Oh, the places they will go
A hospital on a military base which includes “clinics” for all specialties as well as Emergency Dept, Pharmacy and Surgical.
Military Treatment Facility (MTF)
Have served in the military but did not qualify for lifetime Tricare benefits and receive free care through the VA system.
Veteran
The two vendors that Bioventus is contracted with to supply EXOGEN for Veterans.
Medline and Metro Medical
An order that is inputted into MTF system which indicates the HCP is requesting EXOGEN for a patient.
Consult
This type of provider signs up to treat Veterans through the CCN.
Civilian or Community Provider
A system where Veterans can be treated by community HCPs outside of VAMC.
Community Care Network
The payer type for beneficiaries who are Active Duty, Spouses, Dependents or Retirees who qualified for lifetime benefits.
Tricare
The Department that supplies purchase orders (PO) for EXOGEN at the VAMC.
Prosthetics Dept (sometimes referred to as Purchasing)
This entity should submit orders to Humana/East or Health Net/West portals for Tricare patients who are being treated by civilian providers.
Bioventus Reimbursement (not the civilian clinic)
The form needed in order for a CCN provider to place a referral for EXOGEN
Request for Service Form
A hospital that has Primary Care and specialty clinics as well as ER, pharmacy and surgical where all veterans can receive treatment.
Veterans Affairs Medical Center (VAMC)
This type of Tricare patient should be granted Civilian Physician Referral for Evaluation and Treatment (CPRET) by Primary Care Physician/Manager (PCP/PCM) if being sent off base for treatment.
PRIME
This is required in order to close an order through the VAMC channel.
Purchase Order
This can be added into EXOGEN Direct by EoS/TM if not included on Consult using full description of the fracture provided.
ICD-10 code
This proof of authorization is still required for a Veteran to receive EXOGEN through the CCN program.
Purchase Order (PO)
This is the type of HCP who issues a Civilian Physician Referral for Evaluation and Treatment in order for Prime patients to be treated off base by a civilian provider.
Primary Care Physician/Primary Care Manager
This is the secondary to Medicare once a Tricare eligible beneficiary is the age of 65 and has qualified for primary Medicare benefits.
Tricare for Life
Save this document for Prosthetic agent's information or addt'l patient demographics when receiving a faxed Purchase Order.
Fax cover sheet
What is the 11-digit number on the back of the Tricare ID card that is used for Medical Benefits?
DoD Benefits Number/DBN (not to be confused with 10-digit DoD ID number)
The two Third-Party Administrators who pay out for claims submitted by the Civilian provider
TriWest and Optum
Consults are placed at the MTF and then sent to this Department before being auto-routed to Humana or HealthNet.
Referral Management (or Utilization Management)
This type of Tricare plan does not require a referral for treatment by a civilian provider.
SELECT
A catalog system for procurement of supplier's goods for the VA system.
Federal Supply Schedule
If Consult is not urgent, it was marked as this to allow 48-72 hours for order to reach the Vendor for review.
Routine
The information you should look for when you receive an order for a Veteran through one of your civilian clinics.
All of the above: VA/CCN as payer, name and number to contact at the CCN office