Medical Statement.pdf
PDF 80 KB Posted
- Attached to
- Giant Voice Replacement
- Solicitation number
- FA448426Q0039
About this file
This document is a standard clause for inclusion in all federal solicitations, awards, task orders, delivery orders, and calls with performance at Joint Base McGuire-Dix-Lakehurst (JBMDL). The statement establishes the terms under which the 87th Medical Treatment Facility (MTF) may provide urgent health care to contractor employees or agents for injuries sustained while on duty at the installation.
The 87th MTF is authorized to provide medical care necessary to save life or limb and prevent undue pain and suffering, with contractor employees transferred to civilian medical facilities once appropriately stabilized. The contractor or contractor employee is responsible for full payment of all treatment costs within a reasonable timeframe as determined by the Base Legal Office. Billing is processed based on services provided and documented on Air Force Form 552 (Pre-Hospital Evaluation Patient Care Report). If payment cannot be made when the bill is rendered, the government will issue a statement of charges and letter of indebtedness to the contractor employee. Contractor employees and agents are required to provide timely notice to their medical insurance providers and furnish insurance companies with all necessary documentation and information required to process payment claims. The cost of such treatment shall not be borne by the 87th MTF, United States Air Force, or the federal government.
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Text version
The following statement will be placed in all solicitations/awards/TOs/DOs/calls with performance on JBMDL:
“The 87th Medical Treatment Facility (MTF) may provide urgent health care to any contractor employees or agents for injuries occurring while on duty. Urgent health care is defined as medical care authorized to the extent necessary to save life or limb and prevent undue pain and suffering. Contractor employees will be transferred to a civilian medical facility as soon as they are appropriately stabilized. The cost of such treatment will be paid for, in full, within a reasonable period of time (as determined with/by the Base Legal Office's assistance), by the contractor or the contractor's employee and will not be borne by the 87th MTF, the United States Air Force or the government. Billing/accounts receivable is processed based on services provided, which is captured on an Air Force FORM 552 (Pre-Hospital Evaluation Patient Care Report). If a contractor employee or agent cannot pay for the treatment at the time the bill is rendered, a statement of charges and a letter of indebtedness will be completed and billed to such contractor employee for medical services rendered. Contractor employee or agents shall ensure they provide timely notice to their medical insurance company and to the extent an insurance company is to make payment, provide the insurance company with adequate information and documentation necessary to make payment."
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