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TAOP Operations

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TAOP Operations

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    1. TAOP Operations

    2. The World of TAOP

    3. TAOP Office Our staff consists of professional, administrative, and technical personnel engaged in implementing and evaluating policies, standards, systems, & procedures necessary to deliver the comprehensive TRICARE healthcare benefit: Dental Operations: CAPT David Metzler Program Operations: LTCOL David Huth Clinical Operations: LTCOL Carmen Stella Business Operations: MAJ Christoph Hillmer

    4. TAOP Office First & Foremost: We are here to help all of you [REALLY] DoD Field Activity of the USD/P&R operating under the authority, direction, & control of ASD/HA Management of the TRICARE health plan Interacts w/ officials & representatives of Congressional committees, ASD/HA, Office of General Counsel, Services SGs, DVA, & other agencies & organizations to ensure understanding, integration, & implementation of DoD policy concerning TRICARE & MHS transformation

    5. TAOP Office Oversight of healthcare and support contracts TGRO [International SOS] BCACs [APPTIS] Enrollment & Marketing [APPTIS] Collaborate w/ MTF commanders and operational forces w/ delivering healthcare services Responsible for medical & dental care delivery in areas not serviced by an MTF or DTF for AD, ADFMs, & USAFR & ANG on active duty requiring emergent/urgent care

    6. TAOP Office Work w/International SOS to serve AD & their families for healthcare & ensure providers meet established contractual requirements for quality & credentialing.

    8. Program Operations Program Operations

    9. Program Operations Oversee TRICARE policies & benefits Coordinate development, implementation, & oversight of proposed TRICARE Overseas Program [TOP] contract Interpretation/guidance of TMA policies, health benefits, claims resolution assistance, & TRICARE guidance/consultation to MTF commanders, TRICARE staff, Providers, & Beneficiaries Administer & serve as the COR of administrative services contract, providing TRICARE beneficiary supports services, enrollment, marketing, & education

    10. Program Operations A-P Regional Customer Service Center A-P Executive Healthcare Council Personal 1-1 training for MTF BCACs [just ask!] Attend base events [townhalls, in-processing, retirement seminars, fairs, etc.] to market TRICARE Provide classroom training for MTF BCACs & others via the TRICARE Fundamentals Course

    11. Clinical Operations Clinical Operations

    12. Clinical Operations Coordinate delivery of TRICARE benefits to beneficiaries Clinical oversight of contracts Provide guidance to higher local command authorities & MTF commanders Interpret/implement HA & TMA policies Improve screening processes for EFMP enrollees

    13. Clinical Operations Coordinate healthcare services w/ medical directors from ISOS for remote to care for permanently assigned AD & ADFMs & traveling/deployed AD who require urgent or emergent healthcare Work closely w/ Service liaisons, DoD & DoS providers, & senior military leadership Partner w/ ISOS to oversee quality of care provided by HN facilities/providers Provide support/assistance in medical evacuations w/ Services & ISOS

    14. Business Operations Business Operations

    15. Business Operations TAOP Website Management Responsible for resource management, administrative, contracting and information technology matters in TAOP

    16. Dental Operations Dental Operations

    17. Dental Operations Currently the TAOP Dental Representative- Approves AD treatment plans over $500 and specialty dental care in remote countries prior to cashless/claimless service by contractor. Provides initial & approval Non-availability Referral Forms (NARFs) for all ADFM UCCI orthodontia & dental implant treatment in remote countries + approval NARFs ONLY in non-remote countries. Assists UCCI beneficiaries with claims, HNP problems, & benefit issues

    18. Dental Operations Assists ODTF commanders with host nation provider (HNP) dental network development. Teams with contractor to establish dental HNP networks in Remote countries.

    19. Dental Operations Under the RFP, the TAOP Dental Representative will- Continue to perform all duties outlined on previous slide. Under the RFP, the new contractor will- Provide routine, urgent, emergent dental care to all AD enrolled in TOP Prime Remote, except for Guam, American Samoa & Northern Mariana Islands. Render same to AD TDY/TAD, deployed on liberty, or in leave status, in any remote overseas locale*. Provide cashless, claimless access to a network of dental HNPs*.

    20. Dental Operations Augment HNP networks with non-network providers to ensure number, mix, & geographic distribution of HNPs is sufficient to provide services in all DTF and remote areas*. Not authorize non-emergent AD care over $500/episode or $1500/yr without TAOP coordination and approval*. Forward all AD orthodontic service and specialty care requests to TAOP for direction*. (*same)

    21. How can we best support you?

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