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South Region BCAC and Communication Workgroup Partnership Meeting April 15, 2009
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Beneficiary Counseling and Assistance Coordinator (BCAC) and Debt Collection Assistance Officer (DCAO) Chief, Customer Communications TMA, C&CS
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Objectives Discuss Beneficiary Counseling and Assistance Coordinator (BCAC) and Debt Collection Assistance Officer (DCAO) Roles Knowledge and Skills Recognize tools to assist in educational and operational responsibilities
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BCAC - FY00 Authorization Act The SecDef shall require in regulation the establishment of BCAC positions –Each Regional/Area Office designates a full-time BCAC position –MTF Commanders designate a BCAC position as primary/collateral duty Duties outlined in DoD Directive 6015.23 –Delivery of Healthcare at Military Treatment Facilities; Foreign Service Care; Third Party Collection; Beneficiary Counseling and Assistance Coordinators –http://www.dtic.mil/whs/directives/corres/pdf/161523_103002/16 01523p.pdfhttp://www.dtic.mil/whs/directives/corres/pdf/161523_103002/16 01523p.pdf Provide toll-free communication
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BCAC Roles and Responsibilities Serves as beneficiary advocate and problem-solver Coordinates with appropriate points of contact throughout the MHS, including Managed Care Support Contractor (MCSC) points of contact, to best meet beneficiary needs for information or assistance. Counsel beneficiaries and clarify information on their TRICARE benefit; consults with others as necessary. Work with functional experts to provide enrollment, beneficiary counseling, and claims processing information. BCACs shall describe or seek clarification on eligibility requirements and benefits based on the category of beneficiary seeking assistance. Ensures resolution, as often as possible within appropriate timeframe Case tracking/trending
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DCAO – P&R Memo Under Secretary of Defense (Personnel &Readiness) Policy Memorandum, Debt Collection Assistance Officer Program to Assist Service Members with TRICARE Claims Collection Problems, 27 Jun 2000 –Each Regional Office (Lead Agent) designates a full-time BCAC position –MTF Commanders designate a BCAC position as primary/collateral duty –Response to troops is a priority Stand-up program world-wide in 30 days No additional FTEs – utilize available resources Duties outlined in DCAO Implementation and Training Guide –http://www.tricare.mil/customerservicecommunity/documents/DCAOImpl ementationTrainingGuideV3.pdf
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DCAO Roles and Responsibilities - Overview To receive services from a DCAO, beneficiaries must present either a: –Letter from a collection agency indicating initiation of active collection action; and/or –Credit report that reflects a negative credit status due to a TRICARE payment Issue Assist beneficiary in determining basis for debt collection Collect copies of all pertinent documentation; i.e., provider bills and notices, TRICARE EOBs, letters from providers/credit reporting agencies, etc. Obtaining an “Authorization for Disclosure of Medical or Dental Information” form Notify provider(s), collection or credit reporting agency that beneficiary’s case is under review.
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Knowledge/Skills Thorough understanding of TRICARE program and policies –Practical knowledge of TRICARE regional contract –Knowledge of TRICARE special benefit/demonstration Programs (USFHP, CHCBP, etc) General understanding of the Military Health System Skilled in oral/written communication Experience in handling complex healthcare benefit problems
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Operational Elements BCAC/DCAO contacted by the beneficiary assumes responsibility for the issue and/or inquiry Research and resolve the issue Notify beneficiary of problem resolution –Determine beneficiaries satisfaction with case outcome via oral, written, or automated process Track case through resolution
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Assistance Reporting Tool (ART) Address the GAO recommendation to track beneficiary feedback Standardize MHS BCAC/DCAO data collection Support beneficiary satisfaction through systematic issue collection, tracking, resolution, and evaluation Address Leadership’s need for location-specific information Support development and use of marketing and educational materials Create a user-friendly system to support dual-hatted BCACs/DCAOs –Workload management tool Capture beneficiary queries Identify trends and address local/system-wide problems –Maintain a centralized depository at TMA Shifts administrative and management costs Ensures DITSCAP compliance Real Time Data, Ad hoc report capabilities
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Case Tracking Assigns a case identifier Designate as BCAC/DCAO case Resolution: –30 working days for non-priority BCAC cases –60 working days for non-priority DCAO cases –10 working days for congressional/priority inquires Response prepared by original BCAC/DCAO Case categorized in ART; reports as needed
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Principles Problem solving at the grass roots level Responsiveness to customer Maintain customer service focus
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Tools http://www.tricare.mil/customerservicecommunity/resources.aspx –“Push” email capability –BCAC/DCAO links TRICARE University –http://www.tricare.mil/tricareu/TRICARE.milhttp://www.tricare.mil/tricareu/TRICARE.mil TRICARE Resources –Manuals: http://manuals.tricare.osd.milhttp://manuals.tricare.osd.mil –HA Policy/Guidance: http://www.health.mil/HAPolicies.aspxhttp://www.health.mil/HAPolicies.aspx Establish POCs –MTF – Regional/Area Office POCs –TMA & Service POCs –Contractor staff
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BCAC Directory Directory contains names, locations, phone numbers, and email addresses –Public site; hidden site –Think about getting a non-specific email address –Identify if someone is being deleted as someone else is being added. –Remember to forward phone number and email address changes TRICARE web site is updated as soon as the change is entered
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QUESTIONS?
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WWW.TRICARE.MIL
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TRICARE Beneficiary Website www.tricare.mil/mybenefit www.tricare.mil/mybenefit
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Site Overview Tailored beneficiary content Beneficiary Category Location Health Plan Option Customized applications Plan Wizard Compare Plans Covered Services Spanish translation
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Entering the Profile Step 1 Select your beneficiary category Select your country Step 2 If you selected the United States, you’ll need to enter your ZIP code. Step 3 Select your health plan option
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Tailored Home Page Your profile identified in header Most popular topics based on your profile Some link directly to external applications (i.e. Update DEERS) Special messages Announcements
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Site Organization: Main Tabs Overview Medical Dental Vision Prescriptions Mental Health & Behavior Life Events
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Quick Tips to Find it Fast Enter your profile Change the profile to see content for another family member Click on “TRICARE Contacts” to quickly find a toll-free number Click on “Forms” to get a form fast Use Google Custom Search
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How We’re Doing (ACSI Scores)
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What’s Changing Forced Profile New to TRICARE Enhanced tailored home pages Streamlined main tab pages Virtual tour
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Forced Profile
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New to TRICARE
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Enhanced Home Page
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Streamlined Main Tab Pages
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TRICARE PUBLICATION PRODUCTION SCHEDULE OVERVIEW (Please refer to separate attachment.)
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Q&A Don’t forget to send your critique to TROS_marketing@tros.tma.osd.mil TROS_marketing@tros.tma.osd.mil Next meeting is on June 17, 2009.
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