Patient Affairs BranchLesson 1. The Triple Option Benefit Program and the Civilian Health and Medical Program of the Uniformed Services. - Patient Affairs BranchActive Duty (AD) Member. - Patient Affairs BranchMaximum Hospital Benefit - Patient Affairs BranchThe TRICARE Program - Patient Affairs BranchThe TRICARE Program (Cont) - Patient Affairs BranchSection II. Eligible Beneficiaries - Patient Affairs BranchParticipating providers - Patient Affairs BranchSection IV. Entitlements - Patient Affairs BranchGuidelines. - Patient Affairs BranchEntitlement to Outpatient Care Under TRICARE - Patient Affairs BranchFigure 1-1. DD Form 1251, Nonavailability Statement - Patient Affairs BranchHealth Benefits Not Covered Under TRICARE - Patient Affairs BranchHealth Benefits Not Covered Under TRICARE (Cont) - Patient Affairs BranchSection V. Charges Under TRICARE - Patient Affairs BranchTimely Filing of Claims - Patient Affairs BranchFamily members of active duty personnel - Patient Affairs BranchFigure 1-3. Costsharing under TRICARE-Retirees, Their Family Members, and Others - Patient Affairs BranchSection VI. Program for Persons with Disabilities - Patient Affairs BranchServices and Charges - Patient Affairs BranchTable 1-1. Pay grades and share amounts, Program for Persons with Disabilities - Patient Affairs BranchExercises - Patient Affairs Branch - md07550030Exercises (cont) - Patient Affairs Branch - md07550031Exercises (cont) - Patient Affairs Branch - md07550032Exercises (cont) - Patient Affairs Branch - md07550033Solution to Exercises - Patient Affairs Branch - md07550034Solution to Exercises (cont) - Patient Affairs Branch - md07550035Lesson Assignment - Patient Affairs Branch - md07550036Lesson 2. Medical Affirmative Claims. - Patient Affairs BranchRoles and Actions in Establishing Medical Affirmative Claims - Patient Affairs BranchFigure 2-1. DA Form 2985, Admission and Coding Information. - Patient Affairs BranchDA Form 2631-R, Medical Care--Third Party Liability Notification - Patient Affairs BranchFigure 2-2. DA Form 2631-R, Medical Care--Third Party Liability Notification. - Patient Affairs BranchFigure 2-3. DA Form 3154, MSA Invoice and Receipt. - Patient Affairs BranchSection II. Medical Affirmative Claims Actions - Patient Affairs BranchThe owner of the vehicle. - Patient Affairs BranchI'm not quite sure. - Patient Affairs BranchResponses - Patient Affairs Branch - md07550046Responses (cont) - Patient Affairs BranchThe civilian hospital where the patient was receiving care. - Patient Affairs BranchAn RJA in Texas. - Patient Affairs BranchWho initiates the DA Form 2985? - Patient Affairs BranchResponses - Patient Affairs Branch - md07550051Lesson Assignment - Patient Affairs Branch - md07550052Lesson 3. Line of Duty. - Patient Affairs BranchPurpose of Line Duty Determinations - Patient Affairs BranchAuthorized Findings - Patient Affairs BranchProximate Cause - Patient Affairs BranchUnauthorized Absence (AWOL) - Patient Affairs BranchFigure 3-1. Disposition Form for notification of Line of duty findings. - Patient Affairs BranchSection II. Line of Duty Investigations - Patient Affairs BranchFormal Line of Duty Investigation - Patient Affairs BranchTime Limitations - Patient Affairs BranchTable 3-1. Processing an informal investigation (continued). - Patient Affairs BranchTable 3-1. Processing an informal investigation (concluded). - Patient Affairs BranchTable 3-2. Processing a formal investigation (continued). - Patient Affairs BranchTable 3-2. Processing a formal investigation (concluded). - Patient Affairs BranchProcessing a Formal Investigation - Patient Affairs BranchDA Form 2173, Statement of Medical Examination and Duty Status - Patient Affairs BranchFigure 3-2. DA Form 2173, Statement of Medical Examination and Duty Status (Completed). - Patient Affairs BranchFigure 3-3. DD Form 261, Report of Investigation--Line of Duty and Misconduct Status (Completed). - Patient Affairs BranchAppeals and Revision or Correction of Line of Duty Findings. - Patient Affairs BranchRevision or Correction of LD Findings. - Patient Affairs BranchExercises - Patient Affairs Branch - md07550072Exercises (Cont) - Patient Affairs Branch - md07550073Exercises (Cont) - Patient Affairs Branch - md07550074Exercises (Cont) - Patient Affairs Branch - md07550075Solutions to Exercises - Patient Affairs Branch - md07550076Solutions to Exercises (Cont) - Patient Affairs Branch - md07550077Lesson Assignment - Patient Affairs Branch - md07550078Lesson 4. Reporting of Very Seriously Ill/Seriously Ill/Special Category (VSI/SI/SPECAT) Patients. - Patient Affairs BranchFigure 4-1. DA Form 2984, VSI/SI/SPECAT Patient Report. - Patient Affairs BranchPatient Administration. - Patient Affairs BranchRoster of VSI/SI/SPECAT Patients. - Patient Affairs BranchNotification procedures for VSI/SI - Patient Affairs BranchNotification procedures for special category patients - Patient Affairs BranchInternational Requirements - Patient Affairs BranchExercises - Patient Affairs Branch - md07550086Exercises (cont) - Patient Affairs Branch - md07550087Solutions to Exercises - Patient Affairs Branch - md07550088Lesson Assignment - Patient Affairs Branch - md07550089Lesson Assignment (cont) - Patient Affairs BranchSuggestion - Patient Affairs BranchLesson 5. Medical Evaluation and Physical Disability Processing. - Patient Affairs BranchAlphabetic Factors - Patient Affairs BranchNumerical designations - Patient Affairs BranchRecording and Reporting of Initial Physical Profile - Patient Affairs BranchPreparation of DA Form 3349 - Patient Affairs BranchFigure 5-1. DA Form 3349, Physical Profile Board Proceedings - Patient Affairs BranchApproval of DA Form 3349. - Patient Affairs BranchSection II. Hospitalization and Medical Evaluation Preceding Physical Disability Action - Patient Affairs BranchSection III. Physical Disability Processing - Patient Affairs BranchPowers, functions, duties, and responsibilities - Patient Affairs BranchThe Surgeon General. - Patient Affairs BranchSection IV. The medical board - Patient Affairs BranchUse of Medical Boards - Patient Affairs BranchPhysical Evaluation Board Liaison Officer (PEBLO) - Patient Affairs BranchFigure 5-2. DA Form 3947, Medical Board Proceedings. - Patient Affairs BranchRequest for Discharge or Reconsideration - Patient Affairs BranchTable 5-1. Distribution of medical board proceedings - Patient Affairs BranchNotification - Patient Affairs BranchAction following approval of a medical board recommendation for PEB referral - Patient Affairs BranchFigure 5-3. Application for continuance on active duty. - Patient Affairs BranchFigure 5-4. Request for Expeditious Discharge for Physical Disability - Patient Affairs BranchFigure 5-5. Request for statement of service. - Patient Affairs BranchSection V. Physical Evaluation Boards (PEB) - Patient Affairs BranchTable 5-2. Instructions for forwarding medical board proceedings - Patient Affairs BranchInformal board - Patient Affairs BranchFigure 5-6. DA Form 199, Physical Evaluation Board Proceedings. - Patient Affairs BranchTable 5-3. Order for assembly of case records by PEB-Section I--Informal Proceedings (continued). - Patient Affairs BranchTable 5-3. Order for assembly of case records by PEB-Section I--Informal Proceedings (concluded). - Patient Affairs BranchFormal Board - Patient Affairs BranchEvidence - Patient Affairs BranchFigure 5-7. Notice to member of formal PEB hearing (continued). - Patient Affairs BranchFigure 5-7. Notice to member of formal PEB hearing (concluded). - Patient Affairs BranchFigure 5-8. Form letter for member acknowledgement of receipt of notice of formal PEB hearing. - Patient Affairs BranchFigure 5-9. Notice to next of kin (legal guardian) of formal PEB hearing (continued). - Patient Affairs BranchFigure 5-9. Notice to next of kin (legal guardian) of formal PEB hearing (concluded). - Patient Affairs BranchFigure 5-10. Form letter for NOK (legal guardian) acknowledgement of receipt of notice for formal PEB hearing. - Patient Affairs BranchRight of Rebuttal - Patient Affairs BranchPhysical Evaluation Board Findings and Recommendations - Patient Affairs BranchTable 5-4. Order of assembly of case records by PEB--Section II--Formal Proceedings. - Patient Affairs BranchFigure 5-11. Notice to member advising results of formal PEB action. - Patient Affairs BranchFigure 5-12. Form letter for member response to notice of formal PEB action. - Patient Affairs BranchFigure 5-13. Notice to next of kin (legal guardian) advising of formal PEB action. - Patient Affairs BranchFigure 5-14. Form letter for NOK (legal guardian) response to action of formal PEB action when severance or retirement pay is recommended. - Patient Affairs BranchFigure 5-15. Form letter for NOK (legal guardian) response to action of formal PEB when separation without benefits is recommended. - Patient Affairs BranchFigure 5-16. Statement of waiver of right to rebut PEB action. - Patient Affairs BranchFigure 5-17. PEB forwarding letter when member copy of proceedings is nondeliverable - Patient Affairs BranchFigure 5-18. Counsel rebuttal or statement in member's behalf. - Patient Affairs BranchTable 5-5. Distribution of PEB proceedings and allied records. - Patient Affairs BranchReconvened Boards - Patient Affairs BranchSection VI. Review Agencies - Patient Affairs BranchArmy Physical Disability Appeals Boards (APDAB) - Patient Affairs BranchSection VII. Disposition Actions - Patient Affairs BranchDisposition of Medical Records - Patient Affairs BranchSection VIII. Appeal Agencies for Ex-Service Members - Patient Affairs BranchSubsequent actions - Patient Affairs BranchExercises - Patient Affairs Branch - md07550147Exercises (Cont) - Patient Affairs Branch - md07550148Exercises (Cont) - Patient Affairs Branch - md07550149Exercises (Cont) - Patient Affairs Branch - md07550150Solutions to Exercises - Patient Affairs Branch - md07550151Solutions to Exercises (Cont) - Patient Affairs Branch - md07550152Lesson Assignment - Patient Affairs Branch - md07550153Lesson 6. Disposition of the Deceased. - Patient Affairs BranchResponsibilities of Casualty area commander/Major overseas commander - Patient Affairs BranchResponsibilities of mortuary officer - Patient Affairs BranchRecovery. - Patient Affairs BranchTable 6-1. Disposition of remains, U.S. Army. - Patient Affairs BranchClothing - Patient Affairs BranchEscorts - Patient Affairs BranchMortuary Benefits for Other Categories of Personnel - Patient Affairs BranchTerms - Patient Affairs BranchInformation - Patient Affairs BranchCasualty Assistance. - Patient Affairs BranchFigure 6-1. DD Form 93, Record of Emergency Data. - Patient Affairs BranchFigure 6-2. Flow chart for death notification when both NOK and deceased military member are in CONUS. - Patient Affairs BranchSection III. Procedures for Receiving/Processing the Deceased - Patient Affairs BranchResponsible medical officer - Patient Affairs BranchFigure 6-4. DA Form 3894, Hospital Report of Death. - Patient Affairs BranchChief, Patient Administration Division (PAD) - Patient Affairs BranchAuthorization for Autopsy - Patient Affairs BranchFigure 6-5. DA Form 3910, Death Tag. - Patient Affairs BranchFigure 6-6. SF 523, Authorization for Autopsy. - Patient Affairs BranchRecords of Personal Effects (DA Form 54) - Patient Affairs BranchFigure 6-7. DA Form 54, Record of Personal Effects. - Patient Affairs BranchFigure 6-8. Certificate of Death (State of Texas). - Patient Affairs BranchExercises - Patient Affairs Branch - md07550177Exercises (cont) - Patient Affairs Branch - md07550178Exercises (cont) - Patient Affairs Branch - md07550179Exercises (cont) - Patient Affairs Branch - md07550180Exercises (cont) - Patient Affairs Branch - md07550181Exercises (cont) - Patient Affairs Branch - md07550182Exercises (cont) - Patient Affairs Branch - md07550183Exercises (cont) - Patient Affairs Branch - md07550184Exercises (cont) - Patient Affairs Branch - md07550185Exercises (cont) - Patient Affairs Branch - md07550186Exercises (cont) - Patient Affairs Branch - md07550187Solution to Exercises - Patient Affairs Branch - md07550188Solution to Exercises (cont) - Patient Affairs Branch - md07550189Solution to Exercises (cont) - Patient Affairs Branch - md07550190Solution to Exercises (cont) - Patient Affairs Branch - md07550191Solution to Exercises (cont) - Patient Affairs Branch - md07550192Solution to Exercises (cont) - Patient Affairs Branch - md07550193
