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Winter 2011 Q&As

customer service winter 2011

Q: What’s the name of my plan?

A: The Johns Hopkins US Family Health Plan (USFHP). This question comes up five times a day, at least. It can be confusing because the Military Health System is such a large umbrella with many TRICARE offerings under it. Johns Hopkins USFHP is a designated provider of TRICARE Prime benefits available to beneficiaries living in Maryland and surrounding areas.
Issues can arise when providers send bills to a different TRICARE contractor and not to the Johns Hopkins US Family Health Plan. I try to resolve the immediate issue but also educate the member about what card to present. Make sure to tell your provider that you have the Johns Hopkins US Family Health Plan and present that card. It lets the providers know specifically who to contact and where to send the bills.
I also encourage everyone to check the USFHP website, http://www.hopkinsmedicine.org/usfhp, to better understand their coverage

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Q: Which doctors can I use?

A: The Johns Hopkins USFHP has a large network of nearly 12,000 providers. You can use the USFHP website to search for providers, or call Customer Service at 1-800-808-7347 and we can help you. To receive the best benefit and pay the least out of pocket, it’s important that you use physicians in our Johns Hopkins USFHP network.

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Q: Why do I have to answer so many questions when I call Customer Service for help?

A: The protection of patient privacy is key. It’s part of our contract with the Department of Defense, and it’s state and federal law through the Health Insurance Portability and Accountability Act (HIPAA). We need to verify who the caller is, and who the member is, to make sure we’re accessing the correct account. We also have to verify that the caller is authorized to get information about the member.
Sometimes people may not understand why we can’t provide information about their husband or wife. The laws state that each person has his or her own privacy. If you want someone else to be able to access your health information— either a spouse, parent or child—you have to fill out a form indicating that. The form is available through our website, or you can call Customer Service and we will send you one. Remember that when children turn 18, they are considered adults and must fill out their own forms.

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