Medical Affirmative Claims
The Mission of the Medical Affirmative Claims (MAC) is to enact the Federal Claims Collection Act (31 U.S.C. 3711-3720A), (42 U.S.C. 2651-2653) and 4 CFR 101-105. The goal of the MAC is to recover the reasonable value of medical care rendered for injuries or illnesses provided at Government expense to DoD beneficiaries under circumstances creating third party tort liability.
What is a MAC?
If you are a service member, retired from active service or family member of the sponsor and were involved in any type of accident in which a liability may be involved, i.e., motor vehicle accident, animal bite, product liability, slip & fall, or workers’ compensation, your claim will fall under the jurisdiction of the Staff Judge Advocate, Fort Bliss, TX. If you were seen in the emergency room, you need do nothing at all. The claim process is automatically initiated. If you were seen at any clinic other than the E.R. for care related to this incident, our office or the medical claims examiner must be notified in order for WBAMC to retrieve that information for inclusion in your case.
What Can I Expect?
Although each claim is unique, this stage of the process may take two to four weeks from the time you were seen. Within that approximate timeframe, you can expect to receive a self-addressed, stamped questionnaire from the office of the Judge Advocate General (JAG) at Fort Bliss, TX. It will request you to fill out any highlighted portions relevant to the incident. As soon as you fill out this form please return the form to the Fort Bliss Judge Advocate General (JAG). The JAG office will then contact applicable insurance companies and any attorneys that may represent you; JAG will then request a bill from WBAMC. You will also be expected to keep the MAC office and JAG informed the status and duration of medical treatment related to the particular injury, even if the treatment is intensive and long term.
Although we strive to complete your claim as soon as possible, liability claims have up to three years to be finalized. Some claims take longer than three years depending upon the involvement of the court system. Therefore, in the event you are subjected to unwanted contacts from either the insurance companies or other attorneys, please notify your primary medical claims examiner, at 915 568-5846 or 915 568-5822, and they in turn will communicate with these parties on your behalf.
Other MAC Information
- Mac does not handle TRICARE-related issues.
- Mac does not bill for treatment given outside of WBAMC, for example, civilian medical care.
Points of Contact and Location
MAC is located in the Third Party Collections office, room #1-223d (next to TRICARE). Our telephone # is 915 569-2328 and the office hours are 0730-1230 and 1330–1730, Monday-Friday.
Once your claim is initiated, should you require any additional assistance or information regarding your claim, or if you require copies of the billing please contact the MAC representative at 915 569-2328 or the primary medical claims examiner 915 568-5846 or 915 568-5822.
Thank you and we do hope your recovery from this trauma is swift and complete.