in DEERS or the survivor is listed as the sponsor,
the survivor will be treated on the first visit and
referred to the appropriate personnel office for
correction of the DEERS database. For second
and subsequent visits, the survivor will be
required to follow the procedure in item 1, above.
DEERS ELIGIBILITY EXCEPTIONS.The
following beneficiaries are categorized as DEERS
Eligibility Exceptions.
Although authorized care,
they may not be authorized to be enrolled in the
DEERS system. These beneficiaries will NOT be
denied care based upon a DEERS check.
Secretary of the Navy DesigneesSecretary
of the Navy Designees will be treated as
indicated on their letter of designation.
Foreign Military PersonnelThese personnel
and their dependents, assigned through Personnel
Exchange Programs or other means, are or may be
eligible. Eligible members may also include
North Atlantic Treaty Organization (NATO)
military personnel and their dependents
stationed in or passing through the United
States;
crew and passengers of visiting military
aircraft; and
crews of ships of NATO nations that come
into port.
Other foreign military personnel may be eligible through
Public Law or DoD agreements. As such, they will be
treated in accordance with current service directives.
Patients in other organizations, such as Red Cross
workers, Secret Service agents, Federal Aviation
Administration personnel, and some non-retiree
veterans, to name a few, are also in this category.
Ensure current eligibility requirements are met for
these personnel prior to treatment.
TRICARE
TRICARE is an enhancement of the Civilian
Health and Medical Program of the Uniformed
Services (CHAMPUS).
TRICARE is a medical
benefits program established to enhance management
of care services in military medical treatment facilities
and to cost-share charges for medically necessary
civilian services and supplies required in the diagnosis
and treatment of illness or injury. TRICARE is also
utilized if the required services are not available from
the direct care system of the Department of Defense
treatment facilities or designated MTFs.
Information pertaining to eligibility, extent of
care, providers, cost, and claims is contained in the
booklet Sailing with TRICARE, for Sailors and Their
Families. A copy of this publication, along with the
TRICARE Provider Directory and other helpful
TRICARE information is available at your local
TRICARE Service Center. A wealth of guidance is
also available via the DoD TRICARE homepage,
http://www.tricare.osd.mil.
NAVY MEDICINES QUALITY
ASSURANCE PROGRAM
LEARNING OBJECTIVE:
Recall the
philosophy of Navy medicines Quality
Assurance Program.
The Quality Assurance Program is used to
evaluate the degree of excellence of the results of
delivered care and to make improvements so that care
in the future will result in a higher degree of quality.
Quality assurance activities reflect what patients and
providers expect of each other. In past years, various
means of reviewing and evaluating patient care have
been introduced.
In 1979, the JCAH Board of
Commissioners imposed the requirement for hospitals
to coordinate quality assurance activities and to use an
ongoing monitoring system to review and evaluate the
quality and need for care. This approach is effective in
identifying important patient-related problems and is
applicable in every healthcare delivery situation.
Many of the principles, standards, and organizational
requirements of JCAH have been adopted and are
contained in OPNAV 6320.7, Health Care Quality
I n s u r a n c e P o l i c i e s f o r O p e r a t i n g F o rc e s .
BUMEDINST 6010.13, Quality Assurance Program,
lists the required elements for process improvement
(quality assurance) programs of naval hospitals,
medical clinics, and dental clinics.
PATIENT RELATIONS AND
COMMAND PATIENT CONTACT
PROGRAMS
LEARNING OBJECTIVE:
Recall the
philosophy of the Patient Relations Program
a n d t h e C o m m a n d P a t i e n t C o n t a c t
Program.
15-3