FORT BLISS, Texas -- Other health insurances are accepted by William Beaumont Army Medical Center, depending on the beneficiaries' plan, says an employee in the collections office of the hospital.
Christopher Valles, supervisor for third party collections office, says patients that are active duty dependents, non-active duty dependents and veterans are required to inform staff about other health insurances they possess, and this helps both the hospital and patients in many ways.
Tricare is the primary health insurance coverage for active duty and their dependents, and also retirees. According to Tricare, other health insurances are billed first, by law, and then Tricare pays the rest after that. If a patient has Medicare, then Medicare is billed first, then the OHI and Tricare pays last. Active-duty service members are not allowed to use OHI as Tricare is their only coverage.
This coordination of benefits has helped WBAMC.
"The money collected from third parties stays here, locally," said Denise Druckman, third party collections office employee. "It is used to improve hospital patient services in every aspect. This helps us provide exceptional service to our patients."
The hospital will not send beneficiaries a bill for amounts their carrier doesn't cover. WBAMC is entitled to receive the same benefits from third party payers, just like any other medical care provider. The patient's OHI will pay benefits directly to WBAMC and beneficiaries will not be billed for any uncollected charges. This gives the patient with OHI the benefit of meeting their annual deductible on their health insurance, without ever having to spend a dime.
Unlike automobile insurance premiums, a patient's OHI premium will not increase if not used because the health insurance premium is determined by calculated statistical risk data based on the patient's entire insured group. Having and using the OHI will not delay prescription fills either.
A patient survey was found that OHI information was not disclosed by patients because filling out the forms were too cumbersome. Filling out the OHI form every single time a patient had an appointment was considered useless and redundant. WBAMC has constructed a way to make this process extremely easy.
It's called the electronic Other Health Insurance form, or e-OHI. It is a digital form that is easily updated when the beneficiary comes in for any appointment. Trained medical support assistants ensure that the patient's Department of Defense number reflects the correct information on the form after it is auto-populated and is kept up to date, annually. This takes away the annoyance of having to sit and fill out the form manually when patients come to an appointment. WBAMC asks all beneficiaries to bring their OHI cards to their appointments to ensure current and correct information is attached to their medical record.
"William Beaumont is the first Army hospital doing this electronic form so that it will be more convenient for patients," said Valles. "This form is available on all the clinic portals and we are just trying to make it easier for the patients."
"If patients participate more, third party collection funds will help drastically improve the quality of the patient experience in every single way possible," said Valles.
Third party collections are nothing new. Since 1986, WBAMC has been conducting third party collections, and has seen significant growth since the new Affordable Care Act took effect.
"The good news is that we have made it easy to keep track of all this with the new e-OHI," said Druckman. "We are basically updating the information in the most convenient way possible. We listened to our patients and we want them to know that it is really easy to do."
"Secondary insurance payments allow us to put saved money to greater use," said Col. John A. Smyrski III, commander, WBAMC. "OHIs help reduce the cost burden on medical treatment facilities and the cost reduction gives a broader range of services within a constrained healthcare budget. This is a win-win situation for everyone and all we need to do is keep the e-OHI up to date for all our beneficiaries."
Beneficiaries with questions about OHI and how they can begin the process of filling out the OHI form can reach the third party collections office at 915-742-2444.
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