Department of Army Medical Command, CHAMPUS Catastrophic Payments For Fourth Quarter, Fiscal Year 1997, TRICARE Catchment Areas
Final rept Jul-Sep 97
CENTER FOR HEALTHCARE EDUCATION AND STUDIES FORT SAM HOUSTON TX
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This report presents in Appendix A the CHAMPUS Catastrophic Quarterly Payment Reports for the Fourth Quarter Fiscal Year FY 1997 for thirty-four of the Army TRICARE catchment areas. Each Payment Report lists Privacy Act protected hospitalization patient cases having CHAMPUS claims totaling more than the catchment areas specific FY 1997 catastrophic cutoff amount either at the end of the reported quarter or the prior quarter. The difference between the current and previous quarters net claim payments equals the catastrophic net payment made for each patient during the quarter. Table 1 at the end of the Summary contains the CHAMPUS catastrophic Quarterly Payment Schedule, summarizing for each catchment area the catastrophic base cutoff limit, the number of catastrophic cases comprising these Fourth Quarter FY 1997 payment differences, the net claim totals for each of the two quarters, and the payment total between the quarters. The report provides an excellent recap of catastrophic CHAMPUS cases for review by Managed Care, Utilization Management, Comptroller and Deputy Commander for clinical Services personnel.
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