Air Force addressing TRICARE issues

By Lt. Gen. Charles Roadman

Back in January I promised to make sure that TRICARE would work in the Abilene area and to assure the patients, medical providers and military community that we would fix the problems that occurred as TRICARE was implemented there.

A TRICARE working group, composed of local health care providers along with representatives from the contractor and military, have focused on improved billing and claims processing, better education of all parties about TRICARE, better customer service and specific TRICARE policy issues.

This is where we stand to date:

-- Ninety-six percent of the 2,700 claims from August 1996 through January 1997 have been processed. Foundation's commitment is that final resolution on 100 percent will be completed this month.

-- To date, 103 of the 105 specific patient cases identified to the contractor have been contacted, and 88 percent have been resolved or are well on their way to resolution.

-- All 41 of the beneficiaries and providers who raised questions or issues at the town meeting have been contacted and their concerns answered.

-- We now have several provider groups who will now accept assignment and see TRICARE patients. We are expanding the provider network, particularly including specialty care providers.

-- Foundation has established three toll-free lines for people to use for their questions and concerns.

-- They have also established a "provider callback system" where a specific Foundation employee is assigned as a contact with each provider's office, ensuring continuity by allowing the provider to talk to the same person every time they call.

n We also made available a simple checklist for providers and patients to help reduce common billing errors, and a local provider group is testing a new electronic billing program.

-- On-going efforts to provide timely, accurate information - including the distribution of new handbooks, TRICARE education workshops for providers and additional information briefings for active duty, family members and retirees - have begun.

-- To ensure future contract compliance, the independent audit firm Price Waterhouse is reviewing a representative number of claims.

We're well down the road to getting TRICARE in Abilene heading in the right direction and running smoothly - but we still have a lot of work to do.

We value the community concerns and will work to find the best solutions possible.

Our beneficiaries and our TRICARE partners deserve nothing less.

Lt. Gen. Charles H. Roadman II is Air Force Surgeon General, the top doctor in the U.S. Air Force.