Patient Administration

The Patient Administration Division has a dedicated staff that can assist you in many areas. This includes our Release of Information (ROI), Health Insurance Portability and Accountability Act (HIPAA), Admissions and Dispositions, Coding and Outpatient Records.
 

Admissions & Dispositions

Every patient that is admitted or discharged from Martin Army Community Hospital must go through the Admissions & Dispositions Office. Upon admission the patient must present a valid Military Identification Card to verify eligibility for Military Healthcare. If the patient has Other Health Insurance (OHI), please provide this information to the Admission Clerk and complete a Third Party Collection Program Record of Other Health Insurance, DD Form 2569.

In addition to patient admissions, the Admissions & Dispositions office performs inpatient tracking and accountability, constructs Line of Duty's (LOD), coordinates AIREVACs, and initiates Secretary of the Army Designee (SAD) program requests.
 

Medical Records

The Medical Records Office at Martin Army Community Hospital is responsible for the following:

• Patient Registration
• Maintaining the outpatient medical records for all beneficiaries
• Verifying patient eligibility in DEERS
• Processing all requests for Release of Protected Health Information

To request medical records, you must produce the following:

• DD Form 2870 (Please click to download and complete)
• DoD Number (provide on DD Form 2870)
• ID Card
• Medical Power of Attorney and a written statement authorizing pick up privileges (if requesting records for family members over the age of 18)

Please include a legible email address on DD Form 2870. The records will be sent to your email address in a PDF format with password protection via DoD Safe. Scan the signed documents for the request and email them, encrypted if possible, along with a copy of the front and back of the requestor's ID (it cannot be a DOD ID Card) to: dha.moore.martin-ach.list.mach-pad-correspondence@health.mil

Upon receipt, we will acknowledge receipt of your request via email and begin the processing. Normal processing time is 30 business days. The records will be sent to the email address you include on DD Form 2870, it will be in a PDF format with password protection. A separate email with the password will be sent to you so you may access your records. You will receive a courtesy phone call when records on CD is ready for pickup. 

For more information on locating your medical records, please call Martin ACH Outpatient Records Room at DSN 762-408-0076/0077/0078 or email at dha.moore.martin-ach.list.mach-pad-correspondence@health.mil

Uniform Business Office (UBO)

The Uniform Business Office is the billing and collection agency for Martin ACH. The UBO processes all claims and collection of payments for patients who have third party insurance for services rendered at Martin ACH. Once a patient receives a bill for service, they may visit the Treasury Office to make settlement via cash, check, or money order.

 

Patient Administration Contact Representative

The Patient Administration Contact Representative provides a number of services, to include:

• Birth verification and certificates
• Death certificates
• Medical Statements
• Notary Services

Patients must possess a valid military ID for services performed by the contact representative.