TRICARE Patient Administration & Medical Records Guide
*Disclaimer: TRICARE.com is an independent reference site and is not the official TRICARE program. For official policy and government updates, visit TRICARE.mil.*
## Quick answer Patient Administration refers to the administrative operations within a Military Hospital or Clinic (also known as a Military Treatment Facility or MTF) that handle your medical records, registration, and health information management. It is the "business office" of military medicine where you go to update your DEERS information, request copies of your health records, or process third-party insurance claims.
## In detail While clinical staff focus on your health, Patient Administration staff focus on your data and eligibility. These offices are found in every MTF managed by the Defense Health Agency (DHA). Their functions are critical to ensuring your TRICARE benefits are applied correctly.
Key Functions of Patient Administration
* **Beneficiary Registration:** Before you can be seen at an MTF, you must be registered in the local system. Patient Administration verifies your eligibility via the Defense Enrollment Eligibility Reporting System (DEERS). * **Medical Records Management:** They maintain your Outpatient Record (OPR) and Inpatient Record (IPR). Under the MHS GENESIS electronic health record system rollout, these offices help manage the transition from paper to digital files. * **Release of Information (ROI):** If you need your records for a civilian doctor, a VA claim, or personal use, this office processes those requests. * **Third-Party Collections (TPC):** If you have Other Health Insurance (OHI), Patient Administration bills your private insurance first. This reduces the cost to the Department of Defense and does not result in a bill for the service member. * **Patient Advocacy and Assistance:** Many offices house a Health Benefits Adviser (HBA) or a Beneficiary Counseling and Assistance Coordinator (BCAC) to help navigate TRICARE Prime or Select coverage.
### Regional Support Structures In 2026, the administrative oversight of TRICARE claims and referrals outside the MTF is managed by regional contractors: * **East Region:** Humana Military * **West Region:** TriWest Healthcare Alliance * **Pharmacy:** Express Scripts
### Comparing MTF Admin vs. Contractor Admin | Feature | MTF Patient Administration | Regional Contractor (TriWest/Humana) | | :--- | :--- | :--- | | **Primary Focus** | On-base care and medical records | Civilian provider networks and claims | | **Record Requests** | Local MTF treatment records | Summary of civilian care claims | | **Eligibility** | Verified via DEERS | Verified via DEERS | | **Claims** | Third-party billing (private insurance) | TRICARE civilian provider claims |
## Who this applies to * **Active Duty Service Members (ADSMs):** Required to use MTF Patient Administration for all record updates and line-of-duty (LOD) paperwork. * **Active Duty Family Members (ADFMs):** Those enrolled in TRICARE Prime who receive care on-base must use this office for records and registration. * **Retirees and Families:** Those residing near a base who use "Space-Available" care or are enrolled in TRICARE Prime at an MTF. * **Guard/Reserve:** Impacted during activation or when processing medical readiness records.
Common scenarios
### Scenario 1: Transitioning to the VA A Sergeant First Class is retiring in August 2026. She visits the Patient Administration office at Fort Campbell to request a complete copy of her medical records. Because she is transitionng, Patient Admin provides a digital copy of her MHS GENESIS records to ensure her VA disability claim is processed accurately. **Cost: $0.**
### Scenario 2: Other Health Insurance (OHI) A Navy spouse has a private job with Cigna insurance but chooses to see a specialist at Walter Reed NMMC. The Patient Administration office asks for his Cigna card. They bill Cigna for the visit. Under TRICARE rules, the spouse pays **$0 out of pocket** at the MTF, but the government recovers costs from the private insurer.
### Scenario 3: Correcting DEERS Data A Soldier’s newborn child is not showing up in the MTF system. The Soldier visits Patient Administration. The clerk identifies that the child is registered in DEERS but not yet "arrived" in the local MTF database. The clerk syncs the records, allowing the pediatrician to order shots and labs immediately.
## Related terms * **DEERS:** The master database of military members and family members used to verify TRICARE eligibility. * **MHS GENESIS:** The unified electronic health record system used across all military hospitals and clinics as of 2026. * **Third-Party Collections (TPC):** The process where the MTF bills a beneficiary's private health insurance for care provided on-base. * **ROI (Release of Information):** The legal process of authorizing the MTF to share your medical data with an outside entity. * **BCAC:** Beneficiary Counseling and Assistance Coordinator; a staff member who helps solve TRICARE billing and coverage issues.
## Sources * **TRICARE.mil - Medical Records:** https://www.tricare.mil/Resources/MedicalRecords * **Defense Health Agency (DHA):** https://health.mil/Military-Health-Topics/Access-Cost-Quality/Access-to-Care/Patient-Administration-Directives * **Humana Military (East):** https://www.humanamilitary.com/ * **TriWest Healthcare Alliance (West):** https://www.triwest.com/