DPHC Patient Administration Division
Primary Care Clinic Reception Desk performs a multitude of services for the Active Duty TRICARE beneficiaries enrolled to the DiLorenzo Pentagon Health Clinic. Please bring your military ID card, whenever you report to the clinic. Your pentagon access badge is not a substitute for your military ID card. Active Duty Reservist, please bring a copy of your orders, placing you in your active duty status, along with your military ID card.
Patients may request copies of their medical records by completing a DD Form 2870 (Authorization for Disclosure of Medical or Dental Information). If you are requesting your Medical Records be transferred from our facility to another or from another facility to DiLorenzo, you will need to complete a DD Form 877 (Request for Medical/Dental Records or Information). All request may be submitted by mail, fax, or by visiting Medical Records between 7 a.m. and 3 p.m. on weekdays, excluding federal holidays.
•Under normal conditions, PHI may be released to parents of minors under the age of 18, however there may be instances where a disclosure will be required of the minor.
•Telephone requests for PHI cannot be honored.
•Faxed requests will only be honored in an emergency, i.e., when a patient has been admitted to another healthcare facility and information about the patient’s previous health care conditions and treatment is needed to treat the patient’s current medical condition, or for continuity of care. Routine release of PHI is provided on a first-come first-serve basis, however exceptions may be necessary based upon the urgency and the effect of not providing the PHI on the patient health.
•Much of the medical information (PHI) currently generated when outpatient care is received is entered into an electronic hospital system known as the Armed Forces Health Longitudinal Technology (AHLTA). Since the military medical records maintained at this facility are composed of both written and electronic records, these records are referred to as “hybrid” records. When a request for PHI is received, research is performed to assure that all episodes of care are located to provide a comprehensive response to each PHI request. Once all requested PHI is obtained, documentation must be copied and printed off the system to satisfy each request for PHI. Emergency room documentation is not entered into an electronic hospital system, therefore, the PHI requested may not be readily available, and time must be allotted to research each request. Due to the large volume of requests, and our efforts to provide a comprehensive response to each requestor, same day service cannot be provided.
•Requests for PHI for patients who have received mental health treatment require approval of the mental health care provider prior to release. For release of medical records information, the requesting party must mail a signed consent along with specific information being requested to the following address:
DiLorenzo TRICARE Health Clinic
Corridor 8, Room MG914/918A
5801 Army Pentagon
Washington, DC 20310-5801
Attention: Patient Administration
•Insurance companies are charged an administrative fee of $13.25 plus a copying fee of .15 cents per page. Due to the large volume of requests, customers requesting duplication of their medical records should submit their requests in writing no less than 30 business days in advance. Patients requesting PHI for personal use will be provided with one free copy, however, they will be charged a fee for subsequent requests for copies for the same PHI that was previously released. Medical documentation generated since the last request for PHI will be given free of charge.
•Under normal circumstances, active duty members are given priority in the processing of their requests for copies of their medical records/PHI.
Our office copies official medical record sets within DiLorenzo. Outpatient records require a maximum of 30 business days to process.
Behavioral Health and sensitive records must be reviewed and cleared by a provider before release. Please allow the full 30 business days for processing.
The following record requests can normally be processed same day as a walk-in:
•Some Radiology tests
All requests for information must include the following:
•Patient's date of birth
•Sponsor's complete social security number
•Period of treatment/information needed
•Statement authorizing Fort Belvoir Community Hospital to release the records to a specific person/organization
•An address and/or phone number of the receiving person/organization
•The purpose for the release of the information
•Patient's signature/date. Patients who are 18 years and older, or emancipated, must sign an authorization for release of their medical records.
Permanent Change of Station (PCS)
Active-duty members preparing to out-process from DiLorenzo Tricare Health Clinic should visit Medical Records between 7 a.m. and 3 p.m. on weekdays, excluding federal holidays.
•Patients who have orders to PCS or who will leave the service, i.e., Expiration of Term of Service (ETS), must visit the Patient Administration section for copies of their health/outpatient treatment records at least one month before their date of departure.
Expiration Term of Service
Active-duty members preparing to retire or separate should obtain copies of all medical records at least six months prior to their final out-processing date.
This process will take a maximum of 30 business days to process, please do not make a VA appointment until after you have a copy of your medical records.
One free copy of the medical record, per AR 40-66 will be provided, additional copies will be assessed an administrative fee of $13.25 plus a copying fee of .15 cents per page.
•Medical records are maintained at a military treatment facility for a certain number of years based upon army regulations. Outpatient records are maintained for two (2) years after the last date of treatment if you were seen as an outpatient or hospitalized as an inpatient or had an ambulatory procedure within the time frames discussed above, your records will be updated and retained at the hospital. If you haven’t received outpatient care within two years of the last date of treatment or if you have not been hospitalized within five years of the last date of hospitalization or received treatment as an ambulatory procedure visit patient, your records will be retired. These records are retired according to the last date of treatment and shipped to the National Personnel Records Center (NPRC) in St. Louis, Missouri. If you need a copy of those records, you must request them directly from the NPRC. When you request medical records from the NPRC, you must provide them with the sponsor’s Social Security Number or military number if prior to 1971. If possible, be as specific as you can about the date and location of your last period of treatment. This will aid the NPRC in locating your medical records. The address for the NPRC is as follows:
National Personnel Records Center.
Patients may obtain their retired records directly from NPRC online at www.archives.gov/veterans.
Or, write to NPRC at the following address:
Active-Duty military records:
Department of Veterans Affairs
Records Management Center
P.O. Box 5020
St. Louis, MO 63115
1411 Boulder Dr.
Valmeyer, IL 62295
Per DHA-IPM 18-018 Guidance
1a. All components of the DoD Health Record are the property of the U.S. Government. Patients have the right to a copy of the information contained in their DoD Health Record. The DoD is responsible for the maintenance and availability of DoD Health Records at MTFs, which is key to appropriate medical care and legal and administrative proceedings.
2a. MTFs will establish a process that ensures no hand-carrying of DoD Health Records by beneficiaries. A process should be implemented to retrieve records as soon as possible from those beneficiaries who may be in possession of their records.
b. Exceptions to the no hand-carrying guidance.
(1) Circumstances in which the break in continuity of care outweighs the record custody concerns.
-No Service member who is in the process of separating or retiring will hand-carry an original STR for any reason, with the exception of United States Marine Corps members who are required to hand-carry their STR to the final out-processing appointment.
(2) Members assigned or being assigned to active Personnel Reliability Program, Presidential Support Program, or other sensitive duty positions where access to a complete medical record is required.
(3) Members being assigned to a Geographically Separated Unit where access to the EHR is unavailable.
If you have any questions, please contact 703-692-8942 Please bring your military ID card, whenever you report to the clinic.