return to duty, but their continuing treatment does not require a bed assignment. Supplemental care Funds used to obtain civilian health care for eligible beneficiaries when that care is not available in the MTF. Transfer Occurs each time an inpatient is transported from one MTF (civilian or military) to another MTF. TRICARE Extra option The health care option, provided as part of the TRICARE program under Section 199.17. Under this option, beneficiaries may choose to receive care in facilities of the Uniformed Services on a space-available basis, or when CHAMPUS eligible beneficiaries uses the preferred providers in the TRICARE contractor’s network at a beneficial discount, and (usually) no claim forms have to be filed by the patient. When CHAMPUS non-network providers are used, the 132 AR 40–400 27 January 2010
standard CHAMPUS cost shares apply. This option does not require TRICARE enrollment, but the beneficiary must be registered in DEERS. TRICARE managed care support contract A contract providing personnel and other resources to an MTF in order to increase the availability of services. TRICARE Prime option The health care option provided as part of the TRICARE program under Section 199.17. Under this option, beneficiaries enroll to receive all health care from facilities of the Uniformed Services and/or civilian network providers/ practitioners through primary care managers and health care finders resulting in substantial cost savings. TRICARE Program A regionally managed care HMO type program for members of the Uniformed Services and their Families, retired members and their Families, and survivors. TRICARE brings together the health care delivery systems of each of the military services in a cooperative and supportive effort to better serve DOD beneficiaries and use the resources available to military medicine. Through the help of the TRICARE managed care support contracts, civilian provider networks are created along with other managed care support services to develop, implement, and operate a comprehensive managed health care delivery system for military health system beneficiaries. TRICARE Standard option The health care option, provided as part of the TRICARE program under Section 199.17. Under this option, beneficiaries are eligible for care in facilities of the Uniformed Services and CHAMPUS under standard rules and procedures. Uncharacterized service Entry level status separation characterized as honorable or general (under honorable conditions) except as noted in AR 635-200, paragraph 3-9. Uniformed Services The Army, Navy, Marine Corps, Air Force, Coast Guard, Commissioned Corps of the Public Health Service, and the Commissioned Corps of the National Oceanic and Atmospheric Administration. Section III Special Abbreviations and Terms This section contains no entries. AR 40–400 27 January 2010 133
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Army Regulation 40-400 Medical Serv
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Headquarters Department of the Army
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Contents—Continued Department of
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Contents—Continued Autopsy author
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Contents—Continued Chapter 13 Inj
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Chapter 1 Introduction 1-1. Purpose
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nonemergent specialty care. The Pri
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(1) If not prohibited under the law
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Table 2-3 Supplemental care payment
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a. Treatment during and after duty.
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the camp commander or the MTF comma
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e provided an employee paid from ap
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(2) The Health Insurance Portabilit
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(n) Section 13. Signature of the MT
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discharged or transferred. When an
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encompasses the geographic area whe
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(3) Peace Corps applicants. (a) Exc
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the emergency. The patient or respo
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physicians, dentists, nurses (pract
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. Each Uniformed Service secretary
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3-61. Treatment of former military
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Figure 3-2. Sample format memorandu
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4-3. Comfort items for patients a.
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Kingdom, and the United States The
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f. The MTF commander who starts act
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(1) Attempt to arrange transfer to
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(3) Patients who are being or have
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personal decisions will be assisted
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authorities, to the sponsor or NOK.
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(2) Enabling care (EC). AD patients
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patients in absent sick status, cha
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date the packet is mailed to the PE
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(4) A complete, current report of m
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Table 7-1 Distribution of medical b
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d. Instructions for the preparation
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. After approval by the Service rev
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. Soldiers who are in initial entry
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a. The following information will b
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c. Civilians interned by the Army.
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a. Members of the Army, RC, and app
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medical documents by submitting DD
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11-10. Audit and review The MSA is
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lost. The MSA must have the interna
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Figure 11-2. Sample memorandum form
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Chapter 12 Patients’ Trust Fund 1
Page 91 and 92: (2) Deposits and requests for check
Page 93 and 94: whom administrative responsibility
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Page 97 and 98: (4) Establish a process whereby all
Page 99 and 100: (1) Receive and open mail including
Page 101 and 102: d. Patient administrators of deploy
Page 103 and 104: AR 215-1 (not cited) Military Moral
Page 105 and 106: AR 36-2 Audit Services in the Depar
Page 107 and 108: VASRD Veteran’s Administration Sc
Page 109 and 110: DA Form 5009 Medical Record-Release
Page 111 and 112: Appendix B Persons authorized care
Page 113 and 114: Table B-1 Persons authorized care a
Page 127 and 128: (3) Is there a procedure in place t
Page 129 and 130: Glossary Section I Abbreviations AA
Page 131 and 132: EIN employee identification number
Page 133 and 134: MPRJ military personnel records jac
Page 135 and 136: REP 63 Reserve Enlistment Program o
Page 137 and 138: VA Veterans Affairs VARO Veterans A
Page 139 and 140: Disability separation Temporary or
Page 141: Maximum hospital benefit That point
Page 145 and 146: Convalescent leave, 5-1 Cosmetic su
Page 147 and 148: Civilian participants in Army-spons
Page 149 and 150: For assignment to WTU, 8-3 Outside
Page 151 and 152: Special consideration of USFHP bene
Page 153 and 154: Social Security, table 2-1, 3-21, 3
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Patient Administration - Army Publishing Directorate - U.S. Army

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