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TRICARE Operations Manual 6010.62-M, April 2021
Administration
Chapter 1
Section 2
Contract Administration And Instructions
Revision:  
1.0  TRICARE MANUALS
1.1  These include the TRICARE Operations Manual (TOM), TRICARE Policy Manual (TPM), TRICARE Reimbursement Manual (TRM), and TRICARE Systems Manual (TSM). The TRICARE Manuals are the principal vehicles for general operating instructions to all health care delivery contractors and may be accessed at https://manuals.health.mil/. The official archive copies of these documents are maintained at Defense Health Agency (DHA). The documents and all official changes to them will be maintained at DHA in an electronic medium and are available at the above website. An electronic notification will be sent notifying the contractors of changes. The contractor’s can subsequently access the manual or change from the above website.
1.2  The Government will distribute all proposed changes to these documents for review and comment in an electronic medium.
2.0  IMPLEMENTATION OF MANUAL CHANGES
2.1  The contractor shall implement changes in requirements as specified by the Contracting Officer (CO).
2.2  The contractor shall notify the CO in writing within 10 calendar days if a contractor is unable to comply by the implementation date. The notification shall include the reasons for the noncompliance and a proposed plan for reaching compliance.
2.3  The contractor’s proposed plan shall include milestones, if appropriate, and a firm date for completion.
3.0  COMMUNICATIONS WITH DHA
3.1  The contractor shall furnish the CO with designated point(s) of contact and email address(es) for review and comment on proposed Manual changes, and notification of the final publication of Manual changes.
3.2  The contractor shall provide complete replies to routine DHA requests for Rough Order of Magnitude (ROM) estimates, comments, and cost estimates on proposed changes to the Manuals no later than 14 calendar days from the date of the request.
3.3  The contractor shall provide complete replies to urgent DHA requests for ROM estimates, comments, and cost estimates on proposed changes to the Manuals as directed by the Government (less than 14 calendar days from the date of the request). Urgent DHA requests will be generated in the event of an urgent need imposed by law or a program requirement under which significant loss to the Government or harm beneficiaries would result from delay, whether it is a major or minor change.
3.4  The contractor shall return comments to DHA in a format agreed upon by the Government prior to the submission.
3.5  The contractor shall meet the suspense date for responses to requests for information directed to them by the CO.
3.6  The contractor shall use assigned Contracting Officer’s Representative (COR) at DHA as the initial Point of Contact (POC) for program interpretation or other forms of operational guidance.
4.0  DHA-REQUIRED MEETINGS
The contractor shall provide up to four representatives at up to four DHA-sponsored meetings or conferences per option year. The Government will provide a 14 calendar day notice for all DHA-sponsored meetings or conferences. Additional meetings may be scheduled as needed.
5.0  DHA DELEGATION OF RESPONSIBILITY
Responsibility has been delegated to a Government Designated Authority (GDA) to perform the following:
•  Grant exceptions to the claims filing deadline.
•  Grant “good faith payments.”
•  Waive the signature requirements on TRICARE claims.
•  Adjudicate and process unique claims requiring special handling, and claims for emergency care provided by a Department of Veterans Affairs/Veterans Health Administration (DVA/VHA) facility or a facility under the Bureau of Indian Affairs (BIA).
•  Authorize benefits for which the authority has not otherwise been delegated to other DHA officials or contractors.
•  Authorize an “override” of information contained on Defense Enrollment Eligibility Reporting System (DEERS), pending a system update, based on appropriate documentation regarding eligibility under the law, regulation and policy.
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