Third Party Liability, Explanation of Benefits and Debt Collection Assistance Officers

The Federal Medical Care Recovery Act allows TRICARE to be reimbursed for its costs of treatment if you are injured in an accident that was caused by someone else. The DD Form 2527 Statement of Personal Injury Third Party Liability form will be sent to you if a claim is received that appears to have third-party involvement. Within 35 calendar days, you must complete and sign this form and follow the directions for returning the form to the appropriate claims processor.

A TRICARE explanation of benefits (EOB) is not a bill. It is an itemized statement that shows what action TRICARE has taken on your claims. An EOB is for your information and files.

After reviewing the EOB, you have the right to appeal certain decisions regarding your claims. You can file an appeal in writing within 90 days of the date of the EOB notice. (For more information about appeals, see the Information and Assistance section.) You should keep EOBs with your health insurance records for reference.  View a sample South EOB with instructions.

Debt Collection Assistance Officers (DCAOs) are located at military treatment facilities (MTFs) and the TRICARE Regional Offices (TROs) to assist you in resolving health care collection-related issues. Contact a DCAO if you have received a negative credit rating or have been sent to a collection agency due to an issue related to TRICARE services.

When you visit a DCAO for assistance, you must bring or submit documentation associated with a collection action or adverse credit rating, including debt collection letters, EOB statements, and medical/dental bills from providers. The more information you can provide, the faster the cause of the problem will be determined. The DCAO will research your claim, provide you with a written resolution of your collection problem, and inform the collection agency that action is being taken to resolve the issue. DCAOs cannot provide legal advice or repair your credit rating, but they can help you through the debt collection process by providing documentation for the collection or credit-reporting agency to explain the circumstances relating to the debt. To find a DCAO near you, visit the DCAO directory.