All Branch Topic (ABT) Tricare for off duty employment during terminal leave?

[Baron Samedi]

I am aware that I can't see Tricare patients during off duty employment in general, but does this still apply during terminal leave status? Thanks!

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[pawprint]

patients are still active duty while on terminal leave and are authorized to be seen at an MTF and branch clinics.

They are also covered by Tricare in the civilian world for 180 days after their separation date.

 

[pgg]

I am aware that I can't see Tricare patients during off duty employment in general, but does this still apply during terminal leave status? Thanks!

Yes, no exception while on terminal leave.

But to be clear, you absolutely CAN see Tricare patients on ODE. The encounter just isn't billable. The claim will/should be denied if one is submitted.

It's perfectly OK for you to work as a contracted or hourly person, and get paid by your off-duty employer for taking care of Tricare patients. Your employer just has to understand that they can't bill the government for your work. If they're OK with eating the cost, no problem.

 

[pawprint]

Yes, no exception while on terminal leave.

Are you saying that people on terminal leave can’t be seen by an active duty doctor? I’ve worked at multiple MTF’s/clinics where we still saw these people. We could have been doing it wrong, but I’ve seen it done on the Navy side at Portsmouth, San Diego, and lejeune.

 

[armytrainingsir]

Pawprint, the physician is on terminal leave not the patient.

 

[pgg]

Are you saying that people on terminal leave can’t be seen by an active duty doctor?

?

We're talking about active duty physicians, who are on terminal leave, working a civilian moonlighting job, and whether or not they can treat individuals covered by Tricare.

And the answer is an unqualified yes - however the encounter can't be billed to the government.

 

[pawprint]

Copy all, my bad, misinterpreted the question! Thanks yall!

 

[DrMetal]

But to be clear, you absolutely CAN see Tricare patients on ODE. The encounter just isn't billable. The claim will/should be denied if one is submitted.

Nobody cares, nobody actually tracks any of this.

 

[Baron Samedi]

Yes, no exception while on terminal leave.

But to be clear, you absolutely CAN see Tricare patients on ODE. The encounter just isn't billable. The claim will/should be denied if one is submitted.

It's perfectly OK for you to work as a contracted or hourly person, and get paid by your off-duty employer for taking care of Tricare patients. Your employer just has to understand that they can't bill the government for your work. If they're OK with eating the cost, no problem.

Wonderfully helpful advice -- thank you.

 

[pgg]

Nobody cares, nobody actually tracks any of this.

At Portsmouth, our ODE request paperwork had to be signed by the employer, with a section specifically demanding they agree not to bill Tricare for care.

I don't know how diligent any of the places I worked actually were in not billing for my cases. I imagine my NPI was attached to each billing request and I would think Tricare would reflexively deny it. Maybe that's expecting too much basic competence from the government though.

But beyond making a good faith effort to make sure my employers knew they couldn't bill those cases, I never gave it another thought.

 

[armytrainingsir]

I don’t think you can’t bill Medicare/aid either. Anything with federal dollars attached. Regardless, I erred on the side of caution and never did when I had a clinical training site agreement during reserve drill weekends.

YMMV.

 

[Baron Samedi]

I don’t think you can’t bill Medicare/aid either. Anything with federal dollars attached. Regardless, I erred on the side of caution and never did when I had a clinical training site agreement during reserve drill weekends.

YMMV.

I've never seen anything about Medicare. That's about half of what I see and never had any issues. The paperwork never made any mention of it, either.

 

[armytrainingsir]

I've never seen anything about Medicare. That's about half of what I see and never had any issues. The paperwork never made any mention of it, either.

I heard it at an APMC seminar/mtg. Never have seen it in writing. The thought was the .gov has paid professional fees once for that patient, so making the .gov paying ‘twice’ was fraud.

Who knows if the speaker was correct, but it certainly let me know my command would hang me out to dry if it ever was an issue. YMMV.

Thankfully, I never had to worry much about it, as my CTS agreement was low volume and writing off the few .gov payors wasn’t all that burdensome.

 

[Correlate Clinically]

I once asked the MDG medlegal about it in passing. They said so long as the entity you work for signs the agreement/memo acknowledging the restrictions and they handle the billing, you are probably fine. You aren't billing anyone.

That was couched in all sorts of JAG hedging and legal wishy-washyness, though.

 

[backrow]

I heard it at an APMC seminar/mtg. Never have seen it in writing. The thought was the .gov has paid professional fees once for that patient, so making the .gov paying ‘twice’ was fraud.

Who knows if the speaker was correct, but it certainly let me know my command would hang me out to dry if it ever was an issue. YMMV.

Thankfully, I never had to worry much about it, as my CTS agreement was low volume and writing off the few .gov payors wasn’t all that burdensome.

Doesn’t the MHS bill Medicare? Pretty sure they do which is one of the reasons that they want to verify secondary insurance on patients when they check-in for appointments.

 

[Baron Samedi]

For those wondering, Tricare won't even credential you while on terminal leave. I thought I'd try and get it done early, but they told us to resubmit after my ETS date.

 

[Atlas Shrugged]

Doesn’t the MHS bill Medicare? Pretty sure they do which is one of the reasons that they want to verify secondary insurance on patients when they check-in for appointments.

They do not for care rendered as far as I’m aware; I believe they are verboten from billing Medicare. I believe Title 10 US Code section 1095. It’s why DoD facilities aren’t beholden to EMTALA.