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ACCESS TO CARE STANDARDS



GETTING CARE
There are two things you must do before obtaining medical care at Reynolds. First, you must update your status in DEERS (Defense Enrollment Eligibility Reporting System). Second you must enroll in TRICARE Prime or transfer your current enrollment to Fort Sill.

Defense Enrollment Eligibility Reporting System (DEERS)
Proper registration in the Defense Enrollment Eligibility Reporting System (DEERS) is key to receiving timely and effective TRICARE benefits. DEERS is a worldwide, computerized database of uniformed service members, their Family Members, and others who are eligible for military benefits, including TRICARE. All sponsors (active duty, retired, National Guard or Reserve) are automatically registered in DEERS. However, the sponsor must register eligible Family Members. It is vital to keep your DEERS records updated; this includes changes in military career status, addresses, family status, i.e. marriage, divorce, births and adoptions. To update all DEERS information, visit the local ID card facility, Building 4700, or call (580) 442-5010. The ID card facility uses an appointment system. Appointments are available Monday through Wednesday and Friday, 8:30 to 11:30 a.m. and 12:30 to 4 p.m. Walk-ins are seen on Thursday, 12:30 to 3:30 p.m. To update your address and telephone number, visit the website http://www.dmdc.osd.mil, click on Beneficiaries.

TRICARE
TRICARE is the health care program for Active Duty and retired service personnel, their eligible Family Members and survivors. TRICARE does not provide medical coverage for a sponsor’s parents or parent in-laws. TRICARE combines both military and civilian services to deliver the highest quality health care. Reynolds is in the TRICARE South Region. The DoD has selected Humana Military to administer the TRICARE program for more than 2.7 million beneficiaries in the TRICARE South Region. Humana Military is committed to preserving the integrity, flexibility and durability of the Military Health System. For more information regarding Humana Military, go to their website at http://www.humana-military.com, call (800) 444-5445, or visit the TRICARE Service Center (TSC) located on the first floor of RACH, near the south entrance.

TRICARE Prime Enrollment
The TRICARE Service Center (TSC) offers walk-in service to either enroll in TRICARE Prime or transfer your enrollment to Fort Sill. After you complete your TRICARE Prime enrollment paperwork, you will receive a letter notifying you of your assigned Primary Care Manager (PCM). If you do not receive notification of your assigned PCM within 14 days after enrolling, please contact Humana Military at (800) 444-5445 or visit the TSC in the hospital. The Service Center can also assist with questions on TRICARE programs, medical claims, referral assistance, benefits and PCM changes.

TRICARE Plus Enrollment
TRICARE Plus is not a health plan but is simply a way to access primary care. When capacity is available, we offer TRICARE Plus enrollment to Reynolds’ Prime enrollees who turn age 65. You will receive a letter from us prior to your 65th birthday. The letter will instruct you how to enroll in TRICARE Plus if you choose to do so. Through TRICARE Plus, you will receive primary care at the MTF with the same access standards as TRICARE Prime enrollees and will pay no out-of-pocket costs. The two beneficiary counseling and assistance coordinators (BCACs) are located next to the TSC and are available to answer any questions you may have and to assist you with TRICARE Plus enrollment. You can reach them at (580) 558-2483/3161.

Making An Appointment
You may schedule an appointment with your PCM by calling Central Appointments System (CAS) at (580) 558-2000. One of the booking staff will assist you with your appointment needs Monday through Friday, 7 a.m. to 4 p.m. Please do not call the clinic front desk directly to schedule an appointment as you will experience a delay while you are transferred to Central Appointments.

TRICARE Online
TRICARE Online (TOL) is a Department of Defense web-based tool that allows TRICARE Prime and Plus participants the option to book appointments with their PCM through the internet. Over 80 percent of our primary care appointments are accessible online at http://www.tricareonline.com. We encourage you to register with TOL and make your appointments at your convenience. The site also provides access to over 700 health topics covering conditions, diseases, and wellness. There is extensive information about drugs, a medical dictionary and other trusted health resources. To get started, go to http://www.tricareonline.com and follow the easy online instructions to register. Once logged in, click on “appointments” to schedule an appointment with your PCM.

Access Standards
You will receive all routine and primary health care from your PCM and he/she will refer you to specialty care when necessary. You are entitled to access to care within these specific time frames:
  • Acute/Urgent Care appointments within 24 hours
  • Routine Care appointments within 7 days
  • Specialty Care or Wellness appointments within 28 days

Acute/Urgent Care is for an illness or injury that would not result in further disability or death if not treated immediately, but does require professional attention within 24 hours. You would require urgent care for conditions such as a sprain, sore throat, or rising temperature that have the potential to develop into an emergency if treatment is delayed longer than 24 hours. Routine (Primary) Care includes general office visits for the treatment of symptoms, chronic or acute illnesses and diseases, and follow-up care for an ongoing medical condition. Routine care also includes preventive care measures to help keep you healthy. Specialty Care is for those times you need to see a specialist for a diagnosis or treatment that your PCM cannot provide. Your PCM will provide referrals to access services from specialty providers and will coordinate the referral request with Humana Military when necessary. Wellness Care includes health maintenance care such as physical examinations, periodic health examinations, health screenings, and well child care.

Emergency Care is defined as a medical, maternity, or psychiatric condition that would lead a “prudent layperson” (someone who has average knowledge of health and medicine) to believe that a serious medical condition exists, or the absence of immediate medical attention would result in a threat to life, limb, or eyesight, or when the person has painful symptoms requiring immediate attention to relieve suffering. If you need emergency care, go to the nearest emergency room or call 911. For questions or concerns on access standards, ask to speak with the Office Manager or NCOIC. If you need further assistance, please see the Patient Advocate (page 33).

Telephone Consultations
A telephone consultation is Reynolds’ systematic method of addressing patient’s medical needs when appointments are not available with their assigned PCM. Patients may directly request a telephone consultation when they prefer to speak with their PCM or nurse for medication refills, test results or general health questions. If there are no appointments available or if the patient is requesting a telephone consult directly, the CAS clerk will create an electronic telephone consultation and submit it to the nurse of the patient’s PCM. The clinic staff will make every effort to respond to telephone consultations on the day they are received.

For questions or concerns on access standards, ask to speak with the Office Manager of your primary care clinic. If you need further assistance, please see the Patient Advocate.






4301 Wilson Street Fort Sill, Oklahoma 73503-78 | Phone: (580) 558-2800 or 558-2801 |

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