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

medical documents by submitting DD 2642 (CHAMPUS Claim Patient’s Request for Medical Payment) located on the
MMSO Web site (see para 10-7 above). Proof of payment and an itemized bill are required.
10–11. Elective care
Elective care in civilian medical treatment facilities or from other civilian sources is not authorized at Army expense.
Individuals choosing to seek medical/dental care outside the military health system, without prior approval of the MTF
responsible for providing their primary medical care, do so at their own risk. The Soldier should be aware that any
unfavorable outcome resulting from elective care provided by civilian sources could result in a not-in-line-of-duty
finding and potentially eliminates the possibility of receiving disability benefits from the PDES.
Chapter 11
Medical Services Accounts
11–1. Policies
The policies in a through e below apply to all fixed MTFs and table of organization and equipment (TOE) facilities
furnishing medical care on a reimbursable basis to eligible personnel. (See chap 2 and app B.)
a. If the volume of medical care furnished on a reimbursable basis at the MTF does not warrant the establishment of
a separate medical services account (MSA) (for example, U.S. Army health clinics with a small volume of pay
patients), the MTF commander may request an exception to the provisions of paragraphs 11-2 through 11-13 from the
ACOM commander.
b. ACOM commanders are authorized to grant an exception to establishing a separate MSA, if warranted, to MTFs
under their command jurisdiction.
c. Granting an exception to paragraphs 11-2 through 11-13 does not constitute a waiver of requirements to bill and
collect monies due. All accounting procedures specified in this chapter and in the Medical Services Account Users’
Manual will be followed.
d. The MSA accountability must be transferred when a MSAO is relieved or replaced. (See para 11-6 and fig 11-1.)
e. When the MSA is to be discontinued, the MSAO must make a discontinuance statement. (See para 11-7 and fig
11-2.)
11–2. Medical services accountable officer appointment
Each commander of fixed MTFs will appoint an MSAO by written orders. The MSAO may be a commissioned officer,
warrant officer, or civilian employee, not otherwise accountable for appropriated funds or Government property.
However, responsibility for property or custodianship of nonappropriated funds will not prevent appointment.
11–3. Medical services accountable officer deputy appointment
The MSAO may request, by written order, a deputy to assist with the MSA administration. The Deputy MSAO must
qualify under the MSAO criteria as stated in paragraph 11-2. During the MSAOs absence (not to exceed 30 days), the
deputy will assume the duties of the MSAO. If the MSAOs absence exceeds 30 days, the facility commander will
appoint a replacement.
11–4. Assistant medical services accountable officers
Military and civilian personnel will assist the MSAO with the MSA functions. The MSAO will designate MSA
personnel as cashiers. These persons will be assigned on either a full- or a part-time basis.
11–5. Emergency relief of the medical services accountable officer
When the MSAO must be replaced under conditions such as death, incapacity, or for cause, the installation or facility
commander will immediately appoint a disinterested officer to—
a. Count the MSA cash on hand.
b. Transfer the accountability to the newly appointed MSAO by performing the steps given in paragraph 11-6.
c. Follow procedures in paragraph 11-11 if shortage is found. The new MSAO will assume accountability subject to
an adjustment for any shortage.
11–6. Transfer of medical services accounts accountability
When the MSAO is being relieved or replaced, the MSAO will—
a. Ensure that all transactions to the time of transfer are posted to the MSA accounts and records are adequately
documented.
b. Ensure that all cash collections on hand are deposited to the servicing Defense Account Office (DAO).
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