4th Medical Group Patient Handbook

Transcription

1 4th Medical Group Patient Handbook

2 From the Commander The healthcare professionals of the 4th Medical Group (4 MDG) join me in welcoming you to our clinic! Our team of active duty, civilian, contract, and volunteer personnel are here to fuel a healthy, fit, and fighting force for the 4th Fighter Wing (4 FW), and are dedicated to delivering the best healthcare possible for you and your family. Together, we strive to provide a responsive appointment system, high quality preventive services, prompt pharmacy services, and health and education programs that reach out to our community. The availability of specific services may vary according to operational requirements of the 4 FW. In the event we cannot provide the care you require, our Referral Management staff will gladly work with you to arrange the health services you need through our civilian provider network. We encourage you to be an active participant in your healthcare by 1) being aware of your rights as a patient (described elsewhere in this pamphlet); 2) contacting your patient advocate immediately after your appointment if you did not receive the services you were expecting (patient advocates are assigned to each clinic where their pictures and contact info are posted); and 3) helping us find ways to serve you better by sharing your suggestions with a patient advocate, or through questionnaires and surveys. Lastly, if you'd like to join our healthcare team as a Red Cross volunteer, contact the Airmen and Family Readiness Center at We welcome your time and talents! Our volunteers enable us to provide the range and volume of services we currently offer. Again, welcome to the 4 MDG we look forward to helping you. ////SIGNED//// ELEANOR C. NAZAR-SMITH, Colonel, USAF, NC Commander, 4th Medical Group 2

3 INTRODUCTION This pamphlet was prepared to assist you in understanding the services available from the 4 MDG, Seymour Johnson Air Force Base, North Carolina. We encourage you to familiarize yourself with the contents of this pamphlet, as it will aid you in obtaining healthcare and other services. About the 4 MDG The 4 MDG supports the combat capabilities of the 4 FW, and Air Combat Command. It provides primary and specialty outpatient medical and dental care to our enrolled population of approximately 10,500 beneficiaries in the area of Goldsboro, NC, and deploys medical personnel and resources around the world. The healthcare professionals of the 4 MDG are dedicated to providing the best healthcare and support possible to the 4 FW and associate units. Mission Statement Deliver Ready Medics and Quality Care Vision Statement Seamless Quality Healthcare Anytime, Anywhere Culture Everyone Counts Core Values Compassion, Accountability, Respect, Excellence The single access telephone number for the 4 MDG is If you have questions regarding the development, contents, formatting, etc., of this guide, you may contact MSgt Anthony Smith: Revised June anthony.smith.30@us.af.mil DSN: Commercial: (919)

4 TABLE OF CONTENTS PAGE From the Commander 2 Introduction 3 Table of Contents 4 PATIENT POLICES AND INFORMATION 6 Eligibility for Healthcare 6 DEERS 6 Appearance and Behavior 6 Smoking Policy 6 Children in the Clinic 7 Patient Rights and Responsibilities 7 Advance Medical Directives 9 Medical Records 10 Appointments 10 Ambulance Service 10 Tricare 11 Referrals 11 Tricare Dental Program 11 Customer Assistance/Concerns 12 Patient Safety Program 12 Health and Wellness Center 13 Ethics Hearing 13 Third Party Collection Program 13 CLINICAL SERVICES 14 Accessing Medical Care 14 Patient Centered Medical Home Concept 15 Family Health Clinic 15 Sick Call 15 Staff Support Protocols 15 Convalescent Leave 15 Quarters/Fitness Profiles 16 Behavioral Health Services 16 Immunization Clinic 16 Pediatric Clinic 16 Women s Health Clinic 17 Mental Health Clinic and Family Advocacy 17 Physical Therapy 17 Exceptional Family Member Program 17 4

5 AEROMEDICAL SERVICES 18 Flight Medicine 18 Optometry Clinic 18 Public Health 18 Physical Health Assessments 19 Dental Services 19 ANCILLARY AND SUPPORT SERVICES 19 Laboratory 19 X-Ray (Diagnostic Imaging/Radiology) 20 Pharmacy 20 4 MDG Key Numbers 21 Web Resources 22 5

6 PATIENT POLICIES AND INFORMATION Eligibility for Healthcare The principal mission of the 4 MDG is to provide healthcare to active duty (AD) military patients, but many of the clinic's services are available to dependents, retirees, and retiree dependents if enrolled in TRICARE Prime. To substantiate eligibility for healthcare, all patients must be enrolled in the Defense Enrollment Eligibility Reporting System (DEERS), and present a valid military identification (ID) card (if 10 years of age or older) to clinic personnel before receiving healthcare. Patients who do not have a valid ID card or DEERS enrollment may be denied services. These patients will be required to sign a statement of eligibility certifying they are eligible beneficiaries, and must prove eligibility status within 30 days or pay the Air Force an established rate for healthcare furnished. Patients requiring emergency treatment to save life or limb are treated immediately without regard for eligibility and questions regarding eligibility are addressed after the emergency situation is resolved. DEERS DEERS is a Department of Defense (DoD) program designed to help secure military beneficiaries' health benefits by eliminating fraud. This program is as important to you as your military ID card. To find out if you are enrolled, you can call DEERS toll free: If you are not enrolled in DEERS, please contact the Military Personnel Squadron, Customer Service Section at 1600 or telephone Enroll your newborns in DEERS within 5 days of birth. Address changes can be submitted via the TRICARE website. Check the A-to-Z ( list for DEERS Address Change. Appearance and Behavior While in the medical facility, it is necessary that all patients maintain a neat and presentable appearance in accordance with military standards and courtesies. Additionally, we do not permit drinking or possession of alcoholic beverages, gambling, boisterousness, weapons (except by law enforcement officers in the accomplishment of their duties), or profane language in the clinic. Please take a moment and heed signs posted in clinical areas and act accordingly. In addition, please ensure your cell phone is turned off during the duration of your appointment. Smoking Policy The 4 MDG facilities (i.e., Dental Clinic, TRICARE, Main Clinic, Bioenvironmental, and Health and Wellness Center) are SMOKE-FREE and TOBACCO FREE facilities. Tobacco use is a serious health hazard for smokers and those around them. Our goal is to provide you with the best possible healthcare environment. 6

7 Children in the Clinic We at the 4 MDG are concerned for the health and safety of your children and the quality of care we provide. For this reason, we ask that you make child care arrangements prior to coming to our facility. Bringing well children to the clinic exposes them unnecessarily to health and safety risks. Children who are not here as patients, are not permitted in the treatment areas and must not be left unattended. Please be aware of the following: You are responsible for the care, control, and conduct of your children at all times. Do not allow them to run in the hallways, eat in other than designated areas, stand up in strollers or sit or climb on countertops, furnishings, or equipment. We do not have child care facilities within the 4 MDG. You can contact the Child Development Center at or Airman and Family Readiness center at for help with childcare. Base regulations require children under the age of 10 to be supervised by someone at least 13 years of age. Children under the age of 10 may not be left unattended at any time. Leaving children unattended in a car is prohibited. Your cooperation in this matter will help reduce the potential for injuries to your children in this facility. Patient Rights and Responsibilities Patient Rights As a Patient, You have the Right to: Receive quality care and treatment that is consistent with available resources and generally accepted standards, including access to specialty care and to pain assessment and management. Considerate and respectful care, with recognition of personal dignity, psychosocial, spiritual, and cultural values and belief systems. Reasonable safeguards for the confidentiality, integrity, and availability of their protected health information, and similar rights for other PII, in electronic, written, and spoken form as defined by Federal Law. Receive information about the individual(s) responsible for, as well as those providing his or her care, treatment, and services. Explanation concerning their diagnosis, treatment, procedures, and prognosis of illness in terms that are easily understood. All necessary information in non-clinical terms to make knowledgeable decisions on consent or refusal for treatments, participation in clinical trials or other research investigations as applicable. 7

8 Make recommendations, ask questions, or file complaints to the section Patient Advocate or the MDG Patient Advocate. Know if the MTF proposes to engage in or perform research associated with their care or treatment. Care and treatment in a safe environment. Be informed of the facility s rules and regulations that relate to patient or visitor conduct. Receive complete information and an explanation concerning the needs for and alternatives if a medical decision has been made that requires transfer to another Medical Treatment Facility (MTF). Understand the charges for their care and their obligation for payment. Make sure their wishes regarding their healthcare are known even if they are no longer able to communicate or make decisions for themselves. Patient Responsibilities As a Patient, You are Responsible to: Provide accurate and complete information about complaints, past illnesses, hospitalizations, medications, and other matters relating to their health to the best of their knowledge. Patients are responsible for letting their healthcare provider know whether they understand the diagnosis, treatment plan, and expectations. Be considerate of the rights of other patients and MTF healthcare personnel. Patients are responsible for being respectful of the property of other persons and the MTF. Adhere to the medical and nursing treatment plan, including follow-up care, recommend by healthcare providers. This includes keeping appointments on time and notifying the MTF when appointments cannot be kept. Return medical records promptly to the MTF for appropriate filing and maintenance if records are transported by the patients for the purpose of medical appointments, consultations, or changes of duty location. All medical records documenting care provided by any MTF are the property of the U.S. Government. Follow MTF rules and regulations affecting patient care and conduct. Your actions if you refuse treatment or do not follow the practitioner s instructions. Meet financial obligations incurred for their healthcare as promptly as possible. 8

9 Reporting of Recommendations, Concerns, Questions and/or Complaints: Patients can help the 4 MDG Commander provide the best possible care by reporting all recommendations, concerns, questions, and complaints to one of the section Patient Advocates, OIC, or NCOIC located in each clinic. If this route is unsatisfactory, patients can then be referred to the 4 MDG Patient Advocate Officer. Advance Medical Directives The following information will tell you what an Advance Medical Directive is and how you can complete one for yourself. An Advance Medical Directive will let you take an active role in decisions about your healthcare and help you plan for the future in case your health does not allow you to make those decisions. What is an Advance Medical Directive? An Advance Medical Directive informs physicians and other health care providers of important decisions you have already made concerning your future healthcare. It speaks for you when you are no longer able to, either because you are unable to make decisions for yourself or because you are unable to communicate your decisions to your physician. It is a legal document and can be in the form of a Living Will and/or a Healthcare Power of Attorney. What is a Living Will? A Living Will voices your ultimate decision to accept or reject life-sustaining procedures if you are diagnosed as being terminally ill, incurably ill, or in a persistent vegetative state ( coma ). Through a Living Will, you may refuse, in advance, some or all life-sustaining procedures that artificially prolong the dying process. Your Living Will directs the physician to withhold or withdraw such procedures according to your wishes. Some examples of life-sustaining procedures you may elect to refuse are: mechanical ventilation/respirators, artificial nutrition and hydration, antibiotics, etc. These legal documents are called Living Wills because they are instructions about your life. What is a Health Care/Medical Power of Attorney? A Healthcare Power of Attorney is a legal document in which you designate or name a Healthcare Agent. Through this document, you can appoint, in advance, a competent adult to act as your agent to consent to or refuse medical care on your behalf if you are unable to make or communicate your own decisions. It is possible, but not necessary, to have both types of documents. Be aware that both the Living Will and the Healthcare Power of Attorney have no effect as long as you are mentally and physically capable of making decisions for yourself. Who can make Advance Medical Directives? Any competent adult (age of 18 or older) may make an Advance Medical Directive. Do Advance Medical Directives have to be witnessed? Yes, they do. However, family members and certain clinic employees may not be witnesses. It is always wise to contact the Base Legal Office for assistance. What if I do not want an Advance Medical Directive? You are not required to have an Advance Medical Directive in order to receive care at any MTF. It is simply an option we tell you about. Whether or not you decide to have one is your personal decision. Be sure to inform your physician, nursing staff, or health services technicians if you have or desire an Advance Medical Directive. If you have one, a copy should be placed in your Outpatient Record. You should keep the original in a safe place. 9

10 Who can I talk to if I have questions? You can talk to your healthcare provider and the nursing staff about your medical choices. The Legal Office will answer your legal questions and provide legal advice. If you have any questions or would like to complete an Advance Medical Directive, contact the Legal Office at Medical Records Medical records are the property of the United States Government and it is the responsibility of the 4 MDG to maintain the record while each patient is a beneficiary of this clinic. The health record is an important record, which provides a current, concise, and comprehensive account of an individual s medical history. If the record is not available to our medical personnel, valuable medical documents may be lost and part, if not all, of the patient's medical history may be missing. All patients whose servicing medical facility is the 4 MDG will have their records maintained at this facility. In addition to maintaining the medical records, a medical records copying service is available upon request. If you desire a copy of your medical record, a minimum of 30 days advanced notice is required. Whenever you receive care from civilian providers, you should obtain copies of any treatment provided for inclusion in your outpatient record. These documents will give our providers valuable information about your medical condition and will improve their ability to provide quality healthcare. For all scheduled or follow-up appointments within the 4 MDG, the health record will be forwarded to the appropriate clinic prior to each patient appointment. For any appointments outside the MTF, copies of pertinent information must be requested prior to the date of the civilian appointment. An individual cannot obtain the records of a spouse or child over eighteen years of age for any reason without a signed release from that individual. Appointments Visits for most clinics are by appointment only. Appointments are available by calling , or by calling Appointments can also be made by accessing the TRICARE Online website at The clinics and specific PCM may be contacted using phone numbers listed in the back of this pamphlet. Appointments can also be requested via MiCare (Secure Messaging) at the following link: Ambulance Service For on-base emergencies call for an ambulance. The 4 MDG does not currently have ambulance services on Seymour Johnson AFB. The ambulance service from Wayne County will transport patients directly to the Emergency Department at Wayne Memorial Hospital. Off-base military beneficiaries residing in Wayne County should dial 911 for emergencies. All medical bills for active duty members (hospital and/or physician) should be brought to the TRICARE Operations and Patient Administration (TOPA) office. Members need to ensure that they speak with their PCM within 24 hours of visiting an emergency room. 10

11 TRICARE Providing healthcare in today s environment of continuing budget constraints and reduction of military forces is a challenge. We realize these circumstances cause some members of our military family to experience difficulty in obtaining care. Therefore, we support TRICARE, which facilitates healthcare in a timely manner while decreasing your out-of-pocket costs. Many of you have relied on MTFs for most, if not all, of your healthcare. Our MTFs certainly remain an integral part of TRICARE. TRICARE expands your options to include a growing civilian provider network. There are three different TRICARE plans from which you can choose: Prime, Extra, and Standard. Each plan has different cost shares and degrees of freedom for choosing your healthcare providers. For more information call TRICARE ( ), visit the TRICARE Service Center, or visit the TRICARE website ( Referrals If your PCM determines specialty care is needed, a referral is sent to the Referral Management Center (RMC). The RMC staff and Health Net, the Managed Care Support Contractor, partner to coordinate care outside the MTF. For questions referring to this process, call the RMC at , option 4 Beneficiary Counseling and Claims Assistance (BCAC) and Debt Collection Assistance Officers (DCAO) This office provides assistance to beneficiaries with questions and/or medical claims issues. The Health Benefits staff will assist all eligible beneficiaries to include those with Prime, Extra, and Standard coverage. Simply call for assistance. TRICARE Dental Program (TDP) This is a private insurance program for family members of all uniformed services active duty, Selected Reserve, and Individual Ready Reserve personnel of the Uniformed Services. The plan is voluntary, requiring the sponsor to enroll his/her dependents into the TDP. A list of participating dentists and additional information can be obtained from the Dental Clinic, the TRICARE Service Center, or via the contractor s (United Concordia) web site at The TRICARE Retiree Dental program is currently administered via Delta Dental. They may be contacted at (toll-free) or at 11

12 Customer Assistance/Concerns The Patient Advocate Program is designed to ensure you are satisfied with your medical care. Through this program, the 4 MDG provides an immediate response to your concerns. Contact the section Patient Advocate in the area where you have a concern. His or her photograph is posted in the waiting room. If your problem is not adequately addressed to your satisfaction, you may also choose to speak with the OIC or NCOIC, who will try to answer your questions or work with you towards a solution before you leave the clinic. If they are unable to do so, they may refer you to the 4 MDG Patient Advocate Officer where your concern will be documented and reviewed. You may also call the Patient Advocate Officer during normal duty hours at The men and women of the 4 MDG strive to provide excellent quality care. We would like to know your concerns and how you feel about the service you receive while visiting our facility. Please take a moment to comment on the care provided by filling out our customer comment cards available in the clinic waiting areas throughout the facility. This program allows us to measure the level of your satisfaction while identifying and correcting problem areas, thus providing better care and service in the future. In addition, you may receive a call from an independent party who serves as a gatherer for our Service Delivery Assessment survey that provides the 4 MDG with customer service information. You may also receive an survey to evaluate your dental clinic experience. Patient Safety Program The goal of the 4 MDG Patient Safety Program is to spread the word about patient safety to all of our beneficiaries. We encourage you to: Be an active participant in your healthcare. Understand all treatments and medications prescribed for you. Carry a medication list in your wallet. Make sure you can read prescriptions and understand your healthcare provider s directions. When you pick up your medications, look at both the label and the contents to ensure the medications are what you expected. If you have any test (lab, radiology, etc.,) ordered, as a member of your healthcare team how you will be notified of the results and by what timeframe. Additionally, ask your healthcare team what needs to be done if you are not notified of your results by that timeframe. It s all about teamwork and open communication between three partners: healthcare professionals, patients and their families. Patients can contact the Patient Safety Manager if they feel they were a victim of a medical error. Furthermore, patients can voice their concerns about patient safety issues on the customer service comment cards located throughout the clinic. Volunteers We have a very active volunteer staff working in the 4 MDG. Volunteers perform many vital functions that help the everyday operations of the clinic flow smoothly. If you are interested in being one of these valuable volunteers, contact the Airmen and Family Readiness Center, If you are a retiree and are interested in becoming a volunteer, please contact the Retiree Activities Office at

13 Health Promotions - Health & Wellness Center (HAWC) The vision of the HAWC is to assist with the maintenance of an environment that supports and promotes the sustainment of individual and organizational healthy lifestyle choices and behavior. Health Promotions is the process by which we promote healthy lifestyles by identifying health risks and establishing programs designed to eliminate those identified risks within our community. The HAWC is established at each Air Force installation to provide a one-stop-shop for health and fitness assessment, awareness, and prevention programs. The HAWC is located on the 2nd floor of the Fitness Center. Some of the services provided are: Running Clinics Medical Nutritional Therapy Education (Diabetes, Cholesterol, Hypertension, and Weight loss) Exercise prescriptions (until Oct 2014) Physical Fitness Duty Limiting Conditions (until Oct 2014) Hours of operation: M-F from hours. For additional information feel free to stop by the HAWC or contact us at Ethics Hearing Ethical issues or differences of opinion concerning treatment options may arise because the physician and patient/family have different value systems, which may stem from different religious beliefs, ethnic backgrounds and/or upbringing. If a conflict arises that cannot be resolved through discussion between the physician, his/her supervisor and patient/family, an Ethics hearing will be called by the Chief of Medical Services to discuss and make recommendations to help resolve the issue. This does not include differences of opinion concerning treatment options that are medically or legally contraindicated. If you have an ethical dilemma you are encouraged to discuss this issue with your provider or bring the issue to the attention of the clinic Patient Advocate. Third Party Collection Program This program was established in 1986, under the U.S. Code, Title 10 to authorize MTFs to bill health insurance carriers (i.e. Blue Cross Blue Shield, Aetna, etc.) for the cost of medical care provided to healthcare beneficiaries who are covered by these programs. Health insurance does not include TRICARE, Medicare or any of their supplemental programs. Below are some of the most commonly asked questions: What medical services are billed to insurance companies? Insurance companies will be billed for each day a patient is hospitalized in a MTF and for each clinical visit. Do you have Health Insurance? You will be asked this when you schedule an appointment and upon arrival to the clinic. You may be asked to fill out a DD 2569, "Third Party Collection Program - Insurance Information" form to certify whether or not you have civilian health insurance or may sign one electronically. If you are covered by a health insurance program we will need for you to provide your policy number and any other related information. For all future visits, please bring your insurance identification card. 13

14 Healthcare is one of my service benefits, why does the military clinic have to bill my insurance company? Your healthcare is paid by federal tax dollars. The law requires the MTF to recover these costs if they are covered by health insurance. If the full cost of care is not recovered from my insurance company, will I get a bill from the military clinic? No. You will not be billed for any costs we cannot recover. If your insurance company makes full or partial payment you will not be billed. Will I need to pay my deductible? No. The government will absorb the deductible. Additionally, charges billed by the MTFs should be credited toward your deductible, thus reducing your out of pocket expenses if you receive care from a civilian provider. What will I receive from my insurance company? You will receive an Explanation of Benefits (EOB) from your insurance company explaining how much was paid to the MTF and what deductible or co-payments were subtracted from the claim. This is not a bill. You are not responsible for co-payments or deductibles not paid, even if they appear on the EOB. What effect will this have on my health insurance? Health insurance is intended to cover the specific medical needs covered in your policy for the premiums you or your employer pays. Since the DoD MTFs are legally authorized and directed to recover the cost of the health care provided, your health insurance is being used as it was intended. For additional information, please contact the Business Office at CLINICAL SERVICES Accessing Medical Care The 4 MDG does not have an Emergency Room. If you have a true emergency (potential loss of life, limb, or eyesight) call 911 (off base) or (on base) or proceed directly to the nearest emergency room. Non-emergent medical care can be accessed in a variety of ways. If you need to be physically evaluated you can call and book an appointment. You can also use MiCare online to request an appointment or TRICARE online to book your own. If you need to speak with a nurse you can call and leave a message and the nurse will contact you within 4 hours to provide advice. You may also leave a message for your PCM by calling or sending your question/concern via MiCare. Active duty personnel have sick call available daily and we also have support staff protocols for various common conditions which are available to all enrollees during hours specified below. Medication renewals can be done by calling and leaving a message. Your medication will be filled within 72 hours. A medical team member may contact you if there is an issue with the renewal. Please use all of your refills before using this process. If you are new to the clinic please schedule an appointment prior to running out of your medications. Referral renewals can be done by calling and leaving a message. As long as you have established care with a specialist and they require you to be seen, this can be done without a visit. Patients that show up to the clinic without an appointment will be offered one, if available. The use of the Emergency Department (downtown) should be limited to true emergencies. For urgent issues on weekends or after clinic hours call and your call will forwarded to an advice nurse who will either, provide self care instructions, book an available appointment within access standards or refer you to urgent care. 14

15 Patient Centered Medical Home (PCMH): PCMH is an active approach to establish a medical home for everyone. Care is coordinated by your individual medical provider who is leading a team of medical professionals providing continuous, comprehensive and personalized prevention-based healthcare. Why PCMH? We are leading the way in the Air Force because we are committed to providing you greater, faster access to your healthcare team. Through effective communication and building continuous healing relationships you will be receiving greater resources to help care for yourself and your family. The key is continuity! You shouldn t have to worry about seeing a different provider each time you visit the clinic. Every effort will be made to ensure you are cared for by the same family health team (technician, nurse and provider) every time you visit the clinic. Improved continuity means better medical management. We strive to meet your medical needs through your medical home team. PCMH focuses on the patient being the center of healthcare and the driver of care rather than the passive recipient. Care that is truly patient-centered considers patients cultural traditions, personal preferences and values, family situations and lifestyle. It makes the patient and their loved ones an integral part of the care team who collaborate with health care professionals in making clinical decisions. Patient-centered care puts responsibility for important aspects of self-care and monitoring in the patients hands along with the tools and support they need to carry out that responsibility. Patient-centered care ensures that transitions between providers and healthcare settings are respectful, coordinated and efficient. Family Health Clinic (FHC) The FHC hours are M-F On the second Wednesday of each month the clinic closes at 1130 for training. The FHC is composed of 3 PCMH teams. Each team consists of a Family Medicine physician (MD or DO) and either a PA or nurse practitioner, a registered nurse and medical technicians. Sick Call For active duty members in uniform, M-F. This is for acute illness or injury and allows patients to bypass the appointment process as well as limiting impact on the mission. Self-treatment of minor things is encouraged and supervisors are encouraged to use their authority to allow troops to stay home when ill. Members reporting to sick call must be in uniform. Staff Support Protocols Walk-in hours: & Sore throat, male STD, pregnancy tests, urinary tract infections, shaving waiver renewals, wart treatment, wound checks and suture removals. Convalescent Leave Convalescent Leave should be authorized prior to surgery. The PCM will review the specialists recommendations and approve con leave IAW applicable AFI s. Access the clinic website to download the Pre-Surgery checklist. 15

16 Quarters Quarters are issued by a nurse or a provider (electronically). Supervisors are encouraged to allow their troops to go home for straightforward conditions such as a cold or a headache if the mission allows. Quarters are issued by the Family Health Clinic if the member s condition or treatment may cause a risk to the patient, co-workers or the mission i.e. infectious (Pertussis, chicken pox etc.), sedating medications or clinical findings where the member is deemed too sick or not functional. Our goal is to evaluate, treat and return to duty. If a medical evaluation has taken place and no quarters are given, the patient may go home at their supervisors discretion based on mission needs. Fitness Profiles Fitness Profiles are issued in order to prevent worsening of a condition and/or allow for healing of an injury or medical condition. Fitness profiles are not considered to be an urgent issue. We recommend all troops exercise year round as this will prevent injury prior to your fitness test due to overtraining. It will also allow early recognition of a problem that we can address long before it impedes your performance on your fitness test. Being overweight is a common underlying issue for patients with musculoskeletal complaints so we recommend staying at a healthy weight. See your PCM if you feel that you need help with this. Behavioral Health Services Within the Family Health Clinic we offer behavioral health services for many common issues we face. Sleep, stress and coping are reasons many patients visit their PCM and these are best treated with changes in behaviors rather than medications. Immunization Clinic The Immunization clinic is a walk-in clinic. If you would like additional information concerning specific immunizations or allergy skin testing, please contact the clinic at Note: PPD (5TU) tests (TB skin tests) are not administered on Thursdays. Medical Records and Immunization Records are required for immunizations. Hours of operation are and M-F, except for Wednesdays from when the clinic is closed for Immunization Small Pox Clinic and other vaccine related issues. On the second Wednesday of each month the clinic closes from for training. Pediatric Clinic This clinic is for the care of infants and children from birth to 17 years of age. [NOTE: Treatment of infants and children over the age 3 is also available through the Family Health Clinic.] Children under 18 years of age cannot receive routine care without the presence of a parent or legal guardian, or an adult possessing a medical power of attorney. Step-parents require a power of attorney even if they are the sponsor. Medical powers of attorney are available through the Base Legal office, Dependents must call to schedule all PCM appointments utilizing the appointment line at There is no sick call available in the pediatrics clinic, please call the appointment line for acute appointment needs. Walk-in appointments are available M-F from and and are limited to the following services: 16

17 Sore Throat evaluations for ages 3 and older Suture and Staple removal WIC labs Women s Health Clinic The Women s Health Clinic is composed of one Women s Healthcare Nurse Practitioner and support staff trained in the area of women s health. We provide a variety of services ranging from routine annual well women exams to more complex procedures such as colposcopy and endometrial biopsy. Routine Papanicolaou test (Pap smear) is completed in the Family Health Clinic. Counseling is also available on all women s health issues including hormone replacement therapy, disease prevention strategies, and family planning. We have state of the art equipment and an extensive library of educational materials. Mental Health Clinic & Family Advocacy The Mental Health Clinic provides psychotherapeutic services for groups and individuals, marital therapy, parenting skills, and stress management. Alcohol Drug Abuse and Treatment Program (ADAPT) provides substance abuse education and counseling. Family Advocacy includes administration of the Family Advocacy Program. Appointments for dependents, retirees, and retiree dependents are extremely limited. Consequently, these beneficiaries are seen on a space-available basis. Non-active duty patients with psychiatric conditions are normally referred for civilian hospitalization or outpatient care. Outpatient appointments for active duty personnel are made with the clinic by self-referral, referral from healthcare providers or other Air Force agencies. Call for an appointment and/or information. Domestic violence and child abuse prevention and education services are available through our Family Advocacy Outreach Program. Please contact them at for additional information. Physical Therapy Physical therapy provides evaluation and treatment of musculoskeletal and orthopedic/sports medicine injuries. Services are available to active duty personnel ****and open to dependents on a space available basis****. Our goal is to relieve pain, restore function, and prevent injuries utilizing a variety of treatment options including joint mobilization/manipulation, functional dry needling, individualized exercise programs, and various modalities including electrical stimulation, iontophoresis, kinesiotape, and traction. Those eligible for care are seen by referral from credentialed providers to include physicians, physician's assistants, and dentists. Appointments can be made by visiting the Referral Management office or calling or Hours of operation are and M-F. If there are any questions concerning physical therapy services, call Exceptional Family Member Program (EFMP) The EFMP is coordinated through the TRICARE Operations and Business Administration (TOPA) office within the Medical Clinic. The program is designed to ensure that families who require special educational or medical care for chronic physical or mental conditions are screened for the availability of continued care at the gaining installation. All active duty members with families going overseas will go through the overseas clearance process that includes the EFMP program. This program is a mandatory requirement for active duty personnel if they are aware of their family requiring ongoing education, medical, dental or mental healthcare. For more information on this program, call

18 AEROMEDICAL SERVICES Flight Medicine Provides comprehensive healthcare for personnel on flying or special duty operational status (e.g., air traffic controllers) and their family members, and to those personnel in the PRP programs. Active duty personnel are seen for sick call on a walk-in basis, 0730 to 0800 and 1300 to 1330 M-F. Active duty personnel and family members are also seen by appointment at other times during the duty week. Call or for appointments or after hours care. Optometry Clinic The Optometry Clinic provides comprehensive vision care. Active Duty personnel are eligible for a routine eye exam and are issued military spectacles every 12 months. Active Duty dependents enrolled in TRICARE Prime are authorized one routine eye examination per calendar year by either the SJAFB Optometry Clinic (age 6yo and above) or by an approved Civilian Network Provider without a referral or co-pay. Dependents must obtain eyewear through a civilian source at their own expense. Retired members and their dependents (age 3 and older) on TRICARE Prime are authorized one eye exam every 2 years by an approved Civilian Network Provider without a referral or co-pay. Diabetic patients (AD dependents, retired members and their dependents) are allowed annual comprehensive eye examinations either by an approved Civilian Network Provider or at the SJAFB Optometry Clinic. Retired personnel are authorized one pair of military spectacles every 12 months (they just need to bring their written glasses prescription into the Optometry Clinic). Please note: appointment priority is given to Active Duty personnel assigned to SJAFB. Active Duty Members and diabetic patients and dependents above 6yo should call or to schedule an appointment. Public Health Public Health duty hours are 0730 to 1630, M-F of each week except for the second Wednesday of each month when clinic will close at 1130 hours for training. Phone numbers to contact Public Health are /1172. Medical Aspects of Food Service: All facilities located on Seymour Johnson AFB and Fort Fisher that sell, store, prepare or serve food are routinely inspected for compliance with current public health directives. At the present time, approximately 40 facilities are monitored. About 350 food handlers are employed on base and receive recurrent food handling training. Public Health Inspections: Areas in use by the general public on Seymour Johnson AFB and Fort Fisher are inspected for compliance with general public health standards. There are 20 facilities subject to inspection and depending on the facility, inspection intervals will vary from monthly to annually. Preventive Medicine: Preventive medicine programs conducted by Public Health include communicable disease surveillance, tuberculosis detection and control, sexually transmitted disease infection control, fetal protection, clinic employee health, occupational health and illness/injury investigation, medical entomology, deployment medicine and traveler s medicine for unofficial travel to high-risk locations. Initial flight physicals are scheduled through Force Health Management on an appointment basis. Personnel scheduled for examinations will report directly to the Force Health Management Section at 0830 on the day scheduled. To schedule an appointment call

19 Physical Health Assessments (PHA) PHAs online are required annually for all active duty personnel, and are a requirement for worldwide mobility. A face-to-face appointment is required every three years. Special follow-up instructions, regarding laboratory tests or other needed requirements are sent via once the online process is complete. It is extremely important that personnel accomplish the online PHA and any needed follow-up. For questions or concerns, individuals should consult their UDM or Public Health at You can access your IMR/DHA status via the following link: Dental Services Dental services are provided in the Kiecker Dental Clinic, Bldg. 2805, M-F from 0715 to Active duty members are provided comprehensive dental care and may make appointments in person or by calling the Kiecker Dental Clinic at Active duty family members and retirees and their family members are authorized space available care, when not covered under any of the TRICARE dental programs, but this care is extremely limited. Active duty family members are strongly encouraged to use the TRICARE Active Duty Family Member Dental Plan. Retirees and their families are encouraged to use the TRICARE Retiree Dental Program or seek other types of dental insurance wherever they are able to obtain coverage. All beneficiaries are eligible for emergency dental treatment; however, emergency services will only permit treatment for severe pain, infection or trauma. Definitive care following emergency treatment for other than active duty personnel will be referred to civilian providers at the patient's expense. To receive emergency dental treatment during duty hours, patients should report to the Dental Clinic at 0715 or After hours and on non-duty days, patients should call ANCILLARY AND SUPPORT SERVICES Laboratory Telephone Number: Eligibility: All military healthcare system beneficiaries with a legible laboratory requisition signed by a licensed military or civilian provider. Location: Laboratory Services is centrally located in the main clinic building in the hall between Pharmacy Services and Radiology. Hours of operation: M-F for routine services except for the 2nd Wednesday of each month when the clinic is closed from 1130 to 1630 for training. We support patients of extended hours, weekends, and holidays consistent with hours of operation of the 4 MDG. Services: All patient engagements are conducted at the patient reception desk. Basic laboratory tests in hematology, chemistry, urinalysis, serology/immunology, and bacteriology are conducted relevant to Family Practice and Aerospace Medicine. Any more advanced testing is referred to military laboratories at no cost or to civilian laboratories at a cost. 19

20 Special collection directions are available for some testing which may require additional patient engagements with the laboratory, i.e., Lipid Profiles (cholesterol screening): requires a 12 hour fast, water only, continue to take prescribed medications. Result turnaround time is dependent upon the avenue chosen for each test. For external provider requisitions, it is imperative that your provider s expectations of result turnaround time accompany the requisition. X-Ray (Diagnostic Imaging/Radiology) Services include routine radiology. All examinations require a healthcare provider's request. Civilian requests will be honored on a space available basis. Routine radiography will be performed on a walk-in basis. Please call for additional information. Pharmacy The pharmacy dispenses medications upon receipt of a written prescription from a military or civilian physician or dentist. For prescriptions from civilian physicians and dentists, the pharmacy must follow Air Force instructions, federal guidelines, and state of North Carolina law in regard to pharmacy practice. If you receive your care from a civilian provider, have them call the pharmacy BEFORE they write the prescription to find out if we carry the specific medication, or they can access the formulary from the 4 MDG website ( then scroll down to the 4 MDG link and click on read the current patient formulary. This will save you time at the pharmacy. The Pharmacy ( ), in the Thomas Koritz Clinic fills new prescriptions and refill prescriptions. Hours of operation: M-F **Closed on weekends and holidays** (On the second Wednesday of every month, the pharmacy closes at 1130 hours for training.) The pharmacy has a call-in refill service and your refills are ready in two duty days. The phone numbers for this system are or toll free in North Carolina Due to Air Force regulations, the pharmacy must have the original prescription on file in order to refill the prescription. The pharmacy cannot refill prescriptions that were originally filled at another military or civilian pharmacy. You must present your ID and TPC Insurance Verification Card to the Pharmacy window when dropping off a prescription or picking up medication. Pharmacy staff members will dispense medications when presented with the patient's valid ID card. 4 MDG policy requires when picking up medications for another eligible beneficiary, you must have a signed authorization and copy of both the front and back of the patient s military ID card. 20

21 4 MDG KEY NUMBERS APPOINTMENTS or NURSE ADVICE LINE TRICARE or AEROSPACE PHYSIOLOGY BIOENVIRONMENTAL ENGINEERING BUSINESS OPERATIONS FLIGHT TRICARE OPERATIONS/PATIENT ADMIN /64 DENTAL CLINIC DIAGNOSTIC IMAGING (RADIOLOGY) FAMILY ADVOCACY FAMILY HEALTH CLINIC FLIGHT MEDICINE /81 HEALTH/WELLNESS CTR (HAWC) /03 HEALTH BENEFITS ADVISOR IMMUNIZATION CLINIC /48 LABORATORY MENTAL HEALTH /1878 OPTOMETRY (Aerospace Visual Support) PATIENT ADVOCATE OFFICE PATIENT SAFETY OFFICE PERFORMANCE IMPROVEMENT/RISK MGT PHARMACY PHARMACY Automated Refill Service PHYSICAL THERAPY PRP /81 PUBLIC HEALTH GROUP SUPERINTENDENT FIRST SERGEANT REFERRAL MANAGEMENT CENTER /1230/31 CHIEF NURSE CHIEF OF MEDICAL STAFF AMDS/CC MDOS/CC MDSS/CC MDG COMMANDER

22 WEB RESOURCES SJAFB 4th Medical Group TRICARE North TRICARE (Health Net) United Concordia (TRICARE Dental) Delta Dental (Retiree Dental Program) DEERS Address Changes Tricare Mail Order Pharmacy MiCare (Secure Messaging) 4th Medical Group Patient Information Page