You need DD Form 2570, and this page gives you the blank plus the steps for handling it. Start with what the form does: Third Party Collection Program - Report on Program Results. Its official title is DD Form 2570, Third Party Collection Program - Report on Program Results, June 2001..
Your second step is the edition, not stated, listed as not stated. Your third is scope. Because the number carries a DD prefix, you use the same blank as every other military department and defense agency; no service-specific version exists for you to hunt down.
Then settle the schedule. You are working under not stated, with not stated responsible for the document, and your organization layers its own deadlines on that. Ask before you assume a date.
Finally, decide how you will complete it. You can type into a fillable file or print a blank and write by hand, and the rest of this page walks you through both paths in order.
Now fill it in. Work from the top of the page downward, and do not jump ahead — the identifying block comes first, the substance of your entry second, the certification last. Later boxes often depend on what you put at the top.
Before your first entry, look at the corner of the page and compare the printed date with not stated. If they do not match, stop and download again. Old copies circulate in shared drives for years, and a DD form is revised centrally for every service at once, so a superseded blank may not carry the fields your reviewer expects.
For questions about a specific entry, check the form's own instructions, and if that does not settle it, open not stated. The directive controls where they differ.
Download the form
Step one is picking the format. You have PDF to choose from, across 1 pages, with approximately 95 fields to complete.
Choose pdf as your default. Next, click inside a box. A fillable pdf responds by outlining the field and letting you type; the text stays in the document when you save it. A printable pdf does not respond, which tells you to print the page and complete it by hand.
Prefer typing over writing. Your form will likely be scanned and emailed onward, and typed text reproduces at every stage while pen strokes fade or blur. When you do write, print in capitals so the receiving clerk can read it.
Check your software before choosing xfdl. That format belongs to IBM Lotus Forms, long used for Defense form distribution, and it needs the matching viewer. Get the viewer installed, then come back for the file.
You will not be charged for any of these; the whole set is free. Before you start entering data, save the file to your computer and open it there. Fields behave far more reliably in a desktop reader than in a browser preview.
What the form asks for
- Segment reported. Press space bar to mark X in first box if inpatient, second box if outpatient.
- 1. Quarter ending. Four digit year, two digit month.
- 2. Reporting medical treatment facility (MTF).
- 3. Defense Medical Information System (D M I S) identification number.
- 4. Reporting period. (1) a. Current fiscal year. (2) Number of non-active duty inpatient dispositions or visits.
- (3) Number of claims.
- (4) Number of collections.
- (5) Number of claims divided by dispositions or visits, expressed as percentage.
- (6) Total dollar amount billed/charges.
- (1) b. First prior fiscal year. (2) Number of non-active duty inpatient dispositions or visits.
- (3) Number of claims.
- (4) Number of collections.
- (5) Number of claims divided by dispositions or visits, expressed as percentage.
- (6) Total dollar amount billed/charges.
- (1) c. Second prior fiscal year. (2) Number of non-active duty inpatient dispositions or visits.
- (3) Number of claims.
- (4) Number of collections.
- (5) Number of claims divided by dispositions or visits, expressed as percentage.
- (6) Total dollar amount billed/charges.
- 4.a. Current fiscal year. Column 7. Dollar adjustments and refunds. Note 2. Amounts reported for each fiscal year shall equal the subtotal for reasons codes 8 through 16 in Part 2 for the respective fiscal years.
- Current fiscal year. Column 10. Dollar amount collected current fiscal year.
- (11) Dollar amount remaining uncollected. (Column (6) minus (7) plus (8), (9), and (10).)
- (9) Amount collected, PY 1.
- (10) Amount collected current FY.
With the form finished, route it to the office named in not stated or in your organization's own instruction. Keep a copy first. People rarely regret having one and frequently regret not having one.
If the form points you to another document, you can find it by number alone. DD numbering runs across the whole Department, so you do not need to work out which service issued it — one number, one form, everywhere.
Here is where people go wrong. They see a number in an instruction and download whichever form matches it. But DA and DD are separate systems — Army-specific in one case, Department-wide under not stated in the other — so check which series you were sent to before you take the file.
Plan to repeat this step whenever the form comes up again. Revisions follow directive changes, changes in what data is collected, and updates to notice language. Since nobody notifies you, check not stated at download and you have covered it.
One thing this page does not do: tell you whether your submission will be accepted. We publish the document and explain how to complete it, and that is where our role ends. Nothing here is legal advice. Take questions about eligibility, applicability or procedure to not stated, to your servicing personnel office, or to the office named in not stated.
Questions and answers
- What is DD Form 2570?
- DD Form 2570, Third Party Collection Program - Report on Program Results, June 2001.
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?