TOC | TRICARE Operations Center

Welcome to the TOC...”The premier healthcare information web portal for the Military Healthcare System (MHS) providing decision makers at all levels of the organization with meaningful, easy to use, web-base operational tools and reports. ”

If you are a TRICARE Beneficiary and are looking for support with a TRICARE question, please go to http://www.tricare.mil/contactus/ to obtain contact phone numbers for TRICARE Program assistance, to include regional contractor information for TRICARE Reserve Select.

For a faster contact to your Manage Care Support Contractor please use the information provided below:

North Region: HealthNet Federal Services, LLC: 1.877.874.2273
https://www.hnfs.net/common/home/

South Region: Humana Military Healthcare Services, Inc.: 1.800.444.5445
http://www.humana-military.com/

West Region: TriWest Healthcare Alliance: 1.888.874.9378

http://www.triwest.com/

*** NOTE *** The Percentage of Beneficiaries Who See their Assigned PCM (%PCMBN) tool is similar to INSIGHT's %PCMBN. However, the TOC's tool includes ALL appointment types and does not exclude beneficiaries based on BOS. We apologize for any confusion this caused. If you have any questions concerning this tool, please contact Mr. David Petray at david.petray@tma.osd.mil or 703.681.8668. To View the NEW Percentage of Time Enrollee Sees Their Assigned PCM report. Click on the PCM Reports link to the left under the Interactive TOC Tools Menu.

You can not bookmark the following TOC tool sets: Appointment Activities Tool, Inpatient Daily Summary, and Length of Stay, PCM Capacity, Appointment Utilization and Provider Schedules.

If you are a TRICARE Beneficiary and are looking for support with a TRICARE question, please go to http://www.tricare.mil/contactus to obtain contact phone numbers for TRICARE Program assistance, to include regional contractor information for TRICARE Reserve Select.

For a faster contact to your Manage Care Support Contractor please use the information provided below:

North Region: HealthNet Federal Services, LLC: 1.877.874.2273
https://www.hnfs.net/common/home/

South Region: Humana Military Healthcare Services, Inc.: 1.800.444.5445
http://www.humana-military.com/

West Region: TriWest Healthcare Alliance: 1.888.874.9378
http://www.triwest.com/

Click the link to access reports.

Access to Care (ATC) Summary Report: This report answers “Am I meeting ATC standards?” This tool shows the total number of appointments booked, the number of appointments that must meet the ATC standards, the percentage of appointments that met the standard, and the average number of days it took to meet the standard for each ATC category: Acute, Routine, Wellness, and Specialty. The report is generated on a monthly basis using data from the previous month.

Once the January 2009 data has been produced an effort to re-harvest data to re-build historical data will begin and projected to be completed by July 2009.

Access to Care (ATC) Appointment Utilization Report: This report answers “How many appointments were left unbooked?” This tool provides a uniform look at appointment templates at multiple levels: MHS, TRICARE Region, Branch of Service, Facility (DMID ID), Clinic (MEPRS4), Provider. MTF-level management report to evaluate percentage of unused appointment slots to determine how well a clinic's work plan (schedule/template) supports with TRICARE Prime access standards. This tool is generated as an aggregate monthly report. Appointment Utilization Report

Detail Code Usage and Summary Report: This report answers “What detail codes were used to further specify appointment slots?” This tool provides a list of individual detail codes, which further define appointment types and access at the clinic and facility level. The report is generated on a weekly basis using data from the previous week. Archived reports are available from August 2003. Archived reports are available from August 2003.

If you have any questions please email David Petray or phone him at 703-681-8668 or email Glenn C. Webb or phone him at 703-681-8669 for assistance.

Click to access the

CHCS Appointment Activity Tool (AAT)

This tool answers “What patient activity actually occurred in my clinic?” This tool is a complement to the Template Analysis Tool (TAT), which shows the supply of appointments, whereas the AAT shows what actually occurred by appointment status or by appointment type. The AAT displays the end result of patient activity, which can be used to determine the volume of unscheduled demand such as walk-ins or tel-cons vs. planned appointments. The status shows whether the encounter was a kept appointment, cancelled appointment (by clinic or patient), walk-in, sick call, telephone consult, left without being seen (LWOBS), a no-show, ADMIN time for providers, an Occasion of Service (OCC SVC) for special services, booked-non MTF, or an appointment that was left pending. This tool also helps to illustrate the type of care that actually occurred at a clinic. This tool is also used in tandem with the monthly aggregated Access to Care Management report.

Click to access Reports.

Enrollment/Population Reports: These reports answer “What is my enrollment and population?” The TRICARE Relationships Report, the Pure Enrollment Report, and the Population Reports are collected from M2 on a monthly basis. The reports are in an Excel table format and are sorted by beneficiary group and alternate care value (e.g., Active Duty Enrolled, Prime, Plus, etc.) for the enrollment report. Beneficiary groups and catchment/prism areas are broken out for the population reports. These reports will answer approximately 80 percent of enrollment or population inquiries, including questions about TRICARE Plus, Active Duty not enrolled, and the Reserve/Guard enrollment and eligible populations. Archived reports are available from fiscal year 2000.

Click to access the Report.

This tool answers “What is my daily inpatient census?” Inpatient admissions are collected nightly from the Patient File, and then reported for any patients with an inpatient status for any part of a 24-hour period. Starting on the right, the graph shows a 35-day period beginning from the day before the most current receipt of data. For example, if data are received on the current day, the tool begins with the day before, and includes the 34 previous days. The graphs can be presented either in an overall numbers view (using the “Total View” button at the top of the tool bar), or by a beneficiary category view (shown). The daily inpatient census for the MHS averages approximately 4,000 patients, with weekly peaks generally on Wednesdays. This tool can drill down to the Facility, MEPRS inpatient unit, and Staff Physician levels.

Click to access the

This report answers “How many assignment errors do I have between DEERS and CHCS?” This tool is utilized as a method for identifying the current number and type of assignment errors that have been received by a CHCS host. While this may seem like a technical process, a Patient Information Transfer (PIT)/NED error actually represents a patient or family for whom assignment processing has resulted in some type of error. Manual intervention is required to correct the data. Until the error is corrected, the patient or family may encounter difficulties in obtaining access to care. This tool helps both MTFs and higher echelons track potential risks. This report is generated daily.

Click to access

This tool answers “How many patients do I have assigned to me that I am responsible for” The PCM Capacity and Assignment tool provides a quick view of enrollee assignment by beneficiary category, facility, provider group, and PCM. The PCM assignment process affects a clinic’s ability to provide continuity of care to their patients. The manner in which enrolled patients are distributed among providers becomes the first organizing structure governing beneficiaries’ access to the system. In order for the MTF to successfully provide readily available care with a high degree of continuity, the panel assignment size and makeup must be constructed so that PCMs can see their own assigned patients. Beneficiary assignment among PCMs, therefore, must be relatively equal, and remain at a number that normally permits same-day access to requesting panel members. Improper distribution of enrollee assignment could result either in unequal workloads or a breakdown in continuity as patients are referred from the overloaded panel to open appointments with other PCMs. This tool can be used to help avoid such a situation.

Click to access Percentage of Time an Enrollee sees Their Assigned PCM Report

This measure reflects the percentage of appointments in Primary Care clinics that enrollees have with their assigned PCM. To determine the rate, an extract from the Patient Appointment and NED Provider Group files is run against all CHCS hosts each week. The adhoc report indicates if the PCM was the assigned provider for each appointment based on their current enrollment status.

Click the link to access

This tool answers “How many providers have at least one appointment slot and are in clinic on any given day?” This tool shows the number of unique providers with a current schedule in CHCS. Data are collected nightly from the Schedulable Entity File. The tool provides a count of all providers on a given day who have at least one scheduled appointment. The graph displays a 70-day window, encompassing 35 days in the past, the current day, and 34 days in the future. On average, the MHS has approximately 10,000 providers (physicians, nurses, and in some cases corpsmen) who have at least one appointment scheduled on any given day. This graph also is helpful in showing whether provider schedules have been opened at least 30 days in advance.

Click the link to access the

TOL Audit Trail Reports - This report answers the “How many appointments were booked through TOL?” question. This tool was developed to track the number of transactions that occur during a given month using the TOL booking functionality. Because the report tracks transactions and not planned appointments, caution must be used when comparing these numbers to the TOL Planned Appointment Report. Data are collected monthly from the CHCS Audit Trail File and the report presents data for the previous month. Archived data are available from September 2004.

TOL Planned Appointments Reports - This report answers the “How many appointments are Web-Enabled?” question. It includes the MHS roll-ups and detail-level reports for each MTF by clinic. It also provides the ability to look at the distribution of booked appointments by appointment type. The report uses the same data as the Template Analysis Tool. It is a monthly report compiled at the beginning of each month for the previous month. Archived data are available from August 2004.

TOL Audit Archived Reports - This site allows you to pull the archived TOL Audit Trail reports

TOL Registration Reports - This report answers “How many individuals have registered on TOL?” question. This tool was developed to track the number of registrations that occur during a given week using the TOL registration server data. Cumulative data is generated via the TOL Program Office and collected weekly.

TOL Planned Appointments Archived Reports - This site allows you to pull the archived TOL Planned Appointments reports

Please select a view for Direct Care Providers Schedules/Templates:

This tool answers “How many appointments are available for patients?" The TAT shows the level of supply of appointments available for patient scheduling. The TAT is used to help managers determine if clinics and facilities have enough appointments to meet the requirements for Acute, Routine, Wellness, Specialty, and Future Access to Care Standards. The lowest level of data that can be viewed (not shown here) is for a specific provider on a specific day. At this level, the TAT will show an actual provider’s schedule and the duration of each of his/her appointments by clicking on the “Schedule” button. The TAT provides a Scheduling Template point of view and does not include walk-ins or appointments booked the same day of an appointment. On average, there are approximately 100,000 appointments per day within the MHS, with weekly peaks generally occurring on Mondays.

The TOC was developed as a “Home Grown” project within TRICARE Management Activity (TMA). It began with the Template Analysis Tool (TAT), a clinic-level tool, in August 2000. By summer 2001, the TOC was operational with receipt of data from all CHCS hosts, and additional clinic-level tools were added. In September 2002, the leadership at TMA required all TOC tools to aggregate data and provide information at every level of the organization from the provider up to the Military Health System (MHS).

Mission: Provide the MHS with meaningful, easy to use, web-based operational tools that help with the management of health care services.

Vision: To be the premier source of new business tools for the MHS community enabling them to continually improve operations.

The TRICARE Operations Center provides a centralized collection of Composite Health Care System (CHCS) and MHS Mart (M2) data and offers a suite of web-based report tools to assist the entire MHS with a sustainable, near real-time source of information. All Medical Treatment Facilities (MTFs) upload select business data to the TOC on a nightly basis, which is then processed, and displayed via standardized reports. The TOC tools transform MTF data into useful management information, and makes the results available through a series of graphical and tabular tools.

In order to understand the role of the TOC, it is important to understand the basic foundation of its business. The most simplified description of the TOC entails three basic elements:

• Get Data

• Process Data

• Display Data

The TOC team manages the process from end to end. The TOC develops processes to capture the data, manage the processing and conversion of the data, and then posts that data onto the TOC website. The TOC begins the entire process over again each day of the year on a 24X7 basis. There is only a two hour window in the afternoon, EST, where the TOC is not actively processing data.

Unlike other organizations with similar missions, the TOC has ownership of the entire end-to-end process for reporting tools. The TOC team governs the entire life cycle of its products, from requirements creation to report display. However, in an effort to describe the overarching process, the following represents the process the TOC undergoes to "Get Data."

The TOC generates its own reporting requirements, identifies the source system for the data, drafts the code necessary to extract the data, and conducts quality control processes to ensure data accuracy. The primary source of data received by the TOC is the Composite Health Care System (CHCS) and M2 to obtain access to the MDR Data. Aside from the Enrollment and Population Report, the majority of data stems from the CHCS Data Extraction processes.

Click on one of the links to browse another useful site.

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Click on the link to access the Report.

This report answers “Do I have any outliers in my inpatient data?” This report displays the number of patients by their length of stay as an inpatient.

Contact Us

Have questions about the TRICARE Operations Center? Take a look at the TOC History section of our website and see if your questions are able to be resolved there.

Want to send an email to the TRICARE Operations Staff?

For data transmission issues and technical operational concerns please contact our Technical Lead for assistance.

For reporting issues or data questions and/or concerns please contact our Data Analyst for assistance.

For report request, modifications, updates, or suggestions for new reports please contact our Program Manager for assistance.

Have Feedback? Send Us A Note.

If you've checked the website and still have specific questions, ideas, or comments, please send us a note to General Info. We'd love to hear from you!

Contact Us

Have questions about the TRICARE Operations Center? Take a look at the TOC History section of our website and see if your questions are able to be resolved there.

Want to send an email to the TRICARE Operations Staff?

For data transmission issues and technical operational concerns please contact our Technical Lead for assistance.

For reporting issues or data questions and/or concerns please contact our Data Analyst for assistance.

For report request, modifications, updates, or suggestions for new reports please contact our Program Manager for assistance.

Have Feedback? Send Us A Note.

If you've checked the website and still have specific questions, ideas, or comments, please send us a note to General Info. We'd love to hear from you!

The TRICARE Operations Center Military Health System Web site is the official Web presence of the
Office of the Assistant Secretary of Defense (Health Affairs) and the TRICARE Management Activity.
Skyline 5, Suite 810, 5111 Leesburg Pike, Falls Church, VA 22041-3206
TRICARE benefits and program questions: questions@tma.osd.mil

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