Photo By Douglas Stutz | As of September 1, 2024, the Pacific Integrated Referral Management and Appointing...... read more read more
There’s not many in the world faster than USA’s Gabrielle Thomas placing first in the 2024 Olympics 200 meters run with a time of 21.83.
A notable – and subtle - exception was every TRICARE patient who had their call for assistance in July answered by the Pacific Integrated Referral Management and Appointing Center.
Over 36,300 inbound telephone calls were handled by the PIRMAC team assigned to the task. The business norm to reply is 60 seconds. Their collective effort sliced that average more than half. They responded to a call in 21.13 seconds, actually a shade faster than the gold medal comparison.
Numbers only begin to explain the well-choreographed, behind-the-scenes endeavor to get active duty, retirees and their dependents under TRICARE – the uniformed services healthcare program - the care they need in a timely manner.
According to Mr. Gary A. Herschberger, Defense Health Network Indo-Pacific Integrated Referral Management and Appointing Center deputy assistant director [for] healthcare operations, PIRMAC is more than just a call center.
“We’re more than just booking appointments. We’re also a functionality center. We’re full service, able to help patients find out the status of their referral and much more,” said Herschberger.
As of September 1, 2024, the Pacific Integrated Referral Management and Appointing Center has formally replaced the Puget Sound Military Appointment Center. U.S. Army Health Clinic Presidio of Monterey was added to Madigan Army Medical Center, Naval Hospital Bremerton and Naval Hospital Oak Harbor to support Defense Health Agency military treatment facilities with expanded capabilities.
“Perhaps more important, we’re open seven days a week,” Herschberger noted, available Monday through Friday from 6 a.m. to 8 p.m., and weekend hours from 7 a.m. to 5 p.m.
When the well-modulated voice of an appointing agent such as Isabelle contacts an eligible TRICARE patient to arrange their needed doctor or clinic visit, that’s just the aurally noticeable part of PIRMAC. The center is built upon an extensive training program for all those who operate the appointing, referrals and Clear and Legible Report accountability services. There are seven trainers who bring decades of experience to help teach, mentor and guide the staff, which has more than doubled from nearly 60 last year to now almost 130 to handle all responsibilities.
PIRMAC daily operations are organized in overlapping branches, designed to handle and respond to patient appointments needs, all part of the business of delivering the healthcare needs of their patients.
“We’re really a one-stop shop in charge of managing inbound calls, outbound workloads and oversight of Clear and Legible Report processing functions,” explained Anna Ambrose, PIRMAC project manager.
The Clear and Legible Report processing refers to such functions as uploading chart notes of care received by civilian providers that are part of Health Net Federal Services’ network, utilizing multiple access portals to help safeguard the scheduling management of patient care, and streamlining referral processing procedures with booking [appointment] protocols. It’s all designed to get a patient where they need and want to be as timely as possible.
Inbound call duties include scheduling, cancelling and rescheduling appointments in a MTF or informing a patient that their specialty care had been deferred to a TRICARE authorized provider in the network.
Outbound calls handle such requirements as reschedule needs, appointment requests as well as reaching out to patients with an open specialty referral at the MTF and addressing any faux pas in getting any eligible patient a timely doctor or clinic visit.
“A lot of what we do now is standardized,” Herschberger said. “Naval Hospital Bremerton was really ahead in their processes and has been a major contributor to help establish our standardized configuration to ensure nothing is left to chance.”
In the month of July alone, more than 16,600 referrals were processed, with over 92 percent of those referrals processed in less than one business day.
The referrals which come into PIRMAC originate from an aggregate enrollment of more than 130,600 patients to the Puget Sound MTFs.
“There are approximately 263,000 eligible beneficiaries (out of a greater Puget Sound region population of 4.3 million) collectively,” added Herschberger. “While all are not enrolled to an MTF, they all have pharmacy benefits, space available care, etc.”
Helping connect two of the Puget Sound MTFs – Madigan Army Medical Center and Naval Hospital Bremerton – is the Patient Shuttle which has been in place since 2015. The service operates Monday-Friday except federal holidays. It departs NHB by the Urgent Care Clinic entrance at 7 a.m., 10 a.m., 1 p.m. and 4 p.m. The shuttle leaves Madigan by the Main Medical Mall north entrance at 8:30 a.m., 11:30 a.m., 2:30 p.m. and 5:30 p.m.
“We realize that access to care for healthcare is the number one issue and not just in DHA. Navigating the system is also important. That’s what we do for all patients,” Herschberger stressed.
Herschberger emphasizes the global referral processing metric that the overwhelming majority of referrals are dispositioned (retain care in the MTF or defer to the network) within 24 hours. “The benefit of timely referral dispositioning within one business day for the patient is they can be appointed care sooner in the MTF than if deferred to private sector care,” he said.
Although the center name has been altered, the phone number 1-800-404-4506 remains the same, and just a world-class response away.
| Date Taken: | 09.03.2024 |
| Date Posted: | 09.03.2024 17:06 |
| Story ID: | 480004 |
| Location: | BREMERTON , WASHINGTON, US |
| Web Views: | 105 |
| Downloads: | 0 |
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