TRICARE Region South Coast Guard Healthcare Demonstration

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TRICARE Region SouthCoast Guard Healthcare
Demonstration
PURPOSE

• Increase access to care for ADSMs/ADFMs
• Decrease Emergency Room Cost/Utilization
• Increase Patient Satisfaction

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Coast Guard Only UCC Demo
WHAT

• 4 unmanaged visits (no prior referral
  authorization required) to any TRICARE Accepting,
  or Network Participating Urgent Care Center (UCC)
  or Primary Care Provider for acute/non-emergent
  care when your assigned Primary Care Manager
  (PCM) is unavailable.

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Coast Guard UCC DemoWHY

• 721.25 was an average Emergency Room (ERs) cost
  for Coast Guard beneficiaries in 2008.
• Visits to an UCC visit may cost 72.00, only 10
  of a ER visit.
• Convenience eliminates the hassle factor. You
  often wait for hours to be seen in an ER. Now,
  you can get health care for urgent conditions
  without lengthy wait times, when your assigned
  PCM is unavailable.
• This is a precious benefit for you and every
  member of family. Please take advantage of it.
• The majority of ER visits were for urgent care
  conditions ( fever, sore throat, earache, common
  colds, etc) This demonstration program should
  significantly reduce the costs of healthcare for
  the Coast Guard and the U.S. government.

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Coast Guard UCC Demo
A VISIT IS?

• A visit is any primary healthcare visit, (not
  specialty care visit) associated with a single
  episode of care (minor or acute illness or
  injury). Severe injury or illness should proceed
  to the nearest ER.
• EXAMPLE Mrs. Smith sprains her ankle in a
  soccer game on a Saturday afternoon. She goes to
  the nearest TRICARE accepting or network
  participating UCC for care First unmanaged
  visit
• The provider tells her to return Sunday
  morning for a follow-up visit Second unmanaged
  visit

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Coast Guard UCC Demo
WHO

• Who is eligible for this program, Coast Guard
  active duty and active duty family members
  enrolled in PRIME within TRICARE South Region
  only!

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Coast Guard UCC Demo
WHEN

• Extended until 4 MAY 2015.

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Coast Guard UCC Demo
WHERE

• Any TRICARE accepting or network-participating
  UCC. Network providers are searchable on
  Humanas website
• http//www.humana-military.com/

Beneficiary Portal
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Coast Guard UCC Demo
WHERE
Next follow the 1, 2, 3 steps to find an Urgent
Care Center
First, click on Type of Service
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Coast Guard UCC Demo
IMPORTANT TIPS

• For all EMERGENCIES- go directly to ER and/or
  Call 911
• The CG requires that ADSMs need to schedule a
  follow-up appointment with their PCM within 24
  hours of an Urgent Care Center visit or first
  business day following their visit.
• ADFMs should schedule a follow-up appointment
  with their PCM if their injury or illness does
  not improve.

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Contact Information

• Network Urgent Care Centers may be found by
  visiting Humana Militarys website
  http//www.humana-military.com and additional
  information on the project is available at the
  following website link http//www.humana-military
  .com/urgentcaredemo/ and information can be found
  on the TRICARE Regional Office Souths website at
  the following link http//www.tricare.mil/trosout
  h/Coast Guard health Safety Work Life points of
  contacts for this project is LCDR Leah Preston at
  (703) 681- 8716 or leah.preston_at_tma.osd.mil and
  LT William Chew, CG Liaison Officer to TRICARE
  Region South [phone] or William.Chew_at_tros.t
  ma.osd.mil and LT Cory McCollow at [phone]
  or Cory.J.McCollow_at_uscg.mil
• Following your visits to either an urgent care
  center or other Primary Care Manager for urgent
  care please give us your feedback at the
  following website https//surveys.uscg.mil/Commun
  ity/se.ashx?s6F20F77464644EF5 . Thank you