DA FORM 2631 Fillable – Army Pubs 2631 PDF

DAFORMFILLABLE.COM | DA FORM 2631 Fillable – Army Pubs 2631 PDF – In the realm of military healthcare, ensuring that all administrative aspects are correctly managed is critical. DA Form 2631, also known as the Medical Care-Third Party Liability Notification, plays a pivotal role in the process of healthcare cost recovery. This article provides a comprehensive overview of DA Form 2631, detailing its purpose, use, and significance within the military healthcare system.

DA FORM 2631 – Medical Care-Third Party Liability Notification

Form Number DA Form 2631
Form Title Medical Care-Third Party Liability Notification
Form Date 03/01/2000
Form Proponent TSG

What is DA Form 2631?

DA Form 2631 is officially titled “Medical Care-Third Party Liability Notification.” As indicated by its title, this form is used within the U.S. Army to notify third parties who may be liable to pay for medical care provided to soldiers, their dependents, or other eligible individuals. The form serves as a formal document to communicate potential liability for medical expenses incurred during treatment.

Purpose of DA Form 2631

The primary purpose of DA Form 2631 is to facilitate the recovery of medical costs from third-party payers. This might include private insurance companies, liable individuals, or other entities responsible for injuries resulting in medical treatment. The form ensures that the military can reclaim expenses that should be covered by these third parties, thus helping to maintain the financial integrity of military medical services.

When is DA Form 2631 Used?

DA Form 2631 is utilized whenever there is a potential for recovering medical care costs from a third party. This typically occurs in cases of accidents, injuries, or other health incidents where another party is deemed responsible. By using this form, healthcare administrators can initiate the process of cost recovery, which is crucial for sustaining the funding of military healthcare services.

Key Features of DA Form 2631

Content of the Form

DA Form 2631 includes sections for detailed information about the patient, the medical services provided, and the third party believed to be liable. It also contains legal notices pertaining to the Privacy Act, as mandated by AR 340-21, to ensure the confidentiality and appropriate handling of personal and medical information.

Importance of Accuracy and Completeness

Accuracy in filling out DA Form 2631 is paramount. Inaccuracies can lead to delays or denials in reimbursement, which can ultimately impact the financial resources available for military healthcare. Administrators are trained to meticulously review and verify all details on the form to avoid such issues.

Compliance and Regulations

Governing Directives

DA Form 2631 is prescribed by AR 40-400. Administrators and healthcare providers must adhere to these regulations when handling third-party liability cases. Understanding and complying with these guidelines ensure that all procedures related to third-party notifications are legally sound and efficient.

Privacy and Security

Given the sensitive nature of the information involved, DA Form 2631 includes a mandatory Privacy Act Statement to protect the privacy rights of individuals. The form itself is classified as UNCLASSIFIED but is approved for public release, ensuring that it can be distributed widely within the confines of military operations and healthcare systems.


DA Form 2631 is a crucial document for the efficient management of military healthcare finances. By enabling the recovery of costs from third-party payers, it helps ensure that military medical facilities remain adequately funded and capable of providing top-tier medical care to service members and their families. For healthcare administrators, understanding how to correctly and effectively use this form is essential for maintaining the sustainability of military healthcare operations.

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