South Region BCAC and Communication Workgroup Partnership Meeting April 15, 2009.

South Region

BCAC and Communication Workgroup Partnership

Meeting

April 15, 2009

Beneficiary Counseling and Assistance Coordinator (BCAC)

andDebt Collection Assistance Officer

(DCAO)

Chief, Customer CommunicationsTMA, C&CS

Objectives

• Discuss Beneficiary Counseling and Assistance Coordinator (BCAC) and Debt Collection Assistance Officer (DCAO)

• Roles• Knowledge and Skills

• Recognize tools to assist in educational and operational responsibilities

BCAC - FY00 Authorization Act

• The SecDef shall require in regulation the establishment of BCAC positions– Each Regional/Area Office designates a full-time BCAC position– MTF Commanders designate a BCAC position as

primary/collateral duty

• Duties outlined in DoD Directive 6015.23– Delivery of Healthcare at Military Treatment Facilities; Foreign

Service Care; Third Party Collection; Beneficiary Counseling and Assistance Coordinators

– http://www.dtic.mil/whs/directives/corres/pdf/161523_103002/1601523p.pdf

• Provide toll-free communication

BCAC Roles and Responsibilities

• Serves as beneficiary advocate and problem-solver• Coordinates with appropriate points of contact throughout the MHS,

including Managed Care Support Contractor (MCSC) points of contact, to best meet beneficiary needs for information or assistance.

• Counsel beneficiaries and clarify information on their TRICARE benefit; consults with others as necessary.

• Work with functional experts to provide enrollment, beneficiary counseling, and claims processing information. BCACs shall describe or seek clarification on eligibility requirements and benefits based on the category of beneficiary seeking assistance.

• Ensures resolution, as often as possible within appropriate timeframe

• Case tracking/trending

DCAO – P&R Memo

• Under Secretary of Defense (Personnel &Readiness) Policy Memorandum, Debt Collection Assistance Officer Program to Assist Service Members with TRICARE Claims Collection Problems, 27 Jun 2000

– Each Regional Office (Lead Agent) designates a full-time BCAC position– MTF Commanders designate a BCAC position as primary/collateral duty– Response to troops is a priority

• Stand-up program world-wide in 30 days• No additional FTEs – utilize available resources

• Duties outlined in DCAO Implementation and Training Guide– http://www.tricare.mil/customerservicecommunity/documents/

DCAOImplementationTrainingGuideV3.pdf

DCAO Roles and Responsibilities - Overview

• To receive services from a DCAO, beneficiaries must present either a:– Letter from a collection agency indicating initiation of

active collection action; and/or– Credit report that reflects a negative credit status due to a

TRICARE payment Issue• Assist beneficiary in determining basis for debt collection• Collect copies of all pertinent documentation; i.e., provider

bills and notices, TRICARE EOBs, letters from providers/credit reporting agencies, etc.

• Obtaining an “Authorization for Disclosure of Medical or Dental Information” form

• Notify provider(s), collection or credit reporting agency that beneficiary’s case is under review.

Knowledge/Skills

• Thorough understanding of TRICARE program and policies– Practical knowledge of TRICARE regional contract– Knowledge of TRICARE special benefit/demonstration Programs (USFHP, CHCBP, etc)

• General understanding of the Military Health System• Skilled in oral/written communication• Experience in handling complex healthcare benefit problems

Operational Elements

• BCAC/DCAO contacted by the beneficiary assumes responsibility for the issue and/or inquiry

• Research and resolve the issue• Notify beneficiary of problem resolution

– Determine beneficiaries satisfaction with case outcome via oral, written, or automated process

• Track case through resolution

Assistance Reporting Tool (ART)

• Address the GAO recommendation to track beneficiary feedback

• Standardize MHS BCAC/DCAO data collection• Support beneficiary satisfaction through systematic issue

collection, tracking, resolution, and evaluation • Address Leadership’s need for location-specific information• Support development and use of marketing and educational

materials • Create a user-friendly system to support dual-hatted

BCACs/DCAOs– Workload management tool

• Capture beneficiary queries• Identify trends and address local/system-wide problems

– Maintain a centralized depository at TMA • Shifts administrative and management costs • Ensures DITSCAP compliance

• Real Time Data, Ad hoc report capabilities

Case Tracking

• Assigns a case identifier• Designate as BCAC/DCAO case • Resolution:

– 30 working days for non-priority BCAC cases– 60 working days for non-priority DCAO cases – 10 working days for congressional/priority inquires

• Response prepared by original BCAC/DCAO• Case categorized in ART; reports as needed

Principles

• Problem solving at the grass roots level• Responsiveness to customer• Maintain customer service focus

Tools

• http://www.tricare.mil/customerservicecommunity/resources.aspx – “Push” email capability– BCAC/DCAO links

• TRICARE University – http://www.tricare.mil/tricareu/TRICARE.mil

• TRICARE Resources– Manuals: http://manuals.tricare.osd.mil – HA Policy/Guidance: http://www.health.mil/HAPolicies.aspx

• Establish POCs– MTF – Regional/Area Office POCs– TMA & Service POCs– Contractor staff

BCAC Directory

• Directory contains names, locations, phone numbers, and email addresses – Public site; hidden site– Think about getting a non-specific email address– Identify if someone is being deleted as someone else is being

added.– Remember to forward phone number and email address

changes• TRICARE web site is updated as soon as the change is entered

QUESTIONS?

WWW.TRICARE.MIL

TRICARE Beneficiary Websitewww.tricare.mil/mybenefit

Site Overview

Tailored beneficiary content Beneficiary Category Location Health Plan Option

Customized applications Plan Wizard Compare Plans Covered Services

Spanish translation

Entering the Profile

Step 1 Select your beneficiary category Select your country 

Step 2 If you selected the United States, you’ll

need to enter your ZIP code. Step 3

Select your health plan option

Tailored Home Page

Your profile identified in header Most popular topics based on your

profile Some link directly to external

applications (i.e. Update DEERS) Special messages Announcements

Site Organization: Main Tabs

Overview Medical Dental Vision Prescriptions Mental Health & Behavior Life Events

Quick Tips to Find it Fast

Enter your profile Change the profile to see content for

another family member Click on “TRICARE Contacts” to

quickly find a toll-free number Click on “Forms” to get a form fast Use Google Custom Search

How We’re Doing (ACSI Scores)

ACSI Customer Satisfaction Scores - Apr. 01, 2008-Mar. 31, 2009

60

64

61

62 62

63

65

66

68

69 69 69

54

56

58

60

62

64

66

68

70

Month

Sc

ore

Scores

What’s Changing

Forced Profile New to TRICARE Enhanced tailored home pages Streamlined main tab pages Virtual tour

Forced Profile

New to TRICARE

Enhanced Home Page

Streamlined Main Tab Pages

TRICARE PUBLICATION PRODUCTION SCHEDULE

OVERVIEW

(Please refer to separate attachment.)

Q&A

Don’t forget to send your critique to [email protected]

Next meeting is on June 17, 2009.