There are several health coverage policies and plans eligible for cost recovery programs to submit claims. Claim formats that are used in the Military Health System (MHS) are based on encounter services provided, payer requirements, and Service and NCR MD billing policies. The U.S. government may not collect more than the total charge of medical care from any one source or combination of sources. If total payment received exceeds the amount billed, the military treatment facility (MTF) must refund the overage to the payer(s). The table below details the claim format guidelines for each UBO cost recovery program.

• Institutional- Hospital charges (routine service charges associated with hospital stay or ancillary hospital services)
• Professional- Provider charges (professional services provided by a physician or other provider)