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TRICARE Operations Manual 6010.62-M, April 2021
TRICARE Prime Remote (TPR) Program
Chapter 16
Section 3
Enrollment, Beneficiary Education, And Support Services
Revision:  
1.0  ENROLLMENT
1.1  The Government Designated Authority (GDA) will, on an as needed basis, but at least semi-annually, provide the contractor with an update to the TPR directory of units whose members are eligible for enrollment in the program according to Section 1.
1.2  An enrollment request must be submitted by either the Active Duty Service Member (ADSM) or the ADSM’s unit commander for each ADSM enrolling in the TPR Program.
1.2.1  The effective date for TPR Program enrollment is the date the ADSM or the ADSM’s unit commander submitted the enrollment request.
1.2.2  An official enrollment request includes those with:
•  An original signature;
•  A validated electronic signature offered by and collected by the contractor;
•  A verbal consent provided vial telephone and documented in the contractor’s call notes; or
•  A self-attestation by the beneficiary when using the Government-furnished web-based self-service enrollment system/application.
1.2.3  An ADSM’ signature is not required to make enrollment changes using the enrollment portability process outlined in Chapter 6, Section 2.
1.2.4  A signature in not required to complete the enrollment.
1.3  The contractor shall follow enrollment portability and transfer procedures in Chapter 6, Section 2 for ADSM enrollment in the TPR Program.
1.4  Enrollment transfers or disenrollments will occur upon change of duty location out of the geographic area of responsibility, transfer into a Market/Military Medical Treatment Facility (MTF) clinic Prime Service Area (PSA), retirement, or separation from the service.
1.5  The ADSM is responsible for notifying the contractor when an enrollment transfer is needed.
1.6  The contractor shall notify (letter, telephone call, or email) the ADSM of the discrepant enrollment immediately at any point during the enrollment period in which the contractor determines or is advised that an ADSM is no longer eligible for TPR.
1.7  The contractor shall disenroll the ADSM from TPR effective the first of the month after the 30-day notification period if the discrepant enrollment is not corrected within 30 calendar days of the notification date and enroll them in Prime under the following guidelines:
1.7.1  The contractor shall use the address in Defense Enrollment Eligibility Reporting System (DEERS) to reassign the ADSM to TRICARE Prime at a Market/MTF utilizing the Market/MTF enrollment guidelines.
1.7.2  The contractor shall record the ADSM’s TPR enrollment in the DEERS via Government-furnished web-based system/application.
The TPR enrollment card is provided by DMDC.
1.7.3  The contractor shall use the Primary Care Manager (PCM) (unassigned) procedure when enrolling ADSM Astronauts into the TPR program.
1.7.3.1  ADSM Astronauts are not be assigned to a network or other TRICARE authorized PCM.
1.7.3.2  The National Aeronautics and Space Administration (NASA) providers provide primary care for ADSM Astronauts.
1.8  The contractor shall coordinate referrals and authorizations from NASA providers for TPR-enrolled ADSM Astronauts in accordance with Section 2.
2.0  PCM ASSIGNMENT
2.1  At the time of enrollment, an ADSM will select (or will be assigned) a PCM in the local community, if available.
2.2  An ADSM without an assigned PCM may use a local TRICARE-authorized provider for primary care.
3.0  BENEFICIARY EDUCATION
3.1  The contractor shall limit educational activities for TPR enrollees to distributing the informational materials provided by the Government.
3.1.1  Enrollment in the TPR Program is mandatory for ADSMs who qualify for the program (refer to Section 1); therefore, the GDA will determine the initial supply (if hard copies are used) of materials required.
3.1.2  The contractor shall forward materials to the TPR Program Units, including enrollment request options (enrollment forms, the Government-furnished web-based self-service enrollment system/application transactions, and telephonic requests documented in the contractor’s call center notes) for the TPR Program in the ADSM informational materials.
3.2  Educational issues include the PCM concept (and what procedures to follow when a network PCM is not assigned), how to access care in and out of the area using the contractor, how to access specialty care through the contractor and Specified Authorization Staff (SAS), and information on filing medical claims.
3.3  The contractor shall give TPR-enrolled ADSMs and their family members the option of participating in health promotion and wellness programs offered by the contractor in Market/MTF PSAs.
3.4  The Government will provide all TPR enrollees with information about how to obtain self-care manuals (hard or electronic versions).
3.5  The contractor shall distribute Defense Health Agency (DHA)-supplied educational materials unique to the TPR Program.
3.5.1  The contractor may use multiple, contemporary avenues of access (e.g., email, World Wide Web (WWW), telephone, texting, smart phone applications, and other social media) to distribute these educational materials to the ADSM and their family members.
3.5.2  The contractor shall, if the contractor uses traditional mail, pay for postage, envelopes, and mailing costs for distributing educational material.
3.5.3  The contractor shall work in joint efforts of the service unit of the ADSM, the SASs, the Service Medical Departments, and the GDA for educational activities in the TPR Program areas.
3.6  The contractor shall include TPR Program information and updates as part of all TRICARE briefings. The contractor may propose alternative methods for supplying educational information to ADSMs eligible to enroll in the TPR Program.
4.0  SUPPORT SERVICES
4.1  General
The requirements and standards in Chapters 1 and 11, apply to the TPR Program unless otherwise stated in this chapter.
4.2  Inquiries
4.2.1  The contractor shall designate a point of contact for Government inquiries related to the TPR Program.
4.2.2  The contractor shall establish a process for responding to inquiries about the TPR Program and the Supplemental Health Care Program (SHCP).
4.2.3  The contractor shall respond to all inquiries (e.g., written, telephone, walk-in (overseas only)) that are not related to dental care or to SAS reviews of medical care.
4.2.4  The contractor shall forward all inquiries that specifically address dental care or SAS review of medical care to the active duty dental claims contractor or the TPR enrollee’s SAS for response.
4.2.5  The requirements and standards in Chapter 1, Section 3, apply to TPR inquiries.
4.3  Toll-Free Telephone Service
4.3.1  The contractor shall provide toll-free telephone access for TPR Program beneficiary inquiries.
4.3.2  The contractor’s toll-free access telephone line may also serve SHCP beneficiaries, refer to Chapter 1, Section 3 for telephone standards.
4.3.3  The contractor shall be able to differentiate between provider inquiries and beneficiary inquiries through the contractor’s inquiry system, and be able to provide appropriate data on request of the Government.
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