the worlds leading medical assistance company

1
Your Passport to Quality Health
the worlds leading medical assistance company
2
Overview

• Program purpose
• SOS London/tricare functional organizational
  structure
• Routine care
• Urgent / emergent care
• Authorization process
• Air evacuation

3
Program Purpose

• Expansive area
• Difficult to reach locations
• Many command structures with multiple and varied
  missions
• Complex inter-governmental relationships

EUCOM CENTCOM
4
CENTCOM

• As of 1st July 2001 As of 1st August 2002
• Egypt - Djibouti
• Ethiopia - Eritrea
• Kenya
• Kuwait
• Pakistan
• Saudi Arabia
• As of 1st June 2002 As of 1st October 2002
• Jordan - Kazakhstan (Almaty)
• Oman - Kyrgyzstan (Bishkek)
• Qatar - Turkmenistan (Ashgabat)
• UAE - Uzbekistan (Tashkent)

5
Global Remote Program
EUCOM and outside of Continental United States
Start Date 1 SEPTEMBER 03
6
GOALS

• Provide Cashless Access to Care
• Ensure Quality of providers and facilities
• Manage Costs

7
International SOS
International SOS
8
International SOS

• Worlds leading medical assistance company
• More than 20 years experience
• Offices in 39 countries
• Over 200 full time physicians
• Medical referral network in more than 150
  countries

9
International SOS

• Provides active duty and their families assigned
  to remote locations the following
• Credentialed provider network
• PCM concept of operations/advice line, self care
• 24/7 call center
• Referral/Utilization Management
• Emergency air evacuation if military assets are
  not available/feasible
• Cashless and claimless services

10
International SOSFacts Figures

• 3,000 professionals
• 24 call centers
• Offices in 43 countries
• 300 full-time medical staff
• Over 40 in-house languages
• Network of credentialed medical providers
• Handles thousands of cases every day
• Perform one evacuation every hour
• Provide healthcare to 180,000 each year through
  international SOS clinics

11
Hospital Evaluation Criteria

• Physical plant
• Hygiene
• Medical staff
• Nursing staff
• Diagnostic capabilities
• Surgical and intensive care capabilities
• Emergency services
• Administrative organization
• Financial considerations

12
Physician Evaluation Criteria

• Minimum criteria
• graduate of an accredited medical school
• licensed
• Office location and hygiene
• Experience treating foreign patients
• English language proficiency
• Hospital affiliation
• Overseas training
• Local reputation
• Availability

13
TRICARE Program
14
Service Delivery

• Receipt of new request
• By e-mail
• By fax
• By phone
• From POC
• From Provider
• From Member
• From TEO

15
Routine Care

• For Active Duty (AD)and Active Duty Family
  Members(ADFM)
• Primary Care Providers
• Mainly seen by HU / MTF for GP
• Dental and OB-GYN
• Wellness Program investigations
• Specialist care Providers
• Referral from HU / MTF
• Notification to SOS through local POC
• Orthopedist, Ophthalmologist and Dermatologist

16
Urgent / Emergent Care
17
Urgent / Emergent Care

• For AD / ADFM and TDY/TAD personnel
• Urgent Care
• Requiring medical intervention within 24 hours
• Emergent Care
• Requiring medical intervention within 4 hours
• Hospitalization and Patient movement

18
Authorization Process
19
Medical Authorization

• Members eligibility
• Verification through DEERS
• Confirmation from POC/TEO on patients status
• Medical information
• Patients problem identified
• Services required
• Referral Letter for Specialist care provided

20
Medical Authorization

• Approval
• Medical Department to review request and provides
  approval within the parameters of the TRICARE
  program
• Guarantee Letter (GOP)
• Issue Guarantee Letter to provider, copy to POC
  as appropriate

21
Dental Care
22
AD Dental Authorization

• Members eligibility
• Active duty (permanent party)
• Network dentist
• Cashless claimless
• Dental information
• Patients problem identified
• Services required
• GOP (guaranteed letter of payment AD only)
• For current/approved treatment
• Other treatment must be approved prior

23
ADFM Dental Authorization

• Referral services only
• Same network dentist
• Family Member must file claim with UCCI (United
  Concordia Companies inc.)
• No GOP

24
Evacuation Process
25
Medical (Air) Evacuation

• Emergency Only
• SOS Responsibilities
• Contact Theatre Patient Movement Requirements
  Center (TPMRC) all EVACs
• Contact TRICARE Europe (TEO) update on patients
  status

26
SOS Dedicated Air AmbulanceLocations
Europe Baden Baden (Lear 55) Africa Johannesbur
g (Falcon 10, Lear 25 Beechcraft
C90) Gaborone (Cessna 402) Windhoek
(Cessna Citation II) CIS Moscow (Hawker
125-1A) Far East Singapore (Falcon
200) Beijing (Hawker 800XP) Australasia Port
Moresby (Citation II)
30oW
27
SOS Dedicated Air Ambulances
Pacific Ocean
5oS, 68E
Indian Ocean
Atlantic Ocean
17oE
30oW
42oE
28
Your Role
29

• Your Role as a
• TRICARE POC
• Healthcare/Health Unit Provider

• Review local provider list
• Provide International SOS with a
• preferred provider list
• (you will be contacted)

30

• Your Role as a
• TRICARE POC
• Healthcare Provider

• Educate military and family members
• about the TRICARE -International
• SOS Global Remote program
• Coordinate w/TRICARE Europe

31
Global Remote Program
EUCOM and outside of Continental United States
Start Date 1 SEPTEMBER 03
32
Your Passport to Quality Health
the worlds leading medical assistance company