Who needs a DD Form 2527?
The DD 2527 is the Statement of Personal Injury — Possible Third Party Liability, Trocar Management Activity Form. The form must be filed by a patient, if TRI CARE believes that the claimed injury or illness may have been caused by a third party, and they should be held responsible for compensation the cost of treatment rather than the insurance provider. Therefore, it is TRI CARE who is supposed to request a patient to fill out the DD form 2527, so that the appropriate payments are made either by the insurance provider or by the third party proved responsible for the injury or illness.
Why is the DD 2527 Form necessary?
TRI CARE should ask a patient to fill out the DD 2527 Statement of Personal Injury to seek assistance in determining possible third party liability for medical supplies and services claims. Information requested is used in reviewing claims to obtain additional information to determine proper liability of third parties for claims and to facilitate possible recovery by the United States for improperly paid claims.
When is the Statement of Personal Injury — Possible Third Party Liability form due?
The DD Form 2527 has a strict deadline for submission. The patient is obligated to submit it within 35 days after its receipt, otherwise, the medical claim is very likely to be denied. This is also applicable even though the patient does not think that any third parties may be involved.
Is the DD Form 2527 accompanied by any other forms?
No, typically there is no need to accompany the completed Possible Third Party Liability Statement with any other documents or forms.
How to fill out the 2008 Form DD-2527?
The form DD2527 must be fully filled out and provide such details:
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Personal information about the patient (name, address, telephone number);
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Sponsor’s SSN;
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Details about the injury (date, time, location);
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Type and cause of injury;
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Details about treatment (name of military medical facility, dates of treatment)
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Insurance details, etc.
