UBO

SIT/OHI

On this page:

• SIT/OHI Subscription
• What is SIT?
• What is OHI?
• Business Rules
• Background
• Submitting Changes

Keeping Your SIT/OHI Subscription Current

To assist your MTF with keeping its connectivity with DEERS, we recommend that you meet with and build a relationship with your CHCS administrator. By working together, you can insure that you will have continuous connectivity with DEERS and the most up-to-date SIT/OHI information for billing Other Health Insurance (OHI).

If you have any questions, the insurance Verification Point of Contact (VPOC) can be reached at (571) 733-5935 and through the VPOC Helpdesk at: vpoc.helpdesk@altarum.org

To maintain connectivity, each MTF must “subscribe” to the SIT from CHCS to DEERS at least once a week. Regular maintenance of your local SIT will ensure timely updates from DEERS and prevent degradation of billing.

Here's how:
Connecting with Your Local SIT (docx 13.8 KB) (posted 7-14-2011)

Repointing SIT/OHI
Repointing SIT/OHI (doc 27.0 KB)(posted 7-14-2011)

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What is SIT?

The Standard Insurance Table (SIT) is a centralized DEERS database that contains information on Health Insurance Carriers (HICs) and the types of coverage (comprehensive, medical, pharmacy, dental, vision, etc.) that each HIC offers. The primary purpose of the SIT is to provide billing address and other contact information for each carrier based on the coverages they offer. HIC data are entered into the SIT by MTF and purchased care staff, and their input is verified by the TMA Verification Point of Contact (VPOC).

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What is OHI?

Other Health Insurance (OHI) refers to other health insurance policies that a TRICARE beneficiary may carry, representing potential collections for the TPC program under 10 U.S.C. 1095. OHI data refers to information about a patient's policy, such as the policy name and number, coverage type, patient relationship to insured, and effective dates. This information is used to properly route a health care claim sent to the OHI carrier. Currently, OHI is locally stored on CHCS host servers and shared with TPOCS.

A primary source of OHI information is the DD Form 2569 completed by beneficiaries.

DD_2569_2011 pdf 39.8 KB

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Business Rules

SIT and OHI Business Rules were last updated in February 2008. Below are links to the current business rules and supporting documents.

SIT and OHI Business Rules doc 165.0 KB
Understanding SIT Status Codes doc 36.5 KB

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Background

DoD Third Party Collections (TPC) program activities involve the billing of health insurance plans, or agreements, on behalf of beneficiaries for both Inpatient and Outpatient treatment provided in Military Treatment Facilities (MTFs) and Dental Treatment Facilities (DTFs), to the fullest extent allowed under 10 U.S.C. 1095. Inpatient TPC is currently supported by the Composite Health Care System (CHCS) TPC sub-system, while Outpatient TPC is supported by the Third Party Outpatient Collection System (TPOCS). CHCS checks patients' eligibility for military health care against the local Defense Enrollment Eligibility System (DEERS).

The Standard ST/OHI Program was developed to standardize SIT and OHI data across the information systems of the Military Health System (MHS), (including CHCS, TPOCS, New DEERS, Defense On-Line Enrollment System (DOES), and Pharmacy Data Transaction System (PDTS)) by creating centralized OHI and SIT repositories on New DEERS with supporting processes and architecture. With the implementation of New DEERS and its supporting interfaces, SIT data is centrally stored. The centralization of SIT data allows for insurance company claims addresses to be managed and standardized throughout the MHS.

Frequently Asked Questions

Frequently Asked Questions doc 49.5 KB

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Submitting Changes to the SIT/OHI Tables

SIT/OHI changes are completed directly on the local CHCS systems. You can also submit changes via the VPOC Helpdesk. E-mail: vpoc.helpdesk@altarum.org

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Contact us:

For questions or comments, please e-mail UBO.Helpdesk@altarum.org, or leave a message for the Helpdesk staff at (571) 733-5935. Phone messages will be returned within one business day.

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