View Full Version : Dependents’ off-base care on Okinawa to be billed to Tricare

09-24-08, 09:22 AM
Dependents’ off-base care on Okinawa to be billed to Tricare
Families no longer will need to pay up-front costs at hospitals
By Vince Little, Stars and Stripes
Pacific edition, Thursday, September 25, 2008

TORII STATION, Okinawa — Military dependents on Okinawa covered by Tricare will soon be able to receive treatment at off-base hospitals without having to pay up front, Navy officials said Tuesday during an Army Family Action Plan steering committee meeting.

U.S. Naval Hospital officials from Camp Lester said the new agreement with prefectural medical facilities goes into effect Oct. 1.

The delayed billing process already is in place for active-duty servicemembers.

The panel said costly major procedures had led to financial hardships. In some cases, military members obtained expensive loans or took out second mortgages to make payments before insurance could kick in.

Under the new plan, military family members can get care at prefectural hospitals and the debt will be settled through Tricare, Navy officials said.

The committee said it’s trying to make a similar arrangement for Department of Defense civilians, Department of Defense Dependents Schools teachers and other non-Tricare beneficiaries.

Col. Robert Waltemeyer, the U.S. Army Garrison-Japan commander, said prefectural hospitals were reluctant to waive the "pay-as-you-go" system because of unpaid debts by military personnel, some of which stretched back a decade. But the books have now been cleared, he added.

He also said he will raise the issue at a U.S. Forces Japan commanders conference next month in an effort to extend the new plan to the mainland.

Army child care

The Army will begin paying added costs incurred by its families for exceeding time limits at child development centers on Kadena Air Base, the committee announced.

The facilities charge an extra fee if a child stays longer than 10 hours a day or 50 hours in a week. Army families make up 50 percent of such requirements, officials said.

Maj. Jim Crawford, a U.S. Army Japan spokesman, said about 1,400 soldiers are assigned to Okinawa. Roughly 800 are accompanied by dependents.

Panel looks at travel costs

Soldiers and families traveling between Okinawa and the United States on leave may get compensated for added transportation costs under a proposal being considered by the AFAP steering committee.

Waltemeyer said the Army wants to ease the personal financial burden caused by additional legs to and from Narita International Airport, as well as ground transportation expenses on the island.

Such costs aren’t a factor for soldiers on the mainland. At Camp Zama, they get free shuttle service to Narita.

Increasing cost-of-living allowance is a possible solution for Okinawa-based soldiers, according to Waltemeyer. He said a request might be sent up to U.S. Army Pacific in Hawaii.

Army seeking mental-health provider

The Army on Okinawa will hire a social worker or psychologist to alleviate its reliance on other branches for mental health services, said Col. Marilyn Brew, the U.S. Army Medical Activity-Japan commander.

Committee members said no-shows and canceled appointments by soldiers and dependents have placed even more stress on the U.S. Naval Hospital at Lester and Kadena’s behavioral health clinic.

Brew said it’s unclear how soon a specialist could be hired.

Commander praises AFAP efforts

The USARJ and I Corps (Forward) commander attended Tuesday’s session and praised the committee’s efforts to improve quality of life for soldiers and families on the island.

Brig. Gen. Frank Wiercinski also said personnel should take time to learn about what the program has to offer.

"Some people don’t take advantage of everything that’s available," he added. "They should come to town hall meetings and take a look at AFAP issues and services."

AFAP, now in its 25th year, is a tool the command uses to monitor the welfare of Army families and track issues such as health care, education, housing and youth activities.

"Without it, we might not know if there’s a problem," said USARJ Command Sgt. Maj. William Franklin. "When we find out, we can try to put fixes and assistance programs in place. … If you’ve got the ill, we’ve got the pill."


10-10-08, 06:30 AM
TRICARE billing policy for off-base care now includes family members
Brian J. Davis
USNH Okinawa Public Affairs Officer

CAMP LESTER, Okinawa (October 10, 2008) -- In an effort to ease the financial burden of active duty family members referred off base for medical care in Okinawa, U.S. Naval Hospital Okinawa has expanded its deferred payment policy agreements with local medical facilities to include all TRICARE Prime beneficiaries.

Hospital officials occasionally refer patients to local facilities for diagnostic tests or specialty medical services not available at military facilities on the island. However, procedural differences lie in the area of billing and payment for patients not covered by Japan's national health insurance.

"Japanese medical facilities work on a 'pay-as-you-go' system" said Capt. Brian S. Dawson, commanding officer of U.S. Naval Hospital Okinawa.

"Payment in full-in cash-is due at the time of discharge. If, for example, your child has been in the hospital for specialized care for any period of time, the bill can run into the thousands of dollars. For an E-3 or E-4 with a family, having to come up with that kind of money can be a catastrophic financial burden," he said.

Under the current TRICARE policy, a beneficiary must submit a claim for reimbursement after the bill is paid, and some families have reported difficulties meeting the up-front costs, said Dawson.

In response, the Naval Hospital has been working with TRICARE and the local medical establishment to find an alternative.

"We made individual arrangements with each of the local hospitals and clinics that we work with to defer payment and bill the Naval Hospital," said Naval hospital assistant comptroller Navy Lt. Jeremy H. Westcott. "We have been doing this with active duty members, but starting in October, the policy expanded to include active duty family members covered under TRICARE Prime."

The procedure is simple. When the patient's health care provider determines off-base referral is necessary, the provider will fill out the necessary referral paperwork.

The referral paperwork then goes to the hospital's TRICARE office for review and verification of the patient's TRICARE Prime coverage.

Once the paperwork is in order, the TRICARE representative will affix a green stamp on the referral form, which the patient turns over to the off- base medical facility.

The Japanese hospital or clinic will then the send the bill for services directly to the Naval Hospital.

The new policy states the program is currently available only to active duty personnel and family member beneficiaries covered under TRICARE Prime who are referred off base for medical care by a provider at the Naval Hospital.

The only off-base facilities that fall under this policy are hospitals and clinics that are used for referrals and have made prior agreements with the Naval Hospital for billing.

The policy does not apply to patients seeking off base care on their own.