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Billing : TPC

Third Party Collection Program (TPCP)

Title 10, United States Code, Section 1095 authorizes MTFs to recover the cost of providing health care services to covered DoD beneficiaries from third party payers. The Third Party Collection Program (TPCP) is the military program established to accomplish this activity.

All beneficiaries, excluding active duty, are required to provide information regarding Other Health Insurance (OHI) coverage annually or upon change in coverage status. MTF business offices bill third party payers directly. The amount billed represents reasonable charges for the care provided minus the beneficiary’s applicable deductible or co-payment amount. DoD beneficiaries are not responsible for co-payments and deductibles under the TPCP. The rates used for TPCP billing are included in the Inpatient Adjusted Standardized Amounts (ASA) and Outpatient rate packages approved annually by the Assistant Secretary of Defense for Health Affairs.

Funds collected through the TPCP are used to enhance health care delivery at the MTF providing the care.

The key to the TPCP’s success is identifying beneficiary OHI coverage. The UBO Program Office has created an OHI FAQ document to provide patients with background information about OHI collection and verification.

OHI FAQs pdf 28.7 KB

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