Military Medical Support Office (MMSO) at Defense Health Agency–Great Lakes
For remotely located Active Duty and Reserve Component service members, the Military Medical Support Office (MMSO) at Defense Health Agency (DHA) - Great Lakes (DHA-GL):
- Gives pre-authorization for civilian medical care
- Authorizes payment of civilian medical claims
- Coordinates civilian health care services for remotely located service members
- Collaborates with unit representatives regarding line-of duty (LOD) care for remotely located service members
Request Forms
The forms below are submitted to the MMSO at DHA-GL. Instructions and addresses are found on each form.
- Medical Eligibility Request—To verify your eligibility for medical care.
- Pre-Authorization Request for Medical Care—To get authorization for medical care
- Pre-Authorization Request for Surgical Care—To request authorization for surgical care.
- Formal Appeal Request—To submit a denied medical claim or pre-authorization request.
- DHA-GL 07 DVA/DoD MOA Initial Referral & Authorization for SCI-TBI-Blind Rehab
- DHA-GL 07a DVA/DoD MOA Continued Stay for SCI-TBI-Blind Rehab
- DHA-GL 08 DVA-DoD SCI-TBI-Blind DME Request Worksheet
- DHA-GL 41 Worksheet DOD/VA MOA Inpatient-Outpatient Continued Stay Review
Instructions
Review the instructions below for MMSO at DHA-GL processes and procedures.
- DHA-GL Process Guide
- How to forward medical eligibility documentation to DHA-GL
- How to submit pharmacy reimbursement for Guard and Reservist with line of duty (LOD) injuries/illness
- How to submit a request for pre-authorization for line of duty (LOD) care
- How to submit a formal appeal
- How to get a medical bill removed from a credit report
- How to submit Initial pre-authorization DVA DoD MOA
- How to submit Continuity of Care pre-authorization DVA DoD MOA
- Information on the Fair Debt Collection Practices Act
Last Updated 3/9/2022