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Show HBtap$ Juty 30. 1998 Urgent Care Clinic treats patients by appointment dard patients may call the appointment to see if a system at appointment is available. Patients requiring after hours care must be seen in the civilian community and use their TRICARE Standard benefits. by Marty Kessler Beneficiary Services Director 728-260- The Urgent Care Clinic at the base hospital treats TRI CARE Prime patients enrolled to the 75th Medical Group on an appointment basis with urgent medical needs. Clinic hours are 7:30 a.m.-- 8 p.m. weekon weekends and days, and 9 a.m.-noo- n holidays. Active duty family members, retirees and their family space-availab- le TRICARE Extra: Apreferred provider plan that allows TRICARE Standard patients the flexibility to use providers in the Prime network at a reduced cost Patients in this category have the same access to care at the 75th Medical Group as TRICARE Standard patients. Primary Care Manager: A medical professional, either military or civilian, who manages the patient's medical care. members need to know how to obtain care and what to do when the Urgent Care Clinic is closed. To help beneficiaries make health care decisions it's important to examine some terms, what they mean and how they affect patient care. PCMs may be family practitioners, pediatricians or other medical professionals. The 75th Medical Group maintains PCM teams in the Primary Care Clinic, Pediatrics and Flight Medicine. Emergency Care: Care necessary to avoid the loss of life, limb, or potential eyesight Patients who require this type of care should call 911 the Emergency and be treated at the Medical System nearest emergency room. For TRICARE Prime patients emergency care doesn't require an authorization from the patient's PCM; however, patients should notify their PCM within 48 hours after receiving care for medical management puris $10 poses. The patient's for active duty dependents whose sponsor's rank is E-- and below, $30 for active TRICARE Prime: A managed care plan modeled after civilian health maintenance organizations. This plan is the only one out of the three (Prime, Standard, Extra) requiring enrollment. Priority treatment is given to beneficiaries enrolled in Prime at all military hospitals and clinics. Under this program, military and civilian providers Primary Care manage and coordinate the Managers care. Prime patients may be seen in the Urgent Care Clinic. TRICARE Standard: This is the old CHAMPUS program under a new name. Patients who have elected to keep this type of coverage aren't eligible to be seen in the Urgent Care Clinic. They can only be seen at the 75th Medical Group on a space available basis during normal duty 4 and above, and retirees and their dependents. Standard and Extra patients pay the normal out duty dependents p.m. weekdays. Stan hours, 7:30 a.m.-4:3- 0 0 Office : OR E-- 5 390-TIN- T 8468 andor deductible). Accessing Urgent Care During patient cost (cost share ,. and After Hours of Operation: Urgent Care is considered acute in nature when a patient has a medical condition that requires immediate attention (a maximum of 24 hours). Some conditions may Lifetime ernment won't begin paying for the patient's care until after a $300 individual or $600 family deductible has been met. Even then, the patient will have a 50 percent cost share for all allowable charges. The bottom line is that if this happens, the patient will probably be paving for all or most of the care. nature. TRICARE Prime patients with acute medical conditions should contact the dur0 central appointment desk at a.m.-4:3- 0 hours normal (7:30 duty ing p.m. weekdays) to schedule an appointment with the Urgent Care Clinic. To schedule an appointment after normal n duty hours (4:30- - 8 p.m. weekdays, 9 weekends and holidays) contact the Patients Urgent Care Clinic at Ext requiring acute care after the Urgent Care or Clinic is closed should call Ext 728-260- Accessing Care While Out of the Area. TRICARE Prime active duty dependents, retirees and their dependents requiring out of area care while on vacation should follow the same rules as mentioned before. All patients enrolled a.m.-noo- The call will be received by ambulance will contact the PCM staff who, The PCM will contact the patient to PCMs at the 75th Medical Group should call and use the telephone menu options to talk to the appropriate PCM. The patient can also obtain an out of area care authorization by contacting the TriWest corporate office at Remember, care such as well-bab- y checks, routine physicals, annual pap smears, etc. won't be authorized. This n, on-cal- l. . and will tell the beneficiary how to obtain treatment. The average response time for the PCM to contact the patient is approximately 5 minutes (waiting times may vary). All TRICARE Prime care other than emergency care requires authorization from a PCM. Patients, who are unsure if they have an emergency and obtain civilian care without contacting the PCM first should contact the PCM within 48 hours after receiving care. If the care was ten Call Today for Free Estimate AUTO - HOME - COMMERCIAL Blocks up to 58 of suns heat Blocks up to 98 of UV Rays Reduces Fading & Glare Reduces Cooling Cost Makes Existing Glass Safer Highest Quality Materials Patients who don't contact a PCM and civilian care will receive be subject to TRICARE Prime Point "of Service Charges. This means the Gov- warrant treatment in less than 24 hours but aren't considered emergency by 4 775-078- necessary, the PCM will issue an authorization for the care after the fact If a patient receives an authorization for care from the PCM, the beneficiary should of $10 only be liable for the or $30, whichever is applicable. This applies as long as the providers who rendered care accept the CHAMPUS allowable charge. If the providers don't accept the allowable charge, the patient may be responsible for up to 15 percent above the allowable charge in addition to the care is considered routine in nature and could wait until the patient returns to the local area. For more details, contact a Beneficiary Service Representative at the TRICARE Service Center, or call 728-260- 0. mt&emm 4 4 Warranty Free Pick Up 1 Delivery A a "WE PAY TODAY!" rem mi .. 1 n I km n : O'fVfVf Tt-r.-- 4 mm ;. - r WEST VALLEY OGDEN 973-040- 4 622-891- 1 3460 S. Redwood Rd. Blvd. Canyon Plaza Shopping Center. 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