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UBO

About the UBO : Mission

Our mission: To optimize allowable health care cost recovery within compliance guidelines in support of the operational and readiness mission of the Military Health System (MHS).

The UBO supports the TRICARE managed care programs by providing tools and policies to enhance and improve the effectiveness of the financial and collection operations. Further, the UBO supports managing and expediting collections from patients and third party insurers; supports consistent and uniform reporting of expense, manpower and workload data; and enhancing third party reimbursements. These efforts are coordinated by the Chartered UBO Advisory Working Group, which meets quarterly.

The UBO addresses business practices for Medical Services Account (MSA), Third Party Collection (TPC), and Medical Affirmative Claims (MAC) activities.

  • MSA activities involve the first-payer billing of individuals and other Government Agencies for services rendered in MTFs to include, but not limited to, the U.S. Coast Guard, the National Oceanic and Atmospheric Administration, and the U.S. Public Health Service.
  • TPC activities involve billing third-party payers on behalf of non-active duty dependents for treatment provided in MTFs.
  • MAC activities involve billing all areas of liability insurance, such as automobile, products, premises and general casualty, homeowner's and renter's insurance, medical malpractice (by civilian providers), and workers' compensation (other than Federal employees).

Key Participants:

Defense Health Agency (DHA) UBO sets policy and provides program oversight and training. It also provides Automated Information System (AIS) support, issues resolution, and develops rates. The DHA UBO Program Manager chairs the UBO Advisory Working Group and serves as a member of the TPOCS CCB workgroup.

An underlying principal on which the concept of UBO rests is that financial information is a resource that must be managed and must be uniform within the Military Health System.



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