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With so many deployed troops and medical personnel, coordination of care between military treatment facilities (MTFs) and TRICARE’s network of civilian providers has never been more essential.
“When we experience deployments and a loss of military medical personnel, that’s when network providers are even more important,” according to Col. Joyce Grissom, chief, clinical quality program, TRICARE Management Activity. “Short of joining the military, the most patriotic thing civilian providers can do is to be willing to treat TRICARE patients.”
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Provider support of the local MTF is key. An MTF is a military hospital or clinic that is on or near a military base. All providers caring for TRICARE Prime patients either as primary care managers (PCMs) or specialists should refer patients to the local MTF first.
In some areas where many military medical personnel are deployed, more civilian TRICARE Network providers are assuming the role of PCM for deployed beneficiaries’ families and for non-deployed personnel enrolled in TRICARE Prime. When serving as a PCM, providers should always inquire with the MTF for both primary care and specialist treatment before sending a beneficiary elsewhere within the network.
The MTF is required to provide acceptance or refusal of that patient care request quickly, before the patient is reassigned to a TRICARE network provider.
“The MTF ‘right of first refusal’ will help us reach our goal of making the MTFs the most preferred provider within the network,” Donehoo says.
Grissom adds, “The MTFs are saying ‘try us first’ before you turn to another provider.”
It’s important not to make assumptions about the type of care offered at the local MTF. For instance, the type and degree of care varies from one MTF to another. MTFs range in size, from small clinics providing active duty personnel with primary care to very large, multi-specialist teaching hospitals.
During combat situations, as more medical personnel are deployed, the capacity and capabilities of the MTF also shift significantly. Specialty services that become unavailable due to deployment of an MTF clinician can become available when the specialist returns or when the deployed specialist is replaced or back-filled in the MTF by another civilian or military clinician of the same specialty.
“Communication between the MTF and the network is crucial. The very purpose of the network providers is to complement the military resources as our capacity shifts up and down,” Grissom says. “We need to work as a team as patients flow across the system, with the goal of consistent, quality care.
“Our troops and their families should always be getting the right care, regardless of our deployment situation.”
Learn more about your local MTFs and right of first refusal guidelines by reviewing your TRICARE Provider Handbook or the TRICARE Web site at http://www.tricare.osd.mil/mtf/Main.cfm.
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