By Kimbrough Clinical OperationsApril 29, 2011
FORT GEORGE G. MEADE, Md. (April 28, 2011) -- Over the past year, Kimbrough Ambulatory Care Center has made many improvements. An upgrade to services has been the hiring of additional primary care managers (PCM) to meet health care needs and to implement a team-based approach.
Kimbrough Department of Primary Care is converting to a Patient-Centered Medical Home that should improve health care access. The Patient-Centered Medical Home approach is team-based. If your PCM is not available, one of the other providers on the team will see you and communicate with your PCM.
With this new approach, Kimbrough is reminding you of the guidelines that Tricare has in place to ensure quality health care without additional out-of-pocket expense.
* If you have a genuine emergency (threat to life, limb or eyesight), immediately call 911 or go to the nearest emergency room. You do not need a referral or prior authorization before receiving emergency care.
* If you need urgent care (cannot wait to be seen in the clinic the following day), whether in or out of your home region, you must contact your PCM or the on-call physician to coordinate urgent care services and authorization for care.
You should not obtain care outside the clinic unless you first receive guidance from the clinic by calling one of the following numbers:
* During clinic hours: Mondays through Fridays from 7:30 a.m. to 4:30 p.m., call 301-677-8606. If no appointments are available for the same day, please ask to be transferred to a clinic nurse.
* After clinic hours, holidays and weekends: If you need medical assistance outside of regular hours, call 1-866-379-3981.
You can discuss your situation with the on-call provider and decide how to best handle your medical situation. Depending on the illness and circumstance, you may be directed to an emergency room, an urgent care center, asked to come in for an office visit the next day, or given self-treatment measures to perform at home.
* Failure to follow this guideline may leave you with higher out-of pocket expenses for which you will be responsible. If your urgent care is not coordinated and authorized by your PCM or the on-call provider ahead of time, it will be covered under Tricare Prime's point-of-service option. This option has higher cost shares and a deductible.
For information on this or any other Tricare question, please call 1-877-874-2273.