Use of DOD form improves services Published Oct. 17, 2008 LUKE AIR FORCE BASE, Ariz. -- All non-active-duty persons using 56th Medical Group facilities must fill out a Defense Department Form 2569 yearly so the military can bill insurance companies for services, including prescriptions dispensed at the satellite pharmacy. Completing the form is required for all non-active-duty persons including dependants, retirees and dependants of retirees, to inform the clinic if the patient is or is not carrying other health insurance. Title 10 of the United States Code; Section 1059: EOC 9397 directs all military medical facilities to collect this information on the DD Form 2569. Once patients fill out this form, they receive a blue card specifying whether third party insurance is used. The Third Party Collection Program is not affiliated with TRICARE or the new Medicare Pharmacy Benefit Plan. Filling out the form is important and it benefits medical group patients in the following ways: A patient's insurance premium does not increase when their insurance company pays for inpatient and outpatient clinic visits or new or refill pharmaceuticals at the 56th MDG. The premiums do not decrease when not used, and will not increase with use. Insurance deductibles are met without cost to the patient but only if those services are billed to the patients insurance company. If the Third Party Collection office does not have the patient's insurance information, they cannot help the patient meet their deductible. Patients are not responsible for any amount that is not paid by the insurance company and will never receive a bill from the 56th MDG nor pay a co-pay when using a military treatment facility. The dollars collected from the insurance companies will be used to maximize the services available, purchase needed medical equipment and medical supplies. In fiscal year 2004, $1.1 million dollars were reimbursed to the 56th MDG. DOD Form 2569 can be obtained at any clinic within the 56th MDG or at the satellite pharmacy. Patients may also receive one by calling the resource management office at (623) 856-9373. A blue card will be given or mailed to the patient once they have completed and returned the form. These cards identify patients as having filled the form out for the fiscal year and should be presented at each encounter at the 56th MDG. The blue card is strictly for use when having encounters at Luke Air Force Base. Courtesy 56th Medical Support Squadron and 56th Fighter Wing Public Affairs