Attachment_5-_Medical_statement.pdf

Medical Statement for Contracts

Health Care: The medical treatment facility will provide urgent healthcare to contract employees (a contract employee is not a

Government employee but is a contractor or an employee of a contractor) for injuries occurring while on duty. Urgent healthcare is defined as medical care authorized to the extent necessary to save life or limb and prevent undue pain and suffering. The contract employee will be transferred to a civilian medical facility as soon as the contract employee is stabilized. The cost of such treatment will be paid for, in full, within a reasonable period of time, by the contract employee and will not be borne by the 87th Medical Group, the United States Air Force or the Government. An AF Form 1127, Hospital Invoice/Receipt/Accounts Receivable Record, will be prepared to ensure collection and/or billing of charges. If a contract employee cannot pay for the treatment at the time of discharge, a statement of charges and a letter of indebtedness will be completed and billed to the contract employee for medical services rendered.

An Accounts Receivable Record will be established for each contract employee who receives medical care and is unable to pay at the time of discharge. Follow-up on Accounts Receivable will be completed in accordance with AFMAN 41-120, Medical Resource

Management Operations. After an Accounts Receivable Record is established and billing for outpatient medical services has occurred, the SF 558, Medical Record - Emergency Care and Treatment, will be annotated with the date of billing and the voucher number. It will then be forwarded to Outpatient Records in order to be filed in a temporary folder. The contract employee shall ensure that he/she provides timely notice to his/her medical insurance company and that if the insurance company is to make payment, the insurance company has adequate information and documentation to make payment. A contract employee treated for injuries caused during a natural disaster is not charged for outpatient care.