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TRICARE Operations Manual 6010.59-M, April 1, 2015
Communications and Customer Service (C&CS)
Chapter 11
Section 2
Government Staff And Beneficiary Education
Revision:  C-24, May 18, 2018
1.0  Education Requirements For Government Personnel
1.1  Regional Training
The contractor shall conduct one three-day TRICARE training course each quarter covering all aspects of the program including, but not limited to, TRICARE, TRICARE Overseas, and TRICARE Dual-Eligibles. The location of the course shall be within the region; however, the exact location will change each quarter to allow maximum participation by Government personnel who require an in-depth understanding of TRICARE to successfully accomplish their assigned duties. The contractor shall follow the Government-provided training material in delivering the course. The Government will provide all handouts for the course. Government furnished facilities may be provided if determined by the Government to be in the best interest of the Government. The Government will be responsible for registration of attendees and collection of attendee evaluations. The contractor shall provide written feedback to the Government following each course to assist the Government in providing appropriate training materials. The TRICARE Regional Office (TRO)/Program Office will provide oversight of the training.
1.2  Military Treatment Facility (MTF)/Enhanced Multi-Service Market (eMSM) Training
The contractor shall conduct three one-hour training sessions, followed by a question and answer session, for clinical and administrative personnel at each MTF/eMSM monthly. Training sessions shall be at the date and time specified by the MTF Commander/eMSM Manager and shall correspond with the hours personnel work at the facility. The contractor shall follow the Government-provided training materials and handouts in delivering the course which will cover all aspects of TRICARE including, but not limited to, TRICARE Prime, TRICARE Standard/Extra, and TRICARE Select, and the financial impact of MTF/eMSM decisions on both the beneficiary and the Military Health System (MHS). Government-furnished facilities will be provided for the course location.
1.3  Reserve/National Guard (NG) Unit Training
1.3.1  The contractor shall provide one, one-hour briefing covering all aspects of TRICARE, followed by a question and answer session, annually, at each Reserve/NG unit in the contractor’s region. Briefings shall be coordinated through the respective TRO; with dates and times coordinated between the unit, TRO, and contractor. The contractor shall use the Government-provided briefing materials (slides, notes, etc.).
1.3.2  The contractor shall provide training support up to 20 hours per month to be distributed by the Director, TROs to Reserve/NG units.
2.0  Customer Service Support Training
2.1  MTFs/eMSMs
The contractor shall provide customer service support hours to each MTF/eMSM in accordance with the Government MTF/eMSM Education Requirement provided with Section J of the contract, to be used at the discretion of and for the purpose specified by each MTF Commander/eMSM Manager. Examples of possible uses of this time include in-processing briefings/enrollments, TRICARE briefings, and specialty briefings on specific components of TRICARE or focused to a specific subset of TRICARE beneficiaries.
2.2  Director, TROs
The contractor shall provide customer service support not to exceed 40 hours per month to be used at the discretion of and for the purpose specified by the Director, TROs. The designated hours for the Director, TROs, may be used at various locations and outside normal business hours.
3.0  Education for Non-Government Personnel
The contractor shall provide one one-hour briefing, followed by a question and answer session, weekly to an audience specified by the MTF Commander/eMSM Manager. Such audiences might be Ombudsmen, support groups, obstetrical patients, retiree groups, parent groups, or dual-eligibles. The contractor shall follow the Government provided training material in delivering the training. The contractor shall actively announce each briefing time, location, and audience through base publications, local fraternal organizations, flyers posted throughout the installation, and other contemporary avenues for notifying interested parties.
4.0  Beneficiary Education
4.1  The contractor shall develop a beneficiary education program to educate beneficiaries concerning all components of the TRICARE benefit. Contractor suggestions for additional Government furnished materials will be reviewed and approved by the Government on a case-by-case basis (see Section 1).
4.2  The beneficiary educational program shall include the distribution of education materials to all eligible households in accordance with Section 1. Educational efforts include supplying educational materials and brochures to the MTFs/eMSM, participating in “newcomer orientations” at military bases, outreach to NG and Reserve units, briefings at mobilization and demobilization sites and conducting general information sessions for all demographic categories (for example, active duty personnel, Active Duty Family Members (ADFMs), new retirees and their dependents, dual-eligible beneficiaries). The contractor may use contemporary avenues to communicate with beneficiaries including mailings, e-mail, World Wide Web (WWW), telephone, texting, and smart phone applications, and other social media.
4.3  The contractor shall provide reports regarding education presentations, customer satisfaction, beneficiary services, beneficiary access assistance, survey results, customer support hour usage, and SAT after action reports according to contract requirements.
5.0  World WIDE WEB (WWW)
The contractor may elect to provide a web site for beneficiaries to access information specific to the contractor’s management of the TRICARE benefit. This web site shall not merely duplicate beneficiary information contained on the TRICARE web site (http://www.tricare.mil). Information posted on the contractor’s web site shall reflect the “look and feel” of the TRICARE web site (http://www.tricare.mil), and shall be appropriately linked to information on that site. Information contained on the contractor’s web site shall not substitute for written or telephonic communication with the beneficiary if those communication tools are in the best interest of the beneficiary.
6.0  Beneficiary E-mail
The contractor may elect to communicate with beneficiaries via e-mail. All beneficiary communications must be in accordance with Health Insurance Portability and Accountability Act (HIPAA) and the Privacy Act, and may not substitute for telephone or written communications if those are in the best interest of the beneficiary.
7.0  Exclusions
Use of the TRICARE trademarks, logo, brand, name, or any aggregate Government or personal TRICARE data collected as a TRICARE contractor to explicitly promote non-TRICARE related products and services to TRICARE beneficiaries is prohibited. Contractors may state their TRICARE contractor status in company marketing/promotional activities as long as U.S. Government, MHS, or Defense Health Agency (DHA) endorsement of the contractor is not implied.
8.0  Customer Service by Service Assist Teams (SATs)
The contractor shall provide customer service functions to disaster areas. The contractor shall deploy mobile SATs necessary to perform customer service functions to disaster areas, Active Component and Reserve Component troop mobilization areas, Base Realignment and Closure (BRAC) areas, or to any area deemed necessary and requested by the Director, TROs. A modification will be issued by the Contracting Officer (CO) defining the requirement for each SAT. SATs shall be deployed on an as needed basis for a finite period of time as defined in the modification. Within seven calendar days’ notice, the contractor shall deploy one or more teams. SATs shall provide assistance with beneficiary enrollment, provide assistance with access to and referral for care, and provide TRICARE program information.
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