the world’s leading medical assistance company “ Your Passport to Quality Health”
Overview <ul><li>Program purpose </li></ul><ul><li>SOS London/tricare functional organizational structure </li></ul><ul><l...
Program Purpose EUCOM CENTCOM <ul><ul><li>Expansive area </li></ul></ul><ul><ul><li>Difficult to reach locations </li></ul...
<ul><li>As of 1st July 2001   As of 1st August 2002 </li></ul><ul><ul><li>Egypt -  Djibouti </li></ul></ul><ul><ul><li>Eth...
Global Remote Program EUCOM  and outside of Continental United States Start Date: 1 SEPTEMBER 03 the world’s leading medic...
GOALS <ul><li>Provide  Cashless Access  to Care  </li></ul><ul><li>Ensure  Quality  of providers and facilities </li></ul>...
International SOS International SOS
International SOS <ul><ul><li>Worlds leading medical  assistance company </li></ul></ul><ul><ul><li>More than  20 years  e...
International SOS <ul><ul><li>Provides active duty and their families assigned to remote locations the following: </li></u...
International SOS Facts & Figures <ul><li>3,000 professionals   </li></ul><ul><ul><li>24 call centers </li></ul></ul><ul><...
Hospital Evaluation Criteria <ul><li>Physical plant </li></ul><ul><li>Hygiene </li></ul><ul><li>Medical staff </li></ul><u...
Physician Evaluation Criteria   <ul><li>Minimum criteria: </li></ul><ul><ul><li>graduate of an  accredited  medical school...
TRICARE Program
Service Delivery  <ul><li>Receipt of new request </li></ul><ul><ul><li>By e-mail </li></ul></ul><ul><ul><li>By fax  </li><...
Routine Care <ul><li>For Active Duty (AD)and Active Duty Family Members(ADFM) </li></ul><ul><li>Primary Care Providers </l...
Urgent / Emergent Care
Urgent / Emergent Care <ul><li>For AD / ADFM and  TDY/TAD personnel </li></ul><ul><li>Urgent Care </li></ul><ul><ul><li>Re...
Authorization Process
Medical Authorization <ul><li>Member’s eligibility </li></ul><ul><ul><li>Verification through  DEERS </li></ul></ul><ul><u...
Medical Authorization <ul><li>Approval </li></ul><ul><ul><li>Medical Department to review request and provides approval wi...
Dental Care
AD Dental Authorization <ul><li>Member’s eligibility  </li></ul><ul><ul><li>Active duty (permanent party) </li></ul></ul><...
ADFM Dental Authorization <ul><ul><li>Referral services only </li></ul></ul><ul><ul><li>Same network dentist </li></ul></u...
Evacuation Process
Medical (Air) Evacuation <ul><li>Emergency  Only </li></ul><ul><li>SOS Responsibilities </li></ul><ul><ul><li>Contact Thea...
SOS Dedicated Air Ambulance Locations 30 o W <ul><ul><li>Europe:  Baden Baden (Lear 55) </li></ul></ul><ul><ul><li>Africa:...
SOS Dedicated Air Ambulances 30 o W 17 o E 5 o S, 68°E Indian Ocean Atlantic Ocean Pacific Ocean 42 o E          
Your Role
<ul><li>Review  local provider list  </li></ul><ul><li>Provide  International SOS with a  </li></ul><ul><li>preferred prov...
<ul><li>Educate  military and family members  </li></ul><ul><li>about the TRICARE -International  </li></ul><ul><li>SOS Gl...
Global Remote Program EUCOM  and outside of Continental United States Start Date: 1 SEPTEMBER 03 the world’s leading medic...
the world’s leading medical assistance company “ Your Passport to Quality Health”
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the world's leading medical assistance company

  1. 1. the world’s leading medical assistance company “ Your Passport to Quality Health”
  2. 2. Overview <ul><li>Program purpose </li></ul><ul><li>SOS London/tricare functional organizational structure </li></ul><ul><li>Routine care </li></ul><ul><li>Urgent / emergent care </li></ul><ul><li>Authorization process </li></ul><ul><li>Air evacuation </li></ul>
  3. 3. Program Purpose EUCOM CENTCOM <ul><ul><li>Expansive area </li></ul></ul><ul><ul><li>Difficult to reach locations </li></ul></ul><ul><ul><li>Many command structures with multiple and varied missions </li></ul></ul><ul><ul><li>Complex inter-governmental relationships </li></ul></ul>
  4. 4. <ul><li>As of 1st July 2001 As of 1st August 2002 </li></ul><ul><ul><li>Egypt - Djibouti </li></ul></ul><ul><ul><li>Ethiopia - Eritrea </li></ul></ul><ul><ul><li>Kenya </li></ul></ul><ul><ul><li>Kuwait </li></ul></ul><ul><ul><li>Pakistan </li></ul></ul><ul><ul><li>Saudi Arabia </li></ul></ul><ul><li>As of 1st June 2002 As of 1st October 2002 </li></ul><ul><ul><li>Jordan - Kazakhstan (Almaty) </li></ul></ul><ul><ul><li>Oman - Kyrgyzstan (Bishkek) </li></ul></ul><ul><ul><li>Qatar - Turkmenistan (Ashgabat) </li></ul></ul><ul><ul><li>UAE - Uzbekistan (Tashkent) </li></ul></ul>CENTCOM
  5. 5. Global Remote Program EUCOM and outside of Continental United States Start Date: 1 SEPTEMBER 03 the world’s leading medical assistance company “ Your Passport to Quality Health”
  6. 6. GOALS <ul><li>Provide Cashless Access to Care </li></ul><ul><li>Ensure Quality of providers and facilities </li></ul><ul><li>Manage Costs </li></ul>
  7. 7. International SOS International SOS
  8. 8. International SOS <ul><ul><li>Worlds leading medical assistance company </li></ul></ul><ul><ul><li>More than 20 years experience </li></ul></ul><ul><ul><li>Offices in 39 countries </li></ul></ul><ul><ul><li>Over 200 full time physicians </li></ul></ul><ul><ul><li>Medical referral network in more than 150 countries </li></ul></ul>
  9. 9. International SOS <ul><ul><li>Provides active duty and their families assigned to remote locations the following: </li></ul></ul><ul><ul><li>“ Credentialed” provider network </li></ul></ul><ul><ul><li>PCM concept of operations/advice line, self care </li></ul></ul><ul><ul><li>24/7 call center </li></ul></ul><ul><ul><li>Referral/Utilization Management </li></ul></ul><ul><ul><li>Emergency air evacuation if military assets are not available/feasible </li></ul></ul><ul><ul><li>Cashless and claimless services </li></ul></ul>
  10. 10. International SOS Facts & Figures <ul><li>3,000 professionals </li></ul><ul><ul><li>24 call centers </li></ul></ul><ul><ul><li>Offices in 43 countries </li></ul></ul><ul><ul><li>300 full-time medical staff </li></ul></ul><ul><ul><li>Over 40 in-house languages </li></ul></ul><ul><li>Network of credentialed medical providers </li></ul><ul><li>Handles thousands of cases every day </li></ul><ul><li>Perform one evacuation every hour </li></ul><ul><li>Provide healthcare to 180,000 each year through international SOS clinics </li></ul>
  11. 11. Hospital Evaluation Criteria <ul><li>Physical plant </li></ul><ul><li>Hygiene </li></ul><ul><li>Medical staff </li></ul><ul><li>Nursing staff </li></ul><ul><li>Diagnostic capabilities </li></ul><ul><li>Surgical and intensive care capabilities </li></ul><ul><li>Emergency services </li></ul><ul><li>Administrative organization </li></ul><ul><li>Financial considerations </li></ul>
  12. 12. Physician Evaluation Criteria <ul><li>Minimum criteria: </li></ul><ul><ul><li>graduate of an accredited medical school </li></ul></ul><ul><ul><li>licensed </li></ul></ul><ul><li>Office location and hygiene </li></ul><ul><li>Experience treating foreign patients </li></ul><ul><li>English language proficiency </li></ul><ul><li>Hospital affiliation </li></ul><ul><li>Overseas training </li></ul><ul><li>Local reputation </li></ul><ul><li>Availability </li></ul>
  13. 13. TRICARE Program
  14. 14. Service Delivery <ul><li>Receipt of new request </li></ul><ul><ul><li>By e-mail </li></ul></ul><ul><ul><li>By fax </li></ul></ul><ul><ul><li>By phone </li></ul></ul><ul><ul><ul><li>From POC </li></ul></ul></ul><ul><ul><ul><li>From Provider </li></ul></ul></ul><ul><ul><ul><li>From Member </li></ul></ul></ul><ul><ul><ul><li>From TEO </li></ul></ul></ul>
  15. 15. Routine Care <ul><li>For Active Duty (AD)and Active Duty Family Members(ADFM) </li></ul><ul><li>Primary Care Providers </li></ul><ul><ul><li>Mainly seen by HU / MTF for GP </li></ul></ul><ul><ul><li>Dental and OB-GYN </li></ul></ul><ul><ul><li>Wellness Program investigations </li></ul></ul><ul><li>Specialist care Providers </li></ul><ul><ul><li>Referral from HU / MTF </li></ul></ul><ul><ul><li>Notification to SOS through local POC </li></ul></ul><ul><ul><li>Orthopedist, Ophthalmologist and Dermatologist </li></ul></ul>
  16. 16. Urgent / Emergent Care
  17. 17. Urgent / Emergent Care <ul><li>For AD / ADFM and TDY/TAD personnel </li></ul><ul><li>Urgent Care </li></ul><ul><ul><li>Requiring medical intervention within 24 hours </li></ul></ul><ul><li>Emergent Care </li></ul><ul><ul><li>Requiring medical intervention within 4 hours </li></ul></ul><ul><li>Hospitalization and Patient movement </li></ul>
  18. 18. Authorization Process
  19. 19. Medical Authorization <ul><li>Member’s eligibility </li></ul><ul><ul><li>Verification through DEERS </li></ul></ul><ul><ul><li>Confirmation from POC/TEO on patient’s status </li></ul></ul><ul><li>Medical information </li></ul><ul><ul><li>Patient’s problem identified </li></ul></ul><ul><ul><li>Services required </li></ul></ul><ul><li>Referral Letter for Specialist care provided </li></ul>
  20. 20. Medical Authorization <ul><li>Approval </li></ul><ul><ul><li>Medical Department to review request and provides approval within the parameters of the TRICARE program </li></ul></ul><ul><li>Guarantee Letter ( GOP ) </li></ul><ul><ul><li>Issue Guarantee Letter to provider, copy to POC as appropriate </li></ul></ul>
  21. 21. Dental Care
  22. 22. AD Dental Authorization <ul><li>Member’s eligibility </li></ul><ul><ul><li>Active duty (permanent party) </li></ul></ul><ul><ul><li>Network dentist </li></ul></ul><ul><ul><li>Cashless claimless </li></ul></ul><ul><li>Dental information </li></ul><ul><ul><li>Patient’s problem identified </li></ul></ul><ul><ul><li>Services required </li></ul></ul><ul><li>GOP (guaranteed letter of payment AD only) </li></ul><ul><ul><li>For current/approved treatment </li></ul></ul><ul><ul><li>“ Other” treatment must be approved prior </li></ul></ul>
  23. 23. ADFM Dental Authorization <ul><ul><li>Referral services only </li></ul></ul><ul><ul><li>Same network dentist </li></ul></ul><ul><ul><li>Family Member must file claim with UCCI (United Concordia Companies inc.) </li></ul></ul><ul><ul><li>No GOP </li></ul></ul>
  24. 24. Evacuation Process
  25. 25. Medical (Air) Evacuation <ul><li>Emergency Only </li></ul><ul><li>SOS Responsibilities </li></ul><ul><ul><li>Contact Theatre Patient Movement Requirements Center (TPMRC) all EVAC’s </li></ul></ul><ul><ul><li>Contact TRICARE Europe (TEO) update on patient’s status </li></ul></ul>
  26. 26. SOS Dedicated Air Ambulance Locations 30 o W <ul><ul><li>Europe: Baden Baden (Lear 55) </li></ul></ul><ul><ul><li>Africa: Johannesburg (Falcon 10, Lear 25 & Beechcraft C90) </li></ul></ul><ul><ul><li>Gaborone (Cessna 402) </li></ul></ul><ul><ul><li>Windhoek – (Cessna Citation II) </li></ul></ul><ul><ul><li>CIS: Moscow (Hawker 125-1A) </li></ul></ul><ul><ul><li>Far East: Singapore (Falcon 200) </li></ul></ul><ul><ul><li>Beijing (Hawker 800XP) </li></ul></ul><ul><ul><li>Australasia: Port Moresby – (Citation II) </li></ul></ul>
  27. 27. SOS Dedicated Air Ambulances 30 o W 17 o E 5 o S, 68°E Indian Ocean Atlantic Ocean Pacific Ocean 42 o E          
  28. 28. Your Role
  29. 29. <ul><li>Review local provider list </li></ul><ul><li>Provide International SOS with a </li></ul><ul><li>preferred provider list </li></ul><ul><li>( you will be contacted ) </li></ul><ul><li>Your Role as a : </li></ul><ul><li>TRICARE POC </li></ul><ul><li>Healthcare/Health Unit Provider </li></ul>the world’s leading medical assistance company “ Your Passport to Quality Health”
  30. 30. <ul><li>Educate military and family members </li></ul><ul><li>about the TRICARE -International </li></ul><ul><li>SOS Global Remote program </li></ul><ul><li>Coordinate w/TRICARE Europe </li></ul><ul><li>Your Role as a : </li></ul><ul><li>TRICARE POC </li></ul><ul><li>Healthcare Provider </li></ul>the world’s leading medical assistance company “ Your Passport to Quality Health”
  31. 31. Global Remote Program EUCOM and outside of Continental United States Start Date: 1 SEPTEMBER 03 the world’s leading medical assistance company “ Your Passport to Quality Health”
  32. 32. the world’s leading medical assistance company “ Your Passport to Quality Health”
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