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20th Medical Group
 Patient Handbook
        2013
FROM THE COMMANDER



         Welcome to your medical group! The health care professionals of the
20th Medical Group are dedicated to providing the best health care prevention and
treatment services possible. This pamphlet will help you understand how to access
medical services while at Shaw Air Force Base.

         The availability of specific programs or services may vary according to
operational requirements of the 20th Fighter Wing. In the event we cannot provide
the care you require, our TRICARE office staff will work with you to arrange
for your health care at another military treatment facility or through our civilian
provider network.

          Total quality health care through your Patient Centered Medical Home
includes a responsive appointment system, a prompt and accurate pharmacy ser-
vice, health prevention, health education and health promotion programs that reach
out to our community. We strive to provide these services and many more. We rely
on your help to identify areas for improvement through questionnaires and sugges-
tions through our Customer Feedback Program. These tools help us to constantly
re-evaluate the methods and types of services we provide. We invite and encourage
you to take an active part in this process. Also, if you wish to share your time and
talents, we would love to have you as part of our Red Cross volunteer team. If in-
terested in becoming a volunteer, call 895-6654.

         Again, welcome to the 20th Medical Group! We look forward to
partnering with you for all of your healthcare needs.



                                          ////SIGNED////
                                    DEAN B. BORSOS, Colonel, USAF, MSC
                                    Commander, 20th Medical Group




                                         2
INTRODUCTION

This pamphlet was prepared to assist you in understanding the services
available from the 20th Medical Group, Shaw Air Force Base, South Carolina.
We encourage you to familiarize yourself with the contents of this pamphlet, as
it will aid you in obtaining health care and other services.

About the 20th Medical Group
The 20th Medical Group (20 MDG) provides ambulatory medical and dental
services to the 20th Fighter Wing, Headquarters 9th Air Force, USAFCENT,
USARCENT, Shaw associate units and thousands of military retirees in the area.
The Shaw clinic is accredited by the Accreditation Association for Ambulatory
Health Care (AAAHC). The 20 MDG provides primary care services with
aerospace medicine, limited specialty care and ancillary (pharmacy, laboratory,
radiology) capabilities. We do not provide inpatient or emergency services but
ambulance services are available to on base personnel at all times by calling 911.
Outpatient care is provided for pediatric through geriatric patients. Shaw clinic’s
range of services include pediatrics, family health, flight medicine, limited
gynecological services, oral surgery, general dentistry, periodontics,
prosthodontics, physical therapy, optometry, mental health, family advocacy,
laboratory, pharmacy, public health, radiology, health & wellness, and
immunizations. All care not performed at Shaw AFB is arranged through referrals
to a robust network of military hospitals and TRICARE civilian medical resources
in the surrounding communities. We are fortunate to be surrounded with extremely
high caliber medical services and most specialties within a reasonable distance of
the base.

                                Mission Statement

                  Prepare and maintain medically ready forces…
                   Prevent, Heal, Deploy, Anytime, Anywhere.

                                 Vision Statement

        Maximize combat capability by providing unparalleled healthcare.


Medical Group Organization
The 20th Medical Group is comprised of four squadrons, which operate under
the direction of the group commander and his support staff.

Key telephone numbers for each of the major functions are listed inside the back
cover of this pamphlet.


   The single access telephone number for the 20 MDG is 895-CARE (2273).

                                         3
TABLE OF CONTENTS

From the Commander                                  2

Introduction                                        3

Table of Contents                                   4

Patient Policies                                    6

         Eligibility for Health Care                6
         DEERS                                      6
         Appearance and Behavior                    6
         Smoking Policy                             7
         Medical Records                            7
         Third Party Collection Program             7
         No Show Appointments                       8
         Late Show Appointments                     8

Patient Information                                 9
         Patient Appointments                       9
         TRICARE Online                             9
         TRICARE Service Center                     9
         Referrals                                  10
         TRICARE Dental Program                     10
         Beneficiary Counseling/Claims Assistance   10
         Advance Directives                         10

Customer Assistance/Concerns                        11
         Patient Advocate Program                   11
         Ethics Hearings                            11

Patient Rights and Responsibilities                 12
         Patient Rights                             12
         Patient Responsibilities                   13
         Privacy Rights/HIPAA                       13




                                          4
Clinical Services and Programs                                 14
        Ambulance Services                                     14
        Medical In-processing                                  14
        Patient Center Medical Home                            15
        Family Health Clinic                                   15
        Pediatric Clinic                                       15
        Women’s Health Clinic                                  16
        Mental Health Clinic and Family Advocacy               16
        Exceptional Family Member Program                      17
        Physical Therapy                                       17
        Immunizations                                          17

Aerospace Medicine                                             17
        Flight Medicine Flight                                 17
        Health Promotion Flight
        - Health and Wellness Center (HAWC)                    18
        Public Health Flight (occupational health)             18
        Optometry Services Element                             19
        Bioenvironmental Engineering Flight                    19
        Aerospace Physiology Flight                            19

Dental Services                                                20

Ancillary and Support Services                                 20
        Laboratory                                             20
        Diagnostic Imaging/Radiology Services (X-Ray)          21
        Pharmacy                                               21
        Volunteers                                             22

Performance Improvement, Patient Safety                        22

Accreditation Association for Ambulatory Health Care (AAAHC)   23

What are Medical Errors?                                       23

20 Tips to Help Prevent Errors                                 24

20th Medical Group Key Numbers                                 27

Web Resources                                                  28




                                        5
PATIENT POLICIES

Eligibility for Health Care
    The principal mission of the 20th Medical Group is to provide health care to
    active duty military patients. Many of the Clinic’s services are available to
    active duty dependents, as well as retirees and their dependents if enrolled in
    TRICARE Prime or TRICARE Plus. There is very limited capacity for space
    available services to those not enrolled in TRICARE Prime. For health care
    with the best outcome, we strongly encourage you to choose a TRICARE plan
    that facilitates regular wellness exams as well as emergency and hospitalization
    coverage.

    To substantiate eligibility for health care, all patients must be enrolled in the
    Defense Eligibility Enrollment Reporting System (DEERS), and present a val-
    id military identification (ID) card (if 10 years of age or older) to clinic
    personnel before receiving health care. Patients who have neither a valid ID
    card nor DEERS enrollment may be subject to denial of health care and/or
    billed for services. These patients will be required to sign a statement of
    eligibility certifying they are eligible beneficiaries; they must prove eligibility
    status within 30 days or pay the Air Force an established rate for the health
    care furnished. Patients requiring emergency treatment to save life or limb
    are treated immediately without regard for eligibility and questions regarding
    eligibility are addressed after the emergency situation is resolved.

DEERS

   DEERS is a Department of Defense program designed to help secure military
   beneficiaries’ health benefits by eliminating fraud. This program is as
   important to you as your military ID card. To find out if you are enrolled,
   you can call DEERS toll free at 1-800-538-9552. If you are not enrolled in
   DEERS, please contact the Military Personnel Section Customer Service at
   (803) 895-1596. Enroll your newborns in DEERS as soon as possible after
   birth. DEERS is our only source for your address and phone number.
   Please submit changes via the TRICARE web site:
                          www.tricare.osd.mil/DEERSAddress
   Check the A-to-Z list for DEERS Address Change.

Appearance and Behavior
While in this medical facility, it is necessary that all patients maintain a neat
and presentable appearance in accordance with military standards and courtesies.
Proper dress is appreciated, and the wear of footwear is required for your own
protection. Additionally, we do not permit drinking of alcohol or possession of
alcoholic beverages, gambling, boisterousness, weapons (except by law
enforcement officers in the performance of their duties) or profane language
in the clinic.

                                          6
Smoking Policy
The 20th Medical Group is a TOBACCO-FREE campus. Tobacco use is a serious
health hazard. Our goal is to provide you with the best possible health care environ-
ment. Please respect all posted signs. Smoking is allowed only in a designated area
off campus.
Medical Records
In accordance with DoD policy, medical records are the property of the United
States Government, and it is the responsibility of the 20th Medical Group to
maintain the record while each patient is a beneficiary of this medical treatment
facility. The health record is an important record which provides a current, concise
and comprehensive account of an individual’s medical history. If the record is
not available to our medical personnel, valuable medical documents may be lost
and part, if not all, of the patient’s medical history may be missing. All patients
whose servicing medical facility is the 20th Medical Group will have their records
maintained at this facility. Patients who periodically come to this facility for care,
but reside outside of our catchment area, will also have their medical records
maintained here. In addition to maintaining the medical records, a medical records
copying service is available upon request. We require 30 days advance notice to
provide a copy of your medical record.
When you receive care from civilian providers, ask them to send copies of any
treatment provided to the MTF for inclusion in your outpatient record. These
documents will give our providers valuable information about your medical
condition and will improve their ability to provide quality health care. For all
appointments with the 20th Medical Group, the health record will be forwarded to
the appropriate clinic prior to each patient’s appointment. Medical records will not,
under any circumstances, be hand-carried by a patient.

Consistent with SC law; an individual cannot obtain the records of a spouse or child
over 18 years of age for any reason without a signed, witnessed release from that
individual. Children under 16 years of age cannot receive routine care without the
presence of a parent or guardian, or an adult possessing a medical power of
attorney. Medical powers of attorney are available by appointment only through the
Base Legal Office, 895-1560.
Third Party Collection Program
This program was established in 1986, under the U.S. Code, Title 10 to authorize
military medical treatment facilities to bill health insurance carriers (i.e. Blue
Cross Blue Shield, Aetna, etc.) for the cost of medical care provided to health care
beneficiaries who are covered by these programs. Health insurance does not include
TRICARE, Medicare or any of their supplemental programs. Below are some of the
most common asked questions.
What medical services are billed to insurance companies? Insurance companies
will be billed for each clinical visit and any pharmaceutical costs.



                                           7
Do you have health insurance? You will be asked this when you schedule an
appointment and upon arrival at the clinic. There is no paper form to be filled out.
The Clinic will verify and update your information with the Electronic 2569 (E2569)
on file. If a current E2569 is not on file, the information will be asked so a new E-
2569 file can be generated. Other Health Insurance Information, is used to certify
whether or not you have civilian health insurance. If a health insurance program co-
vers you, we need you to provide your policy number and any other related infor-
mation. Always having your cards with you will make the process faster.
Health care is one of my service benefits; why does the military clinic have
to bill my insurance company? Your health care is paid by federal tax dollars. The
law requires military treatment facilities to recover these costs if they are
covered by another health insurance company.
If the full cost of care is not recovered from my insurance company, will I
get a bill from the military clinic? No. You will not be billed for any costs we
cannot recover.
Will I need to pay my deductible? No. The government will absorb the
deductible. Additionally, charges billed by military medical treatment facilities
should be credited toward your deductible, thus reducing your out-of-pocket
expenses if you receive care from a civilian provider.
What will I receive from my insurance company? You will receive an
Explanation of Benefits (EOB) from your insurance company explaining how
much was paid to the military treatment facility and what deductible or
co-payments were subtracted from the claim. This is not a bill. You are not
responsible for co-payments or deductibles not paid, even if they appear on the EOB.
For additional information, please contact Resource Management office at
895-6418

No Show
An appointment is designated a No-Show when a patient does not keep a scheduled
appointment or cancels less than two hours prior to a scheduled appointment. Pa-
tients arriving past the start time of the appointment will be considered a ―no-show‖
and will need to reschedule the appointment or seek care from a network urgent care
facility. Appointments before 0900 need to be cancelled prior to the close of busi-
ness the previous duty day. A patient who fails to provide notification as specified
above is considered a No-Show.

Commanders may be notified of No-Shows of Active Duty members under their
command. The 20 MDG is not required to record these as disclosures under
HIPAA, as this falls under the definition of treatment.

Late Shows
An appointment is designated a Late-Show when a patient arrives at the clinic greater
than 10 minutes after their scheduled appointment time. The 20 MDG will try to ac-
commodate Late-Show patients, however, it is the patients responsibility to be on
time for their appointment or notify the 20 MDG in advance if they must cancel.
                                          8
PATIENT INFORMATION

Patient Appointments
Visits for all 20th Medical Group Clinics are by appointment only.

In the event of an emergency, immediately call 911 or go to the nearest emergency
room.

Appointments are available by calling:

                              (803) 895-CARE (2273)
                       0700 – 1600, Monday through Friday

Our long distance patients can also call by dialing our toll free number,
1-877-796-Care (2273). Unscheduled ―walk-in‖ visits are strongly discouraged
since they cause delays for patients with scheduled appointments. Please call ahead
so we may give you proper service.
After normal duty hours, for urgent medical issues that are not life threatening but
require treatment within 24 hours, contact the on-call PCM at (803) 895-CARE to
discuss the condition and possible referral to an Urgent Care facility. It is important
that you coordinate follow-up care with your PCM to ensure both required care and
referral authorizations are appropriately completed.

TRICARE Online
To make appointments 24 hours a day 7 days a week, visit www.tricareonline.com
to register for an account. TRICARE Online (TOL) is an interactive site that offers
enrolled beneficiaries who register for an account the ability to book appointment
with their provider.

TRICARE Service Center
The TRICARE Service Center (TSC) and Managed Care Office are your overall
continuity of care departments, which facilitate your care throughout the military
and civilian health care systems. A listing of 20 MDG providers is also available
for your review in this office. If you have any questions concerning this
information, please call HUMANA, our Managed Care Support Contractor at
1-800-444-5445 or visit the Shaw AFB TSC/Managed Care Office, Monday-Friday
from 0730 to 1630.
Many of you have relied on military medical treatment facilities for most, if not all,
of your health care. Our medical treatment facilities are an integral part of
TRICARE. TRICARE expands your options to include a growing civilian provider
network. These providers have been carefully selected to participate in TRICARE
because of their high quality care standards.
There are three different TRICARE plans from which you can choose: Prime,
Extra and Standard. Each plan has different cost shares and degrees of freedom
for choosing your health care providers. For more information call 1-800-444-5445,
or visit the Shaw AFB TRICARE Service Center/Managed Care Office.


                                           9
Referrals
When you need specialty care, your Family Health Provider will refer you to a
network of other specialists. You and your providers will be notified of your
authorized referral within 10 business days. Notification will either be by phone
or in writing. You can also check on your authorization, 24-hours a day by calling
1-800-444-5445 or by logging onto www.humana-military.com and registering for
beneficiary services. If you need any changes to a referral, you should contact the
Referral Management Center at (803) 895-6559.

TRICARE Dental Program (TDP)
This is a private insurance program for family members of all uniformed services
active duty, Selected Reserve and Individual Ready Reserve personnel of the
Uniformed Services. The plan is voluntary, requiring the sponsor to enroll his/her
dependents into the TRICARE Dental Program. A list of participating dentists and
additional information can be obtained from the TRICARE Service Center.

The TRICARE Retiree Dental program is currently administered via MetLife.
They may be contacted at 1-855-MET-TDP1 (1-855-638-8372, toll-free) or at
http://mybenefits.metlife.com/tricare.

Beneficiary Counseling and Claims Assistance (BCAC) and Debt Collection As-
sistance Officers (DCAO)
This office provides assistance to beneficiaries with questions and/or medical
claims issues. The Health Benefits staff will assist all eligible beneficiaries to
include those with Prime, Standard and Extra coverage. Simply call (803) 895-6228
for assistance.

Advance Directives
An Advance Directive contains written instructions you have made concerning
your future medical care in case you become unable to make decisions for yourself
or become unable to communicate to your provider about your decisions. It is a
legal document and can be in the form of a Living Will and/or a Medical Power of
Attorney. Be sure to inform your provider, nurse, or health technician if you have
or desire an Advance Directive. The Legal Office will answer your questions and
provide legal advice. If you have any questions or would like to complete an
Advance Directive, contact the Legal Office at 895-1560.




                                        10
CUSTOMER ASSISTANCE/CONCERNS

Patient Advocate Program
The Patient Advocate Program is designed to ensure you are satisfied with
your medical care. Through this program, the 20th Medical Group provides an
immediate response to your concerns. Contact the patient customer service
representative in the area where you have a concern. His or her name and
photograph are posted in the waiting room. If your problem is not addressed to
your satisfaction, you may also speak with the OIC or NCOIC, who will try to
answer your questions or work with you towards a solution before you leave the
clinic. If the OIC or NCOIC is unable to do so, he or she may refer you to their
Squadron Superintendent or Squadron Commander. Another avenue to express any
concern is the 20th Medical Group Patient Advocate Office, where your concern
will be documented and sent for review. All patient complaints should be in written
form and signed by the patient, which will allow clear communication and account-
ability. You may also call the Patient Advocate Office during normal duty hours at
803-895-6817.

The men and women of the 20th Medical Group strive to provide excellent quality
care. We would like to know your concerns and how you feel about the service
you receive while visiting our facility. Please take a moment to comment on the
care provided by filling out our customer comment cards available in the clinic
waiting areas. This program is important to the medical group and to you, because
it allows us to measure the level of your satisfaction while identifying and
correcting problem areas, thus providing better care and service in the future.
In addition, you may receive a call from an independent party who serves as a
gatherer for our Service Delivery Assessment survey that provides the 20 MDG
with customer service information. You will receive an e-mail survey to evaluate
your dental clinic experience.

Ethics Hearing
Ethical issues or differences of opinion concerning treatment options may arise
because the physician and patient/family have different value systems, which
may stem from different religious beliefs, ethnic backgrounds or upbringing. If a
conflict arises that cannot be resolved through discussion between the provider,
their supervisor and patient/family, an ethics hearing may be called by our Chief of
the Medical Staff (Senior Provider) to discuss and make recommendations to help
resolve the issue. This does not include differences of opinion concerning treatment
options that are medically or legally contraindicated.




                                        11
PATIENT’S RIGHTS AND RESPONSIBILITIES

Patient Rights
As a Patient, You have the Right to:
Receive emergency care without preauthorization where and when acute symp-
toms are so severe that a ―sensible layperson‖ would want emergency care to pre-
vent serious harm or death.
Timely, considerate, and respectful care at all times and under all circumstances.
An environment of shared respect which is free from discrimination.
Accurate information about the TRICARE program to include covered health bene-
fits and health plan options.
A choice of healthcare providers, either within TRICARE Prime network or the
Military Treatment Facility (MTF).
Receive accurate, accessible and understandable healthcare information.
Ask questions and receive timely answers to those questions.
Choose someone to make decisions on your behalf if you cannot do so.
Know all of your treatment options including the option of no treatment.
Know the risks, benefits, and consequences of each of these options.
Refuse care as allowed by law.
Privacy and protection of your personal health information.
Communicate with healthcare providers in confidence as allowed by law and regu-
lation.
Review and obtain a copy of your own medical records through the release of infor-
mation request.
Request amendments to your records, within specific legal limits.
A fair and efficient process to appeal medical necessity decisions by your MTF or
by TRICARE that includes both internal review and independent external review.
To discuss complaints with your provider or Patient Advocate.
Contact a TRICARE Debt Collection Assistance Office if unable to pay fees.
Review a provider directory maintained in Managed Care to assist with understand-
ing your provider’s education and training and selecting a Primary Care Manager.
Review publicly-reported MTF quality measures; please view MTF slide presenta-
tion in main patient waiting area.



                                         12
Patient Responsibilities
As a Patient, You are Responsible to:

Have respect for the rights of other patients and MTF staff.

Become educated about TRICARE coverage, options, and rules, to include required
fees.

Tell your healthcare professional everything you know about your illness or condi-
tion, past healthcare, and any and all medications or supplements you are taking,
and any legal healthcare directives that affect your care.

Inform the provider or nurse about any changes in how you feel.

Participate in decisions related to your healthcare and ask questions if you do not
understand any part of the proposed treatment.

Follow your treatment plan(s), which is established by your provider (s).

Provide an adult attendant if required by your healthcare team.

Maximize healthy habits, such as increased exercise and a healthy diet as well as
reduced tobacco use and knowingly spread disease.

Accept the consequences if you refuse to follow the plan of care.

Keep appointments or call to change or cancel them at least 24 hours in advance.

Report wrongdoing and fraud to appropriate authorities.

If you have any questions regarding your rights and responsibilities please
talk with your healthcare provider or the respective Department Patient
Advocate.

Patient Privacy Rights
Congress recognized the need for the national patient record privacy standards and
enacted the Health Insurance Portability and Accountability Act of 1996 (HIPAA),
which became effective 14 April 2003. The law included provisions designed to
save money for health care businesses by encouraging electronic standards, but in
the process required new safeguards to protect the security and confidentiality of
the information. Patient’s rights include:




                                         13
A written notice of privacy practices from health plans and providers. To access the
MHS policy practices, contact the privacy officer at any DoD Medical Treatment
Facility or go to this website: http://www.tricare.mil/tma/hipaa

Right to access, review and request correction of and obtain a copy of your
protected health information (PHI), such as your medical record.

Right to an accounting of certain disclosures of your PHI.

Right to request restriction of uses and disclosure of PHI.

Right to file a complaint regarding privacy infractions.

The 20th Medical Group will serve as your advocate for privacy issues and
the proper dissemination of your health care information in compliance with the
HIPAA legislation. The Privacy Officer can be reached at (803) 895-6455 for any
concerns or assistance you may require.

CLINICAL SERVICES AND PROGRAMS

Ambulance Services
The 20th Medical Group does not have an emergency department or urgent care
care services. For all emergencies (i.e., off- or on-base), call 911. Our
ambulance transports patients directly to the emergency room at Tuomey Regional
Medical Center. For emergencies occurring in the civilian community, the Sumter
County Emergency Services will only transport patients to the Tuomey Regional
Medical Center Emergency Room. The hospital and physician’s bills for active
duty members and their dependents should be brought to the TRICARE Service
Center as soon as you receive them. Make sure you speak with your Family Health
Provider prior to (when the situation permits), or within 24 hours, if you go to an
emergency department or seek urgent care outside of the military treatment facility.
Routine care outside the MTF obtained without a prior approved referral is
generally not a covered (reimbursable) benefit and the member may be subject to
point-of-service charges.

Medical In-processing
To help smooth your transition into your new home here at Shaw AFB, the
20th Medical Group asks each newly enrolled dependent beneficiary to complete
a medical assessment form. These forms are reviewed by your Primary Care
Manager so that they may address your current and preventative health care needs.
Additionally, all active duty members are required to in-process through
TRICARE, Public Health, and the Dental Clinic. The goal is to ensure you know
what health care services are available here at Shaw and how to get help when you
need it. For more information, contact Managed Care at 895-6228.



                                         14
Patient Centered Medical Home (PCMH)
Family Health Providers are health care providers specially designated to manage
all health care needs of active duty members and other individuals enrolled to
TRICARE Prime. The goals are for the Family Health Provider to become familiar
with the needs of their assigned patients, and to ensure that all care is appropriately
managed. To the maximum extent possible, patient visits will be scheduled with
the assigned Family Health Provider or one of their Family Health team partners.
Family Health Providers are designated in Family Medicine, Pediatrics and Flight
Medicine.

Family Health Clinic (Bldg. 1048): The Family Health Clinic functions as one of
the main entry points of care in this facility. Specialty care referrals are initiated
through this clinic by your Family Health Provider, and then transmitted to the
TRICARE Service Center/Managed Care Office for authorization and scheduling.
NOTE: The Family Health Clinic cares for patients of all ages, from pediatrics to
geriatrics. Call 895-CARE (2273) or go to TRICAREOnline.com to schedule
appointments.

Duty Hours: The Family Health Clinic is open Monday through Friday from
0730 – 1630. The Family Health Clinic is CLOSED on weekends, holidays and
down days. The Family Health Clinic has no emergency services. If you have a true
medical EMERGENCY, call 911.

Preventive Health Assessment (PHA) Appointments: Active duty members may
schedule their PHA appointments by calling 895-6373.

School and Athletic Physicals: School and athletic physicals are normally
performed in the summer months before school begins, and are publicized.
Appointments can be made by calling 895-CARE (2273), Monday through Friday.

Provider On-Call: The Provider On-Call can be reached by calling 895-CARE
(2273) after hours. The Provider On-Call is not located within the facility.

NOTE: If you are on flying status, an air traffic controller, parachutist, weapons
controller or administratively qualified for the Personnel Reliability Program, the
Flight Medicine Clinic is your Family Health Provider. You can contact the Flight
Medicine Clinic by calling 895-2273 during non-duty hours (ask to be forwarded to
the on-call Flight Medicine provider).

Pediatric Clinic
The Pediatric Clinic (Bldg. 1053) is open for children 16 years and under. Children
of any age with chronic or special needs may also be seen in this clinic.

Duty Hours: The Pediatric Clinic is open Monday through Friday, 0730 – 1630.
Call 895-CARE (2273) to schedule appointments.


                                          15
Women’s Health Clinic
The Women’s Health Clinic is co-located within the Family Health Clinic and pro-
vides a variety of gynecological services to female patients assigned to the 20th
Medical Group. Gynecological services include all active duty pap smears (no re-
ferral needed), space available dependent spouse pap smears, abnormal pap follow-
up and treatment, specialized gynecological problems, limited procedures, family
planning and individualized patient counseling and education. Patients with gyne-
cological concerns are seen on a referral only/case-by-case basis, based on the na-
ture of the referral. Civilian consultation is utilized for any patients whose medical
history requires additional support.

Pregnancy tests are available on a walk-in basis. Please note that Shaw AFB does
not provide obstetrical services. Once a woman has a positive pregnancy test
from the lab, she will be scheduled for a new parent briefing and provided with
appropriate information for obtaining obstetrical services in the local community.

Duty Hours: The Women’s Health Clinic is open Monday through Friday,
0730 – 1630 daily. All injections are done on a walk-in basis, Monday through
Friday between the hours of 0800 - 1100 and 1300 – 1500.

Mental Health & Family Advocacy
The Mental Health Flight provides triage, clinical assessments, evaluations, and
outpatient treatment psychiatric services for active duty members. Substance abuse
evaluations and treatment are also available. Care for dependents, retirees and de-
pendents of retirees is limited. Mental Health care for these beneficiary categories
is referred to the civilian community. Outpatient appointments for active duty per-
sonnel can be made through self-referral, referral from health care providers, com-
mand, or other Air Force agencies.

 The Family Advocacy Program is designed to provide therapeutic, preventive and
educational services to military families at risk for and/or experiencing family vio-
lence. The Family Advocacy Outreach and Prevention Team develops programs
and services in cooperation with other community agencies aimed at strengthening
and enriching Air Force families. The New Parent Support Program offers support
for new parents, provides parenting classes, and many psychological, educational
and de-velopmental classes.

Access to Care: To schedule an appointment with the Mental Health Clinic, please
call 895-6199 between 0730 – 1630, Monday through Friday.

For more information about the Mental Health Clinic, please call 895-6199. For
information about Family Advocacy, please call 895-6201.




                                          16
Exceptional Family Member Program—Medical (EFMP-M)
The Exceptional Family Member Program—Medical (EFMP-M) is designed to
provide assistance to eligible personnel with dependents who receive special
educational or medical attention for chronic physical or mental conditions or who
require frequent services by a specialist. This assistance may be in the form of
referral to available support services or counseling on special assignment
considerations. For more information on this program, call 895-6776.

Physical Therapy
Physical Therapy (Bldg. 1048) provides health care devoted to relieving pain,
restoring function and preventing injuries and disabilities to all active duty
personnel and DoD beneficiaries. Those eligible for care are seen by referral from
a physician, physician assistant, nurse practitioner or dentist. NOTE: The Physical
Therapy Clinic does not provide services for patients requiring long-term care for
pediatric or adult neurological conditions, neonatal intensive care intervention or
developmental disabilities. These patients are referred through TRICARE to
specialty facilities to better meet their needs.

Access to Care: To schedule appointments, please call 803-895-6562 or come by
the Physical Therapy Clinic front desk.

Duty Hours: Physical Therapy is open Monday, 0730-1630;


Immunizations
The Immunization Clinic is a walk-in clinic. Childhood immunizations are
scheduled to follow standard well-baby check-ups. Parents should bring copy of
their child’s immunization record. NOTE: PPD tests (TB skin tests) require two
visits (one to administer the test and one to read it 48 to 72 hours later) and are not
administered on any Thursday or on the Friday before a long weekend.

Information: For additional information concerning specific immunizations, please
contact the clinic at 895-6492.

Duty Hours: Immunizations is open 0730 – 1600, Monday through Friday.
            This section is closed daily from 1200 – 1300.

AEROSPACE MEDICINE

Flight Medicine
Flight Medicine (Bldg. 1005) provides primary medical care for all personnel on
flight /special operator status and their dependents. This includes aircrew, air traffic
controllers, space operators, and other special operational duty personnel. Addition-
ally, certain



                                           17
AD and civilian employees in the Occupational Health program are seen for
their annual assessment. All medical needs of personnel on flight/special operator
status must be coordinated through the Flight Medicine Flight.

Active Duty Sick Call: Hours for sick call are 0730 and 1300, Monday through
Friday. Sick call is limited to acute problems or return to flight controlling status.

Access to Care: To schedule an appointment, please call 895-CARE (2273)
from 0730 – 1600, Monday through Friday. Arrive 20 minutes early for scheduled
appointments.

Duty Hours: Flight Medicine is open 0730 – 1630, Monday, Tuesday, Wednesday,
and Thursday and from 0730 – 1530 Friday.

Health Promotion Flight (Health and Wellness Center (HAWC))
Health Promotions is a program designed to promote healthy lifestyles by
identifying health risks and establishing programs that facilitate changes towards
the adoption of healthier behaviors in our Air Force community. The HAWC
provides a ―one-stop-shop‖ for health and fitness assessment, awareness and
prevention programs.

The HAWC (Bldg. 901) provides tobacco cessation programs, nutritional
counseling, disease risk counseling (cholesterol, diabetes and high blood pressure),
health risk appraisals and exercise prescriptions, and supports the commander’s
fitness program. Books and videos on various health topics can be signed out,
and educational materials are available on all the above topics. The HAWC is a
member of the Shaw Prevention Team and partners with Family Support, Family
Advocacy, Family Member’s Program Flight, the Chaplain, and Mental Health in
providing programs to meet the needs of our Shaw AFB community. Stop by and
see if we can make a difference in pointing you in the direction of getting healthy
and staying healthy.

Information: For additional information, call the HAWC at 895-1216/17.

Duty Hours: The HAWC is open 0730 – 1630, Monday through Friday.

Public Health Flight
The Public Health Flight (Bldg. 1054) is organized in two major elements,
Community Health Management and Force Health Management.

The Community Health Element oversees issues related to the base population
as a whole. These programs include Communicable Disease Surveillance,
Epidemiology, Food Safety, Facility Sanitation and Disease Vector Surveillance.




                                           18
The Force Health Management Element oversees issues related to force
mobilization. These include tracking and completion of the Preventive Health
Assessment and Individual Medical Readiness database, oversight of Occupational
Medical Examinations, hearing testing, and Pre/Post Deployment Processing.
Duty Hours: Public Health is open from 0730 – 1630, Monday through Friday.
Call 895-6193/6185 to access services.

Optometry Services Element
Optometry (Bldg. 1048, 2nd Floor) provides comprehensive vision care, to include
routine eye examinations and urgent eye care (red eyes, eye injuries, etc.) for active
duty personnel. Family members and retirees receive eye care through TRICARE
with a civilian provider. Optometry provides Diabetic Eye exams for all TRICARE
beneficiaries, and Corneal Refractive Surgery pre-operatively and post-operatively.
Active Duty and retiree patients can bring their eyeglass prescriptions to the clinic
to order military eyewear.
Access to Care: To schedule an appointment, please call 895-CARE (2273), op-
tion1, option 4 from 0700 – 1600, Monday through Friday. For urgent eye care
appointments, call 895-CARE (2273).
Duty Hours: Optometry is open 0730 – 1630 Monday through Thursday
                              0730 – 1530 Friday
Bioenvironmental Engineering Flight
The Bioenvironmental Engineering Flight (Bldg. 1005) applies knowledge of
engineering and the sciences to assist commanders in employing risk management
principles to meet their mission in peacetime and during contingency operations.
Our top priority is to perform risk assessment surveys evaluating systems,
installations, facilities, and planning documents for chemical, physical and
biological stress factors which may cause illness, injury, reduced productivity,
performance or significant discomfort among Air Force personnel in occupational
environments. The flight advises commanders on impact to mission of
unacceptable risks and provides possible solutions.
Call 895-6196 to access services.
Aerospace Physiology Flight (APF)
The Aerospace Physiology Flight (Bldg. 1047) acquaints aircrew and high altitude
parachutists with the stresses and equipment of aerospace operations in order to
prepare them to successfully function and survive during all situations. Our goal is
to improve aviation safety by providing academics in a controlled environment that
will ultimately increase human performance. By working as a team, we provide our
customers the highest quality of physiological training while maintaining combat
readiness and efficiency for High Altitude Airdrop Mission Support.
Access to Care/Training: You may reach us at 895-6791 from 0700-1600, Monday
through Friday.

Duty Hours: Aerospace Physiology is open from 0700-1600, Monday through
Friday.
                                      19
Dental Services

Dental Services (Bldg. 1046) provides comprehensive dental care to active duty
personnel in an effort to ensure Shaw AFB is ―dentally ready‖ for worldwide duty.
Eligible active duty family members should be enrolled in the TRICARE Dental
Plan (www.metlife.com). Retirees and their families can enroll in the TRICARE
Retiree Dental Plan (www.ddpdelta.org) or may seek other types of dental
insurance coverage. Covered benefits/procedures should be provided by the
individual’s participating network dentist. Space-available care is very limited,
due to primary mission demands and other requirements.

Dental Emergencies: Same-day evaluation and management of dental emergencies
(trauma, bleeding, swelling, infection, severe pain, etc.) is available for all
beneficiary categories. Call 895-6988/6989 during duty hours and 895-CARE
(2273) during non-duty hours. NOTE: Non-active duty personnel must first at-
tempt to access their network dentist, as this provides continuity of care. The
cost of emergency service is covered by the TRICARE Dental Plan.

Access to Care: To schedule an appointment, please call 895-6988 or you may
make it in person.

Duty Hours: Dental Services is open 0730 – 1630, Monday through Friday


ANCILLARY AND SUPPORT SERVICES

Laboratory
The Laboratory (Bldg. 1048) supports Family Health, Pediatrics, Women’s Health
Clinic and Flight Medicine in conducting various clinical laboratory tests. Tests not
performed in-house are processed through our shipping department to be tested at
various military and civilian reference laboratories.

All patient encounters are conducted at the laboratory reception desk. Special
collection directions are available for some requested tests. All military health care
system beneficiaries with a legible laboratory request signed by a licensed military
or civilian provider are eligible for our services.

Access to Care: The Laboratory is a walk-in clinic, or you may contact our front
desk at (803) 895-6515 for any further questions.

Duty Hours: The Laboratory is open from 0730 – 1630, Monday through Friday.




                                          20
Diagnostic Imaging/Radiology Services (X-Ray)
Diagnostic Imaging/Radiology Services (Bldg. 1048) provides routine radiography
services. Special procedures to include fluoroscopy, ultrasound and mammography
are referred to other military or civilian sources. All examinations require a health
care provider’s request. Requests from civilian providers will be honored with a
legible prescription. Routine radiography will be performed on a walk-in basis
while all special examinations will be scheduled through TRICARE.

Information: You may reach us at (803) 895-6625 for any additional information.

Duty Hours: Diagnostic Imaging/Radiology Services is open from 0730 – 1630,
Monday through Friday.

Pharmacy
The 20 MDG Pharmacy dispenses medications upon receipt of a written prescrip-
tion from a military or civilian provider. New and existing prescriptions from 20
MDG providers and from civilian providers are filled at the main pharmacy.
The 20 MDG Pharmacy will gladly fill civilian provider prescriptions.

If you receive your care from a civilian provider, please come by the Pharmacy and
pick up a list of medications stocked at the 20 MDG Pharmacy or access our for-
mulary online at www.shaw.af.mil/units/medicalservices/index.asp.
We will not be able to fill a prescription for a medication not on our formulary.

The 20 MDG Pharmacy must follow South Carolina State law with regard to phar-
macy practice.

All patients must pull a ticket from the ticket station located in the pharmacy lobby
for their prescription to be processed. Your ticket number will be called to the first
free pharmacy window in the order it was pulled from the machine. Prescription
refills are filled at the Satellite Pharmacy (located in the Base Exchange complex).

Pharmacy hours of operation are:

Main Pharmacy                                  Satellite Pharmacy

Monday-Friday: 0745 - 1700 hrs.                Monday-Friday: 0900 – 1700 hrs.

                   Closed on Sat/Sun/Holidays/Wing Down Days

The satellite Pharmacy has a convenient call-in refill service.
Refills called in before 1200 are ready the next duty day. Refills called in after
1200 are ready within two duty days.

The phone numbers for this system are 895-6678 or toll free at 1-877-796-2273.




                                          21
You must present your Identification Card (ID) to the Pharmacy window when
dropping off a prescription or picking up medication. Pharmacy staff members will
dispense medications when presented with a valid ID card.
Patients may also elect to have their prescriptions filled at either the TRICARE
Mail Order Pharmacy (TMOP) or a local civilian pharmacy that accepts TRICARE.
Unless you are active duty, there will be a co-pay for each prescription filled at
these locations. There is no co-pay for active duty members. Keep in mind those
medications that are non-formulary at Shaw AFB may be formulary medications at
these two pharmacies, and may therefore be available at the lower co-pays.
Prescriptions filled at local civilian pharmacies are limited to a 30-day supply
of medication. Most prescriptions filled through the TMOP can be filled up to a
90-day supply of medication if the prescription is written for that quantity.
The co-pay for a 90-day supply of medication through the TMOP is the same as
a 30-day supply of medication from a local civilian pharmacy.
In order to utilize the TMOP, patients need to register with TMOP. Registration
forms can be obtained at the Shaw Pharmacy. They can also be obtained by
contacting the TMOP at the following toll-free number: 866-363-8667.
Additional questions about the TMOP can be answered by your pharmacy staff at
Shaw, the toll-free number provided above, or through the following website:
www.express-scripts.com.
Patients with civilian prescriptions, may also utilize the prescription drop-off box
located in the waiting area of the main pharmacy. The beneficiary must fill out the
provided envelope completely. Prescriptions that are dropped in the prescription
drop box may be picked up 2 hours later at window 4.
Please call the Pharmacy at 803-895-6464 if you have questions.
Volunteers
We have a very active volunteer staff working in the 20th Medical Group.
Volunteers perform many vital functions that help the everyday operations of the
clinic flow smoothly. If you are interested in becoming one of these valuable
volunteers, contact the Red Cross Volunteer Coordinator, 895-1251.
PERFORMANCE IMPROVEMENT/PATIENT SAFETY
It is the goal of the 20th Medical Group to provide our patients with safe,
quality medical and dental care. You have the right to report any unsafe condition
or patient safety concern to the 20th Medical Group Leadership, by requesting any
20th Medical Group staff member or Customer Service Representative to complete
the documentation in the DoD Patient Safety Reporting System.
You are also an important part of this on-going commitment to excellence. Your
comments regarding care you receive at the clinic are important to us. You may
receive a call asking for your comments regarding a recent visit; the information
you give will help us maintain our high standards of excellence. The survey is
brief; please take the time to participate. In addition, you are welcome to complete
a comment card (located throughout the facility) at anytime.

                                         22
ACCREDITATION ASSOCIATION FOR AMBULATORY HEALTH CARE
(AAAHC)

AAAHC has committed to its mission to remain the preeminent leader in develop-
ing standards to advance and promote patient safety, quality, value and measure-
ment of performance for ambulatory health care through peer-based accreditation
processes, education and research. Anyone believing that he or she has pertinent
and valid information about such matters may contact the AAAHC at any time
through the following mechanisms:
Accreditation Association for Ambulatory Health Care
5250 Old Orchard Road, Suite 200
Skokie, IL 60077
Phone: (847) 853-6060
Fax:     (847) 853-9028
Email: info@aaahc.org
Web: www.aaahc.org

WHAT ARE MEDICAL ERRORS?

Medical errors are one of the nation’s leading causes of death and injury. Govern-
ment agencies, purchasers of group health care and health care providers are work-
ing together to make the U.S. health care system safer for patients and the public. In
recent years, medical errors have received much attention. Steps are being taken to
reduce the number of errors that occur. One of these steps is to educate patients on
what they can do to help prevent medical errors. Listed below are tips to help make
your health care experience safer. You are an important part of your health care
team; if you have questions, SPEAK UP.

Medical errors happen when something that was planned as a part of medical care
doesn't work out, or when the wrong plan was used in the first place. Medical errors
can occur anywhere in the health care system:
   Hospitals
   Clinics
   Outpatient Surgery Centers
   Providers' Offices
   Nursing Homes
   Pharmacies
   Patients' Homes

Errors can involve:
 Medicines
 Surgery
 Diagnosis
 Equipment
 Lab reports

                                         23
20 TIPS TO HELP PREVENT MEDICAL ERRORS

1. The single most important way you can help to prevent errors is to be an active
member of your health care team.
That means taking part in every decision about your health care. Research shows
that patients who are more involved with their care tend to get better results. Some
specific tips follow.

Medicines

2. Make sure that all of your providers know about everything you are taking.
This includes prescription and over-the-counter medicines, and dietary supple-
ments such as vitamins and herbs.
At least once a year, bring all of your medicines and supplements with you to your
provider. "Brown bagging" your medicines can help you and your provider talk
about them and find out if there are any problems. It can also help your provider
keep your records up to date, which can help you get better quality care. With the
Patient Centered Medical Home a partnership is one of our main goals. So that you
will have a list of current medication readily available, please list them on the last
page of this pamphlet.

3. Make sure your provider knows about any allergies and adverse reactions you
have had to medicines.
This can help you avoid getting a medicine that can harm you.

4. When your provider writes you a prescription, make sure you can read it.
If you can't read your provider's handwriting, your pharmacist might not be able to
either.

5. Ask for information about your medicines in terms you can understand--both
when your medicines are prescribed and when you receive them.
   What is the medicine for?
   How am I supposed to take it, and for how long?
   What side effects are likely? What do I do if they occur?
   Is this medicine safe to take with other medicines or dietary supplements I am
    taking?
   What food, drink or activities should I avoid while taking this medicine?

6. When you pick up your medicine from the pharmacy, ask: Is this the medicine
that my provider prescribed?
A study by the Massachusetts College of Pharmacy and Allied Health Sciences
found that 88 percent of medicine errors involved the wrong drug or the wrong
dose.


                                          24
7. If you have any questions about the directions on your medicine labels, ask.
Medicine labels can be hard to understand. For example, ask if "four doses daily"
means taking a dose every 6 hours around the clock or just during regular waking
hours.

8. Ask your pharmacist for the best device to measure your liquid medicine. Also,
ask questions if you're not sure how to use it.
Research shows that many people do not understand the right way to measure
liquid medicines. For example, many use household teaspoons, which often do not
hold a true teaspoon of liquid. Special devices, like marked syringes, help people to
measure the right dose. Being taught how to use the devices helps even more.

9. Ask for written information about the side effects your medicine could cause.
If you know what might happen, you will be better prepared if it does, or if
something unexpected happens instead. You can then report the problem to
your provider right away and get help before the problem gets worse.

Hospital Stays

10. If you have a choice, choose a hospital at which many patients have the
procedure or surgery you need.
Research shows that patients tend to have better results when they are treated in
hospitals that have a great deal of experience with their condition.

11. If you are in a hospital, consider asking all health care workers who have
direct contact with you whether they have washed their hands.
Hand washing is an important way to prevent the spread of infections in hospitals.
Yet, it is not done regularly or thoroughly enough. A study found that when
patients checked whether health care workers washed their hands, the workers
washed their hands more often and used more soap.

12. When you are being discharged from the hospital, ask your provider to ex-
plain the treatment plan you will use at home.
This includes learning about your medicines and finding out when you can get back
to your regular activities. Research shows that at discharge time, providers think
their patients understand more than they really do about what they should or should
not do when they return home.




                                         25
Surgery

13. If you are having surgery, make sure that you, your provider and your sur-
geon all agree and are clear on exactly what will be done.
Doing surgery at the wrong site (for example, operating on the left knee instead
of the right) is rare. But even once is too often. The good news is that wrong-site
surgery is 100 percent preventable. The American Academy of Orthopedic
Surgeons urges its members to sign their initials directly on the site to be operated
on before the surgery.

Other Steps You Can Take

14. Speak up if you have questions or concerns.
You have a right to question anyone who is involved with your care.

15. Make sure that someone, such as your personal provider, is in charge of your
care.
This is especially important if you have many health problems or are in a hospital.

16. Make sure that all health professionals involved in your care have important
health information about you.
Do not assume that everyone knows everything they need to.

17. Ask a family member or friend to be there with you and to be your advocate
(someone who can help get things done and speak up for you if you can't).
Even if you think you don't need help now, you might need it later.

18. Know that " ore is not always better.
              m
It is a good idea to find out why a test or treatment is needed and how it can help
you. You could be better off without it.

19. If you have a test, don't assume that no news is good news.
Ask about the results. Consider asking when the test is ordered when and how you
should hear back about the results.

20. Learn about your condition and treatments by asking your provider and
nurse and by using other reliable sources.


Reference: ―Patient Fact Sheet, 20 Tips to Prevent Medical Errors‖
www.ahrq.gov/consumer




                                          26
20TH MEDICAL GROUP KEY NUMBERS


APPOINTMENTS                          895-CARE/1-877-796-CARE

AEROSPACE PHYSIOLOGY (APF)            895-6791
BIOENVIRONMENTAL ENGINEERING          895-6196
DENTAL                                895-6988
FAMILY ADVOCACY                       895-6201
FAMILY HEALTH                         895-CARE
FLIGHT MEDICINE                       895-6746
HEALTH AND WELLNESS CENTER(HAWC)      895-1216
HEALTH BENEFITS ADVISOR               895-6727
IMMUNIZATION CLINIC                   895-6492
LABORATORY                            895-6515
MENTAL HEALTH                         895-6199
MEDICAL RECORDS                       895-6505
OPTOMETRY                             895-6579
PATIENT ADVOCATE                      895-6817
PEDIATRICS                            895-CARE
PERFORMANCE IMPROVEMENT               895-6336
PHARMACY                              895-CARE, prompt #6
PHARMACY SATELLITE                    895-CARE, prompt #6
PHARMACY – Automated Refill Service   895-CARE, prompt #6
PHYSICAL THERAPY                      895-6562
PRIMARY CARE (PCM) TEAMS              895-CARE
PRIVACY OFFICER                       895-6455
PUBLIC HEALTH                         895-6193/6185
PATIENT ADMINISTRATION                895-6228
TRICARE                               1-800-444-5445
WOMEN’S HEALTH CLINIC                 895-2273




                                 27
WEB RESOURCES

   Shaw Air Force Base                          http://www.shaw.af.mil/
   TRICARE                                      http://www.tricare.mil/
   TRICARE (Humana)                             http://www.humana-military.com/
   TRICARE (General and local info)             http://www.tricareonline.com/
   TRICARE Regional Office South                http://www.tricare.mil/trosouth/
   Delta Dental (Retiree Dental Program)        www.trdp.org/
   MetLife (TRICARE Dental)                     http://mybenefits.metlife.com/tricare
   DEERS Address Changes                        http://www.tricare.mil/deers/default.cfm
   National Mail Order Pharmacy (NMOP)          www.express-scripts.com




As of 31 Jan 13                            28                            MDGP 41-119

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20 MDG Patient Handbook

  • 1. 20th Medical Group Patient Handbook 2013
  • 2. FROM THE COMMANDER Welcome to your medical group! The health care professionals of the 20th Medical Group are dedicated to providing the best health care prevention and treatment services possible. This pamphlet will help you understand how to access medical services while at Shaw Air Force Base. The availability of specific programs or services may vary according to operational requirements of the 20th Fighter Wing. In the event we cannot provide the care you require, our TRICARE office staff will work with you to arrange for your health care at another military treatment facility or through our civilian provider network. Total quality health care through your Patient Centered Medical Home includes a responsive appointment system, a prompt and accurate pharmacy ser- vice, health prevention, health education and health promotion programs that reach out to our community. We strive to provide these services and many more. We rely on your help to identify areas for improvement through questionnaires and sugges- tions through our Customer Feedback Program. These tools help us to constantly re-evaluate the methods and types of services we provide. We invite and encourage you to take an active part in this process. Also, if you wish to share your time and talents, we would love to have you as part of our Red Cross volunteer team. If in- terested in becoming a volunteer, call 895-6654. Again, welcome to the 20th Medical Group! We look forward to partnering with you for all of your healthcare needs. ////SIGNED//// DEAN B. BORSOS, Colonel, USAF, MSC Commander, 20th Medical Group 2
  • 3. INTRODUCTION This pamphlet was prepared to assist you in understanding the services available from the 20th Medical Group, Shaw Air Force Base, South Carolina. We encourage you to familiarize yourself with the contents of this pamphlet, as it will aid you in obtaining health care and other services. About the 20th Medical Group The 20th Medical Group (20 MDG) provides ambulatory medical and dental services to the 20th Fighter Wing, Headquarters 9th Air Force, USAFCENT, USARCENT, Shaw associate units and thousands of military retirees in the area. The Shaw clinic is accredited by the Accreditation Association for Ambulatory Health Care (AAAHC). The 20 MDG provides primary care services with aerospace medicine, limited specialty care and ancillary (pharmacy, laboratory, radiology) capabilities. We do not provide inpatient or emergency services but ambulance services are available to on base personnel at all times by calling 911. Outpatient care is provided for pediatric through geriatric patients. Shaw clinic’s range of services include pediatrics, family health, flight medicine, limited gynecological services, oral surgery, general dentistry, periodontics, prosthodontics, physical therapy, optometry, mental health, family advocacy, laboratory, pharmacy, public health, radiology, health & wellness, and immunizations. All care not performed at Shaw AFB is arranged through referrals to a robust network of military hospitals and TRICARE civilian medical resources in the surrounding communities. We are fortunate to be surrounded with extremely high caliber medical services and most specialties within a reasonable distance of the base. Mission Statement Prepare and maintain medically ready forces… Prevent, Heal, Deploy, Anytime, Anywhere. Vision Statement Maximize combat capability by providing unparalleled healthcare. Medical Group Organization The 20th Medical Group is comprised of four squadrons, which operate under the direction of the group commander and his support staff. Key telephone numbers for each of the major functions are listed inside the back cover of this pamphlet. The single access telephone number for the 20 MDG is 895-CARE (2273). 3
  • 4. TABLE OF CONTENTS From the Commander 2 Introduction 3 Table of Contents 4 Patient Policies 6 Eligibility for Health Care 6 DEERS 6 Appearance and Behavior 6 Smoking Policy 7 Medical Records 7 Third Party Collection Program 7 No Show Appointments 8 Late Show Appointments 8 Patient Information 9 Patient Appointments 9 TRICARE Online 9 TRICARE Service Center 9 Referrals 10 TRICARE Dental Program 10 Beneficiary Counseling/Claims Assistance 10 Advance Directives 10 Customer Assistance/Concerns 11 Patient Advocate Program 11 Ethics Hearings 11 Patient Rights and Responsibilities 12 Patient Rights 12 Patient Responsibilities 13 Privacy Rights/HIPAA 13 4
  • 5. Clinical Services and Programs 14 Ambulance Services 14 Medical In-processing 14 Patient Center Medical Home 15 Family Health Clinic 15 Pediatric Clinic 15 Women’s Health Clinic 16 Mental Health Clinic and Family Advocacy 16 Exceptional Family Member Program 17 Physical Therapy 17 Immunizations 17 Aerospace Medicine 17 Flight Medicine Flight 17 Health Promotion Flight - Health and Wellness Center (HAWC) 18 Public Health Flight (occupational health) 18 Optometry Services Element 19 Bioenvironmental Engineering Flight 19 Aerospace Physiology Flight 19 Dental Services 20 Ancillary and Support Services 20 Laboratory 20 Diagnostic Imaging/Radiology Services (X-Ray) 21 Pharmacy 21 Volunteers 22 Performance Improvement, Patient Safety 22 Accreditation Association for Ambulatory Health Care (AAAHC) 23 What are Medical Errors? 23 20 Tips to Help Prevent Errors 24 20th Medical Group Key Numbers 27 Web Resources 28 5
  • 6. PATIENT POLICIES Eligibility for Health Care The principal mission of the 20th Medical Group is to provide health care to active duty military patients. Many of the Clinic’s services are available to active duty dependents, as well as retirees and their dependents if enrolled in TRICARE Prime or TRICARE Plus. There is very limited capacity for space available services to those not enrolled in TRICARE Prime. For health care with the best outcome, we strongly encourage you to choose a TRICARE plan that facilitates regular wellness exams as well as emergency and hospitalization coverage. To substantiate eligibility for health care, all patients must be enrolled in the Defense Eligibility Enrollment Reporting System (DEERS), and present a val- id military identification (ID) card (if 10 years of age or older) to clinic personnel before receiving health care. Patients who have neither a valid ID card nor DEERS enrollment may be subject to denial of health care and/or billed for services. These patients will be required to sign a statement of eligibility certifying they are eligible beneficiaries; they must prove eligibility status within 30 days or pay the Air Force an established rate for the health care furnished. Patients requiring emergency treatment to save life or limb are treated immediately without regard for eligibility and questions regarding eligibility are addressed after the emergency situation is resolved. DEERS DEERS is a Department of Defense program designed to help secure military beneficiaries’ health benefits by eliminating fraud. This program is as important to you as your military ID card. To find out if you are enrolled, you can call DEERS toll free at 1-800-538-9552. If you are not enrolled in DEERS, please contact the Military Personnel Section Customer Service at (803) 895-1596. Enroll your newborns in DEERS as soon as possible after birth. DEERS is our only source for your address and phone number. Please submit changes via the TRICARE web site: www.tricare.osd.mil/DEERSAddress Check the A-to-Z list for DEERS Address Change. Appearance and Behavior While in this medical facility, it is necessary that all patients maintain a neat and presentable appearance in accordance with military standards and courtesies. Proper dress is appreciated, and the wear of footwear is required for your own protection. Additionally, we do not permit drinking of alcohol or possession of alcoholic beverages, gambling, boisterousness, weapons (except by law enforcement officers in the performance of their duties) or profane language in the clinic. 6
  • 7. Smoking Policy The 20th Medical Group is a TOBACCO-FREE campus. Tobacco use is a serious health hazard. Our goal is to provide you with the best possible health care environ- ment. Please respect all posted signs. Smoking is allowed only in a designated area off campus. Medical Records In accordance with DoD policy, medical records are the property of the United States Government, and it is the responsibility of the 20th Medical Group to maintain the record while each patient is a beneficiary of this medical treatment facility. The health record is an important record which provides a current, concise and comprehensive account of an individual’s medical history. If the record is not available to our medical personnel, valuable medical documents may be lost and part, if not all, of the patient’s medical history may be missing. All patients whose servicing medical facility is the 20th Medical Group will have their records maintained at this facility. Patients who periodically come to this facility for care, but reside outside of our catchment area, will also have their medical records maintained here. In addition to maintaining the medical records, a medical records copying service is available upon request. We require 30 days advance notice to provide a copy of your medical record. When you receive care from civilian providers, ask them to send copies of any treatment provided to the MTF for inclusion in your outpatient record. These documents will give our providers valuable information about your medical condition and will improve their ability to provide quality health care. For all appointments with the 20th Medical Group, the health record will be forwarded to the appropriate clinic prior to each patient’s appointment. Medical records will not, under any circumstances, be hand-carried by a patient. Consistent with SC law; an individual cannot obtain the records of a spouse or child over 18 years of age for any reason without a signed, witnessed release from that individual. Children under 16 years of age cannot receive routine care without the presence of a parent or guardian, or an adult possessing a medical power of attorney. Medical powers of attorney are available by appointment only through the Base Legal Office, 895-1560. Third Party Collection Program This program was established in 1986, under the U.S. Code, Title 10 to authorize military medical treatment facilities to bill health insurance carriers (i.e. Blue Cross Blue Shield, Aetna, etc.) for the cost of medical care provided to health care beneficiaries who are covered by these programs. Health insurance does not include TRICARE, Medicare or any of their supplemental programs. Below are some of the most common asked questions. What medical services are billed to insurance companies? Insurance companies will be billed for each clinical visit and any pharmaceutical costs. 7
  • 8. Do you have health insurance? You will be asked this when you schedule an appointment and upon arrival at the clinic. There is no paper form to be filled out. The Clinic will verify and update your information with the Electronic 2569 (E2569) on file. If a current E2569 is not on file, the information will be asked so a new E- 2569 file can be generated. Other Health Insurance Information, is used to certify whether or not you have civilian health insurance. If a health insurance program co- vers you, we need you to provide your policy number and any other related infor- mation. Always having your cards with you will make the process faster. Health care is one of my service benefits; why does the military clinic have to bill my insurance company? Your health care is paid by federal tax dollars. The law requires military treatment facilities to recover these costs if they are covered by another health insurance company. If the full cost of care is not recovered from my insurance company, will I get a bill from the military clinic? No. You will not be billed for any costs we cannot recover. Will I need to pay my deductible? No. The government will absorb the deductible. Additionally, charges billed by military medical treatment facilities should be credited toward your deductible, thus reducing your out-of-pocket expenses if you receive care from a civilian provider. What will I receive from my insurance company? You will receive an Explanation of Benefits (EOB) from your insurance company explaining how much was paid to the military treatment facility and what deductible or co-payments were subtracted from the claim. This is not a bill. You are not responsible for co-payments or deductibles not paid, even if they appear on the EOB. For additional information, please contact Resource Management office at 895-6418 No Show An appointment is designated a No-Show when a patient does not keep a scheduled appointment or cancels less than two hours prior to a scheduled appointment. Pa- tients arriving past the start time of the appointment will be considered a ―no-show‖ and will need to reschedule the appointment or seek care from a network urgent care facility. Appointments before 0900 need to be cancelled prior to the close of busi- ness the previous duty day. A patient who fails to provide notification as specified above is considered a No-Show. Commanders may be notified of No-Shows of Active Duty members under their command. The 20 MDG is not required to record these as disclosures under HIPAA, as this falls under the definition of treatment. Late Shows An appointment is designated a Late-Show when a patient arrives at the clinic greater than 10 minutes after their scheduled appointment time. The 20 MDG will try to ac- commodate Late-Show patients, however, it is the patients responsibility to be on time for their appointment or notify the 20 MDG in advance if they must cancel. 8
  • 9. PATIENT INFORMATION Patient Appointments Visits for all 20th Medical Group Clinics are by appointment only. In the event of an emergency, immediately call 911 or go to the nearest emergency room. Appointments are available by calling: (803) 895-CARE (2273) 0700 – 1600, Monday through Friday Our long distance patients can also call by dialing our toll free number, 1-877-796-Care (2273). Unscheduled ―walk-in‖ visits are strongly discouraged since they cause delays for patients with scheduled appointments. Please call ahead so we may give you proper service. After normal duty hours, for urgent medical issues that are not life threatening but require treatment within 24 hours, contact the on-call PCM at (803) 895-CARE to discuss the condition and possible referral to an Urgent Care facility. It is important that you coordinate follow-up care with your PCM to ensure both required care and referral authorizations are appropriately completed. TRICARE Online To make appointments 24 hours a day 7 days a week, visit www.tricareonline.com to register for an account. TRICARE Online (TOL) is an interactive site that offers enrolled beneficiaries who register for an account the ability to book appointment with their provider. TRICARE Service Center The TRICARE Service Center (TSC) and Managed Care Office are your overall continuity of care departments, which facilitate your care throughout the military and civilian health care systems. A listing of 20 MDG providers is also available for your review in this office. If you have any questions concerning this information, please call HUMANA, our Managed Care Support Contractor at 1-800-444-5445 or visit the Shaw AFB TSC/Managed Care Office, Monday-Friday from 0730 to 1630. Many of you have relied on military medical treatment facilities for most, if not all, of your health care. Our medical treatment facilities are an integral part of TRICARE. TRICARE expands your options to include a growing civilian provider network. These providers have been carefully selected to participate in TRICARE because of their high quality care standards. There are three different TRICARE plans from which you can choose: Prime, Extra and Standard. Each plan has different cost shares and degrees of freedom for choosing your health care providers. For more information call 1-800-444-5445, or visit the Shaw AFB TRICARE Service Center/Managed Care Office. 9
  • 10. Referrals When you need specialty care, your Family Health Provider will refer you to a network of other specialists. You and your providers will be notified of your authorized referral within 10 business days. Notification will either be by phone or in writing. You can also check on your authorization, 24-hours a day by calling 1-800-444-5445 or by logging onto www.humana-military.com and registering for beneficiary services. If you need any changes to a referral, you should contact the Referral Management Center at (803) 895-6559. TRICARE Dental Program (TDP) This is a private insurance program for family members of all uniformed services active duty, Selected Reserve and Individual Ready Reserve personnel of the Uniformed Services. The plan is voluntary, requiring the sponsor to enroll his/her dependents into the TRICARE Dental Program. A list of participating dentists and additional information can be obtained from the TRICARE Service Center. The TRICARE Retiree Dental program is currently administered via MetLife. They may be contacted at 1-855-MET-TDP1 (1-855-638-8372, toll-free) or at http://mybenefits.metlife.com/tricare. Beneficiary Counseling and Claims Assistance (BCAC) and Debt Collection As- sistance Officers (DCAO) This office provides assistance to beneficiaries with questions and/or medical claims issues. The Health Benefits staff will assist all eligible beneficiaries to include those with Prime, Standard and Extra coverage. Simply call (803) 895-6228 for assistance. Advance Directives An Advance Directive contains written instructions you have made concerning your future medical care in case you become unable to make decisions for yourself or become unable to communicate to your provider about your decisions. It is a legal document and can be in the form of a Living Will and/or a Medical Power of Attorney. Be sure to inform your provider, nurse, or health technician if you have or desire an Advance Directive. The Legal Office will answer your questions and provide legal advice. If you have any questions or would like to complete an Advance Directive, contact the Legal Office at 895-1560. 10
  • 11. CUSTOMER ASSISTANCE/CONCERNS Patient Advocate Program The Patient Advocate Program is designed to ensure you are satisfied with your medical care. Through this program, the 20th Medical Group provides an immediate response to your concerns. Contact the patient customer service representative in the area where you have a concern. His or her name and photograph are posted in the waiting room. If your problem is not addressed to your satisfaction, you may also speak with the OIC or NCOIC, who will try to answer your questions or work with you towards a solution before you leave the clinic. If the OIC or NCOIC is unable to do so, he or she may refer you to their Squadron Superintendent or Squadron Commander. Another avenue to express any concern is the 20th Medical Group Patient Advocate Office, where your concern will be documented and sent for review. All patient complaints should be in written form and signed by the patient, which will allow clear communication and account- ability. You may also call the Patient Advocate Office during normal duty hours at 803-895-6817. The men and women of the 20th Medical Group strive to provide excellent quality care. We would like to know your concerns and how you feel about the service you receive while visiting our facility. Please take a moment to comment on the care provided by filling out our customer comment cards available in the clinic waiting areas. This program is important to the medical group and to you, because it allows us to measure the level of your satisfaction while identifying and correcting problem areas, thus providing better care and service in the future. In addition, you may receive a call from an independent party who serves as a gatherer for our Service Delivery Assessment survey that provides the 20 MDG with customer service information. You will receive an e-mail survey to evaluate your dental clinic experience. Ethics Hearing Ethical issues or differences of opinion concerning treatment options may arise because the physician and patient/family have different value systems, which may stem from different religious beliefs, ethnic backgrounds or upbringing. If a conflict arises that cannot be resolved through discussion between the provider, their supervisor and patient/family, an ethics hearing may be called by our Chief of the Medical Staff (Senior Provider) to discuss and make recommendations to help resolve the issue. This does not include differences of opinion concerning treatment options that are medically or legally contraindicated. 11
  • 12. PATIENT’S RIGHTS AND RESPONSIBILITIES Patient Rights As a Patient, You have the Right to: Receive emergency care without preauthorization where and when acute symp- toms are so severe that a ―sensible layperson‖ would want emergency care to pre- vent serious harm or death. Timely, considerate, and respectful care at all times and under all circumstances. An environment of shared respect which is free from discrimination. Accurate information about the TRICARE program to include covered health bene- fits and health plan options. A choice of healthcare providers, either within TRICARE Prime network or the Military Treatment Facility (MTF). Receive accurate, accessible and understandable healthcare information. Ask questions and receive timely answers to those questions. Choose someone to make decisions on your behalf if you cannot do so. Know all of your treatment options including the option of no treatment. Know the risks, benefits, and consequences of each of these options. Refuse care as allowed by law. Privacy and protection of your personal health information. Communicate with healthcare providers in confidence as allowed by law and regu- lation. Review and obtain a copy of your own medical records through the release of infor- mation request. Request amendments to your records, within specific legal limits. A fair and efficient process to appeal medical necessity decisions by your MTF or by TRICARE that includes both internal review and independent external review. To discuss complaints with your provider or Patient Advocate. Contact a TRICARE Debt Collection Assistance Office if unable to pay fees. Review a provider directory maintained in Managed Care to assist with understand- ing your provider’s education and training and selecting a Primary Care Manager. Review publicly-reported MTF quality measures; please view MTF slide presenta- tion in main patient waiting area. 12
  • 13. Patient Responsibilities As a Patient, You are Responsible to: Have respect for the rights of other patients and MTF staff. Become educated about TRICARE coverage, options, and rules, to include required fees. Tell your healthcare professional everything you know about your illness or condi- tion, past healthcare, and any and all medications or supplements you are taking, and any legal healthcare directives that affect your care. Inform the provider or nurse about any changes in how you feel. Participate in decisions related to your healthcare and ask questions if you do not understand any part of the proposed treatment. Follow your treatment plan(s), which is established by your provider (s). Provide an adult attendant if required by your healthcare team. Maximize healthy habits, such as increased exercise and a healthy diet as well as reduced tobacco use and knowingly spread disease. Accept the consequences if you refuse to follow the plan of care. Keep appointments or call to change or cancel them at least 24 hours in advance. Report wrongdoing and fraud to appropriate authorities. If you have any questions regarding your rights and responsibilities please talk with your healthcare provider or the respective Department Patient Advocate. Patient Privacy Rights Congress recognized the need for the national patient record privacy standards and enacted the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which became effective 14 April 2003. The law included provisions designed to save money for health care businesses by encouraging electronic standards, but in the process required new safeguards to protect the security and confidentiality of the information. Patient’s rights include: 13
  • 14. A written notice of privacy practices from health plans and providers. To access the MHS policy practices, contact the privacy officer at any DoD Medical Treatment Facility or go to this website: http://www.tricare.mil/tma/hipaa Right to access, review and request correction of and obtain a copy of your protected health information (PHI), such as your medical record. Right to an accounting of certain disclosures of your PHI. Right to request restriction of uses and disclosure of PHI. Right to file a complaint regarding privacy infractions. The 20th Medical Group will serve as your advocate for privacy issues and the proper dissemination of your health care information in compliance with the HIPAA legislation. The Privacy Officer can be reached at (803) 895-6455 for any concerns or assistance you may require. CLINICAL SERVICES AND PROGRAMS Ambulance Services The 20th Medical Group does not have an emergency department or urgent care care services. For all emergencies (i.e., off- or on-base), call 911. Our ambulance transports patients directly to the emergency room at Tuomey Regional Medical Center. For emergencies occurring in the civilian community, the Sumter County Emergency Services will only transport patients to the Tuomey Regional Medical Center Emergency Room. The hospital and physician’s bills for active duty members and their dependents should be brought to the TRICARE Service Center as soon as you receive them. Make sure you speak with your Family Health Provider prior to (when the situation permits), or within 24 hours, if you go to an emergency department or seek urgent care outside of the military treatment facility. Routine care outside the MTF obtained without a prior approved referral is generally not a covered (reimbursable) benefit and the member may be subject to point-of-service charges. Medical In-processing To help smooth your transition into your new home here at Shaw AFB, the 20th Medical Group asks each newly enrolled dependent beneficiary to complete a medical assessment form. These forms are reviewed by your Primary Care Manager so that they may address your current and preventative health care needs. Additionally, all active duty members are required to in-process through TRICARE, Public Health, and the Dental Clinic. The goal is to ensure you know what health care services are available here at Shaw and how to get help when you need it. For more information, contact Managed Care at 895-6228. 14
  • 15. Patient Centered Medical Home (PCMH) Family Health Providers are health care providers specially designated to manage all health care needs of active duty members and other individuals enrolled to TRICARE Prime. The goals are for the Family Health Provider to become familiar with the needs of their assigned patients, and to ensure that all care is appropriately managed. To the maximum extent possible, patient visits will be scheduled with the assigned Family Health Provider or one of their Family Health team partners. Family Health Providers are designated in Family Medicine, Pediatrics and Flight Medicine. Family Health Clinic (Bldg. 1048): The Family Health Clinic functions as one of the main entry points of care in this facility. Specialty care referrals are initiated through this clinic by your Family Health Provider, and then transmitted to the TRICARE Service Center/Managed Care Office for authorization and scheduling. NOTE: The Family Health Clinic cares for patients of all ages, from pediatrics to geriatrics. Call 895-CARE (2273) or go to TRICAREOnline.com to schedule appointments. Duty Hours: The Family Health Clinic is open Monday through Friday from 0730 – 1630. The Family Health Clinic is CLOSED on weekends, holidays and down days. The Family Health Clinic has no emergency services. If you have a true medical EMERGENCY, call 911. Preventive Health Assessment (PHA) Appointments: Active duty members may schedule their PHA appointments by calling 895-6373. School and Athletic Physicals: School and athletic physicals are normally performed in the summer months before school begins, and are publicized. Appointments can be made by calling 895-CARE (2273), Monday through Friday. Provider On-Call: The Provider On-Call can be reached by calling 895-CARE (2273) after hours. The Provider On-Call is not located within the facility. NOTE: If you are on flying status, an air traffic controller, parachutist, weapons controller or administratively qualified for the Personnel Reliability Program, the Flight Medicine Clinic is your Family Health Provider. You can contact the Flight Medicine Clinic by calling 895-2273 during non-duty hours (ask to be forwarded to the on-call Flight Medicine provider). Pediatric Clinic The Pediatric Clinic (Bldg. 1053) is open for children 16 years and under. Children of any age with chronic or special needs may also be seen in this clinic. Duty Hours: The Pediatric Clinic is open Monday through Friday, 0730 – 1630. Call 895-CARE (2273) to schedule appointments. 15
  • 16. Women’s Health Clinic The Women’s Health Clinic is co-located within the Family Health Clinic and pro- vides a variety of gynecological services to female patients assigned to the 20th Medical Group. Gynecological services include all active duty pap smears (no re- ferral needed), space available dependent spouse pap smears, abnormal pap follow- up and treatment, specialized gynecological problems, limited procedures, family planning and individualized patient counseling and education. Patients with gyne- cological concerns are seen on a referral only/case-by-case basis, based on the na- ture of the referral. Civilian consultation is utilized for any patients whose medical history requires additional support. Pregnancy tests are available on a walk-in basis. Please note that Shaw AFB does not provide obstetrical services. Once a woman has a positive pregnancy test from the lab, she will be scheduled for a new parent briefing and provided with appropriate information for obtaining obstetrical services in the local community. Duty Hours: The Women’s Health Clinic is open Monday through Friday, 0730 – 1630 daily. All injections are done on a walk-in basis, Monday through Friday between the hours of 0800 - 1100 and 1300 – 1500. Mental Health & Family Advocacy The Mental Health Flight provides triage, clinical assessments, evaluations, and outpatient treatment psychiatric services for active duty members. Substance abuse evaluations and treatment are also available. Care for dependents, retirees and de- pendents of retirees is limited. Mental Health care for these beneficiary categories is referred to the civilian community. Outpatient appointments for active duty per- sonnel can be made through self-referral, referral from health care providers, com- mand, or other Air Force agencies. The Family Advocacy Program is designed to provide therapeutic, preventive and educational services to military families at risk for and/or experiencing family vio- lence. The Family Advocacy Outreach and Prevention Team develops programs and services in cooperation with other community agencies aimed at strengthening and enriching Air Force families. The New Parent Support Program offers support for new parents, provides parenting classes, and many psychological, educational and de-velopmental classes. Access to Care: To schedule an appointment with the Mental Health Clinic, please call 895-6199 between 0730 – 1630, Monday through Friday. For more information about the Mental Health Clinic, please call 895-6199. For information about Family Advocacy, please call 895-6201. 16
  • 17. Exceptional Family Member Program—Medical (EFMP-M) The Exceptional Family Member Program—Medical (EFMP-M) is designed to provide assistance to eligible personnel with dependents who receive special educational or medical attention for chronic physical or mental conditions or who require frequent services by a specialist. This assistance may be in the form of referral to available support services or counseling on special assignment considerations. For more information on this program, call 895-6776. Physical Therapy Physical Therapy (Bldg. 1048) provides health care devoted to relieving pain, restoring function and preventing injuries and disabilities to all active duty personnel and DoD beneficiaries. Those eligible for care are seen by referral from a physician, physician assistant, nurse practitioner or dentist. NOTE: The Physical Therapy Clinic does not provide services for patients requiring long-term care for pediatric or adult neurological conditions, neonatal intensive care intervention or developmental disabilities. These patients are referred through TRICARE to specialty facilities to better meet their needs. Access to Care: To schedule appointments, please call 803-895-6562 or come by the Physical Therapy Clinic front desk. Duty Hours: Physical Therapy is open Monday, 0730-1630; Immunizations The Immunization Clinic is a walk-in clinic. Childhood immunizations are scheduled to follow standard well-baby check-ups. Parents should bring copy of their child’s immunization record. NOTE: PPD tests (TB skin tests) require two visits (one to administer the test and one to read it 48 to 72 hours later) and are not administered on any Thursday or on the Friday before a long weekend. Information: For additional information concerning specific immunizations, please contact the clinic at 895-6492. Duty Hours: Immunizations is open 0730 – 1600, Monday through Friday. This section is closed daily from 1200 – 1300. AEROSPACE MEDICINE Flight Medicine Flight Medicine (Bldg. 1005) provides primary medical care for all personnel on flight /special operator status and their dependents. This includes aircrew, air traffic controllers, space operators, and other special operational duty personnel. Addition- ally, certain 17
  • 18. AD and civilian employees in the Occupational Health program are seen for their annual assessment. All medical needs of personnel on flight/special operator status must be coordinated through the Flight Medicine Flight. Active Duty Sick Call: Hours for sick call are 0730 and 1300, Monday through Friday. Sick call is limited to acute problems or return to flight controlling status. Access to Care: To schedule an appointment, please call 895-CARE (2273) from 0730 – 1600, Monday through Friday. Arrive 20 minutes early for scheduled appointments. Duty Hours: Flight Medicine is open 0730 – 1630, Monday, Tuesday, Wednesday, and Thursday and from 0730 – 1530 Friday. Health Promotion Flight (Health and Wellness Center (HAWC)) Health Promotions is a program designed to promote healthy lifestyles by identifying health risks and establishing programs that facilitate changes towards the adoption of healthier behaviors in our Air Force community. The HAWC provides a ―one-stop-shop‖ for health and fitness assessment, awareness and prevention programs. The HAWC (Bldg. 901) provides tobacco cessation programs, nutritional counseling, disease risk counseling (cholesterol, diabetes and high blood pressure), health risk appraisals and exercise prescriptions, and supports the commander’s fitness program. Books and videos on various health topics can be signed out, and educational materials are available on all the above topics. The HAWC is a member of the Shaw Prevention Team and partners with Family Support, Family Advocacy, Family Member’s Program Flight, the Chaplain, and Mental Health in providing programs to meet the needs of our Shaw AFB community. Stop by and see if we can make a difference in pointing you in the direction of getting healthy and staying healthy. Information: For additional information, call the HAWC at 895-1216/17. Duty Hours: The HAWC is open 0730 – 1630, Monday through Friday. Public Health Flight The Public Health Flight (Bldg. 1054) is organized in two major elements, Community Health Management and Force Health Management. The Community Health Element oversees issues related to the base population as a whole. These programs include Communicable Disease Surveillance, Epidemiology, Food Safety, Facility Sanitation and Disease Vector Surveillance. 18
  • 19. The Force Health Management Element oversees issues related to force mobilization. These include tracking and completion of the Preventive Health Assessment and Individual Medical Readiness database, oversight of Occupational Medical Examinations, hearing testing, and Pre/Post Deployment Processing. Duty Hours: Public Health is open from 0730 – 1630, Monday through Friday. Call 895-6193/6185 to access services. Optometry Services Element Optometry (Bldg. 1048, 2nd Floor) provides comprehensive vision care, to include routine eye examinations and urgent eye care (red eyes, eye injuries, etc.) for active duty personnel. Family members and retirees receive eye care through TRICARE with a civilian provider. Optometry provides Diabetic Eye exams for all TRICARE beneficiaries, and Corneal Refractive Surgery pre-operatively and post-operatively. Active Duty and retiree patients can bring their eyeglass prescriptions to the clinic to order military eyewear. Access to Care: To schedule an appointment, please call 895-CARE (2273), op- tion1, option 4 from 0700 – 1600, Monday through Friday. For urgent eye care appointments, call 895-CARE (2273). Duty Hours: Optometry is open 0730 – 1630 Monday through Thursday 0730 – 1530 Friday Bioenvironmental Engineering Flight The Bioenvironmental Engineering Flight (Bldg. 1005) applies knowledge of engineering and the sciences to assist commanders in employing risk management principles to meet their mission in peacetime and during contingency operations. Our top priority is to perform risk assessment surveys evaluating systems, installations, facilities, and planning documents for chemical, physical and biological stress factors which may cause illness, injury, reduced productivity, performance or significant discomfort among Air Force personnel in occupational environments. The flight advises commanders on impact to mission of unacceptable risks and provides possible solutions. Call 895-6196 to access services. Aerospace Physiology Flight (APF) The Aerospace Physiology Flight (Bldg. 1047) acquaints aircrew and high altitude parachutists with the stresses and equipment of aerospace operations in order to prepare them to successfully function and survive during all situations. Our goal is to improve aviation safety by providing academics in a controlled environment that will ultimately increase human performance. By working as a team, we provide our customers the highest quality of physiological training while maintaining combat readiness and efficiency for High Altitude Airdrop Mission Support. Access to Care/Training: You may reach us at 895-6791 from 0700-1600, Monday through Friday. Duty Hours: Aerospace Physiology is open from 0700-1600, Monday through Friday. 19
  • 20. Dental Services Dental Services (Bldg. 1046) provides comprehensive dental care to active duty personnel in an effort to ensure Shaw AFB is ―dentally ready‖ for worldwide duty. Eligible active duty family members should be enrolled in the TRICARE Dental Plan (www.metlife.com). Retirees and their families can enroll in the TRICARE Retiree Dental Plan (www.ddpdelta.org) or may seek other types of dental insurance coverage. Covered benefits/procedures should be provided by the individual’s participating network dentist. Space-available care is very limited, due to primary mission demands and other requirements. Dental Emergencies: Same-day evaluation and management of dental emergencies (trauma, bleeding, swelling, infection, severe pain, etc.) is available for all beneficiary categories. Call 895-6988/6989 during duty hours and 895-CARE (2273) during non-duty hours. NOTE: Non-active duty personnel must first at- tempt to access their network dentist, as this provides continuity of care. The cost of emergency service is covered by the TRICARE Dental Plan. Access to Care: To schedule an appointment, please call 895-6988 or you may make it in person. Duty Hours: Dental Services is open 0730 – 1630, Monday through Friday ANCILLARY AND SUPPORT SERVICES Laboratory The Laboratory (Bldg. 1048) supports Family Health, Pediatrics, Women’s Health Clinic and Flight Medicine in conducting various clinical laboratory tests. Tests not performed in-house are processed through our shipping department to be tested at various military and civilian reference laboratories. All patient encounters are conducted at the laboratory reception desk. Special collection directions are available for some requested tests. All military health care system beneficiaries with a legible laboratory request signed by a licensed military or civilian provider are eligible for our services. Access to Care: The Laboratory is a walk-in clinic, or you may contact our front desk at (803) 895-6515 for any further questions. Duty Hours: The Laboratory is open from 0730 – 1630, Monday through Friday. 20
  • 21. Diagnostic Imaging/Radiology Services (X-Ray) Diagnostic Imaging/Radiology Services (Bldg. 1048) provides routine radiography services. Special procedures to include fluoroscopy, ultrasound and mammography are referred to other military or civilian sources. All examinations require a health care provider’s request. Requests from civilian providers will be honored with a legible prescription. Routine radiography will be performed on a walk-in basis while all special examinations will be scheduled through TRICARE. Information: You may reach us at (803) 895-6625 for any additional information. Duty Hours: Diagnostic Imaging/Radiology Services is open from 0730 – 1630, Monday through Friday. Pharmacy The 20 MDG Pharmacy dispenses medications upon receipt of a written prescrip- tion from a military or civilian provider. New and existing prescriptions from 20 MDG providers and from civilian providers are filled at the main pharmacy. The 20 MDG Pharmacy will gladly fill civilian provider prescriptions. If you receive your care from a civilian provider, please come by the Pharmacy and pick up a list of medications stocked at the 20 MDG Pharmacy or access our for- mulary online at www.shaw.af.mil/units/medicalservices/index.asp. We will not be able to fill a prescription for a medication not on our formulary. The 20 MDG Pharmacy must follow South Carolina State law with regard to phar- macy practice. All patients must pull a ticket from the ticket station located in the pharmacy lobby for their prescription to be processed. Your ticket number will be called to the first free pharmacy window in the order it was pulled from the machine. Prescription refills are filled at the Satellite Pharmacy (located in the Base Exchange complex). Pharmacy hours of operation are: Main Pharmacy Satellite Pharmacy Monday-Friday: 0745 - 1700 hrs. Monday-Friday: 0900 – 1700 hrs. Closed on Sat/Sun/Holidays/Wing Down Days The satellite Pharmacy has a convenient call-in refill service. Refills called in before 1200 are ready the next duty day. Refills called in after 1200 are ready within two duty days. The phone numbers for this system are 895-6678 or toll free at 1-877-796-2273. 21
  • 22. You must present your Identification Card (ID) to the Pharmacy window when dropping off a prescription or picking up medication. Pharmacy staff members will dispense medications when presented with a valid ID card. Patients may also elect to have their prescriptions filled at either the TRICARE Mail Order Pharmacy (TMOP) or a local civilian pharmacy that accepts TRICARE. Unless you are active duty, there will be a co-pay for each prescription filled at these locations. There is no co-pay for active duty members. Keep in mind those medications that are non-formulary at Shaw AFB may be formulary medications at these two pharmacies, and may therefore be available at the lower co-pays. Prescriptions filled at local civilian pharmacies are limited to a 30-day supply of medication. Most prescriptions filled through the TMOP can be filled up to a 90-day supply of medication if the prescription is written for that quantity. The co-pay for a 90-day supply of medication through the TMOP is the same as a 30-day supply of medication from a local civilian pharmacy. In order to utilize the TMOP, patients need to register with TMOP. Registration forms can be obtained at the Shaw Pharmacy. They can also be obtained by contacting the TMOP at the following toll-free number: 866-363-8667. Additional questions about the TMOP can be answered by your pharmacy staff at Shaw, the toll-free number provided above, or through the following website: www.express-scripts.com. Patients with civilian prescriptions, may also utilize the prescription drop-off box located in the waiting area of the main pharmacy. The beneficiary must fill out the provided envelope completely. Prescriptions that are dropped in the prescription drop box may be picked up 2 hours later at window 4. Please call the Pharmacy at 803-895-6464 if you have questions. Volunteers We have a very active volunteer staff working in the 20th Medical Group. Volunteers perform many vital functions that help the everyday operations of the clinic flow smoothly. If you are interested in becoming one of these valuable volunteers, contact the Red Cross Volunteer Coordinator, 895-1251. PERFORMANCE IMPROVEMENT/PATIENT SAFETY It is the goal of the 20th Medical Group to provide our patients with safe, quality medical and dental care. You have the right to report any unsafe condition or patient safety concern to the 20th Medical Group Leadership, by requesting any 20th Medical Group staff member or Customer Service Representative to complete the documentation in the DoD Patient Safety Reporting System. You are also an important part of this on-going commitment to excellence. Your comments regarding care you receive at the clinic are important to us. You may receive a call asking for your comments regarding a recent visit; the information you give will help us maintain our high standards of excellence. The survey is brief; please take the time to participate. In addition, you are welcome to complete a comment card (located throughout the facility) at anytime. 22
  • 23. ACCREDITATION ASSOCIATION FOR AMBULATORY HEALTH CARE (AAAHC) AAAHC has committed to its mission to remain the preeminent leader in develop- ing standards to advance and promote patient safety, quality, value and measure- ment of performance for ambulatory health care through peer-based accreditation processes, education and research. Anyone believing that he or she has pertinent and valid information about such matters may contact the AAAHC at any time through the following mechanisms: Accreditation Association for Ambulatory Health Care 5250 Old Orchard Road, Suite 200 Skokie, IL 60077 Phone: (847) 853-6060 Fax: (847) 853-9028 Email: info@aaahc.org Web: www.aaahc.org WHAT ARE MEDICAL ERRORS? Medical errors are one of the nation’s leading causes of death and injury. Govern- ment agencies, purchasers of group health care and health care providers are work- ing together to make the U.S. health care system safer for patients and the public. In recent years, medical errors have received much attention. Steps are being taken to reduce the number of errors that occur. One of these steps is to educate patients on what they can do to help prevent medical errors. Listed below are tips to help make your health care experience safer. You are an important part of your health care team; if you have questions, SPEAK UP. Medical errors happen when something that was planned as a part of medical care doesn't work out, or when the wrong plan was used in the first place. Medical errors can occur anywhere in the health care system:  Hospitals  Clinics  Outpatient Surgery Centers  Providers' Offices  Nursing Homes  Pharmacies  Patients' Homes Errors can involve:  Medicines  Surgery  Diagnosis  Equipment  Lab reports 23
  • 24. 20 TIPS TO HELP PREVENT MEDICAL ERRORS 1. The single most important way you can help to prevent errors is to be an active member of your health care team. That means taking part in every decision about your health care. Research shows that patients who are more involved with their care tend to get better results. Some specific tips follow. Medicines 2. Make sure that all of your providers know about everything you are taking. This includes prescription and over-the-counter medicines, and dietary supple- ments such as vitamins and herbs. At least once a year, bring all of your medicines and supplements with you to your provider. "Brown bagging" your medicines can help you and your provider talk about them and find out if there are any problems. It can also help your provider keep your records up to date, which can help you get better quality care. With the Patient Centered Medical Home a partnership is one of our main goals. So that you will have a list of current medication readily available, please list them on the last page of this pamphlet. 3. Make sure your provider knows about any allergies and adverse reactions you have had to medicines. This can help you avoid getting a medicine that can harm you. 4. When your provider writes you a prescription, make sure you can read it. If you can't read your provider's handwriting, your pharmacist might not be able to either. 5. Ask for information about your medicines in terms you can understand--both when your medicines are prescribed and when you receive them.  What is the medicine for?  How am I supposed to take it, and for how long?  What side effects are likely? What do I do if they occur?  Is this medicine safe to take with other medicines or dietary supplements I am taking?  What food, drink or activities should I avoid while taking this medicine? 6. When you pick up your medicine from the pharmacy, ask: Is this the medicine that my provider prescribed? A study by the Massachusetts College of Pharmacy and Allied Health Sciences found that 88 percent of medicine errors involved the wrong drug or the wrong dose. 24
  • 25. 7. If you have any questions about the directions on your medicine labels, ask. Medicine labels can be hard to understand. For example, ask if "four doses daily" means taking a dose every 6 hours around the clock or just during regular waking hours. 8. Ask your pharmacist for the best device to measure your liquid medicine. Also, ask questions if you're not sure how to use it. Research shows that many people do not understand the right way to measure liquid medicines. For example, many use household teaspoons, which often do not hold a true teaspoon of liquid. Special devices, like marked syringes, help people to measure the right dose. Being taught how to use the devices helps even more. 9. Ask for written information about the side effects your medicine could cause. If you know what might happen, you will be better prepared if it does, or if something unexpected happens instead. You can then report the problem to your provider right away and get help before the problem gets worse. Hospital Stays 10. If you have a choice, choose a hospital at which many patients have the procedure or surgery you need. Research shows that patients tend to have better results when they are treated in hospitals that have a great deal of experience with their condition. 11. If you are in a hospital, consider asking all health care workers who have direct contact with you whether they have washed their hands. Hand washing is an important way to prevent the spread of infections in hospitals. Yet, it is not done regularly or thoroughly enough. A study found that when patients checked whether health care workers washed their hands, the workers washed their hands more often and used more soap. 12. When you are being discharged from the hospital, ask your provider to ex- plain the treatment plan you will use at home. This includes learning about your medicines and finding out when you can get back to your regular activities. Research shows that at discharge time, providers think their patients understand more than they really do about what they should or should not do when they return home. 25
  • 26. Surgery 13. If you are having surgery, make sure that you, your provider and your sur- geon all agree and are clear on exactly what will be done. Doing surgery at the wrong site (for example, operating on the left knee instead of the right) is rare. But even once is too often. The good news is that wrong-site surgery is 100 percent preventable. The American Academy of Orthopedic Surgeons urges its members to sign their initials directly on the site to be operated on before the surgery. Other Steps You Can Take 14. Speak up if you have questions or concerns. You have a right to question anyone who is involved with your care. 15. Make sure that someone, such as your personal provider, is in charge of your care. This is especially important if you have many health problems or are in a hospital. 16. Make sure that all health professionals involved in your care have important health information about you. Do not assume that everyone knows everything they need to. 17. Ask a family member or friend to be there with you and to be your advocate (someone who can help get things done and speak up for you if you can't). Even if you think you don't need help now, you might need it later. 18. Know that " ore is not always better. m It is a good idea to find out why a test or treatment is needed and how it can help you. You could be better off without it. 19. If you have a test, don't assume that no news is good news. Ask about the results. Consider asking when the test is ordered when and how you should hear back about the results. 20. Learn about your condition and treatments by asking your provider and nurse and by using other reliable sources. Reference: ―Patient Fact Sheet, 20 Tips to Prevent Medical Errors‖ www.ahrq.gov/consumer 26
  • 27. 20TH MEDICAL GROUP KEY NUMBERS APPOINTMENTS 895-CARE/1-877-796-CARE AEROSPACE PHYSIOLOGY (APF) 895-6791 BIOENVIRONMENTAL ENGINEERING 895-6196 DENTAL 895-6988 FAMILY ADVOCACY 895-6201 FAMILY HEALTH 895-CARE FLIGHT MEDICINE 895-6746 HEALTH AND WELLNESS CENTER(HAWC) 895-1216 HEALTH BENEFITS ADVISOR 895-6727 IMMUNIZATION CLINIC 895-6492 LABORATORY 895-6515 MENTAL HEALTH 895-6199 MEDICAL RECORDS 895-6505 OPTOMETRY 895-6579 PATIENT ADVOCATE 895-6817 PEDIATRICS 895-CARE PERFORMANCE IMPROVEMENT 895-6336 PHARMACY 895-CARE, prompt #6 PHARMACY SATELLITE 895-CARE, prompt #6 PHARMACY – Automated Refill Service 895-CARE, prompt #6 PHYSICAL THERAPY 895-6562 PRIMARY CARE (PCM) TEAMS 895-CARE PRIVACY OFFICER 895-6455 PUBLIC HEALTH 895-6193/6185 PATIENT ADMINISTRATION 895-6228 TRICARE 1-800-444-5445 WOMEN’S HEALTH CLINIC 895-2273 27
  • 28. WEB RESOURCES Shaw Air Force Base http://www.shaw.af.mil/ TRICARE http://www.tricare.mil/ TRICARE (Humana) http://www.humana-military.com/ TRICARE (General and local info) http://www.tricareonline.com/ TRICARE Regional Office South http://www.tricare.mil/trosouth/ Delta Dental (Retiree Dental Program) www.trdp.org/ MetLife (TRICARE Dental) http://mybenefits.metlife.com/tricare DEERS Address Changes http://www.tricare.mil/deers/default.cfm National Mail Order Pharmacy (NMOP) www.express-scripts.com As of 31 Jan 13 28 MDGP 41-119