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Welcome North Region Providers

NEW! Air Ambulance Claims: DHA adopted the Medicare Ambulance Fee Schedule, but is reevaluating air ambulance service fees.  Until DHA provides direction, air ambulance claims will be held.  We apologize for the inconvenience & thank you for your patience.


NEW! Revised Professional Claim Form: Beginning April 1, 2014, only professional claims submitted on the 02/12 1500 Claim Form will be accepted.


NEW! Outpatient Prospective Payment System (OPPS): Centers for Medicare & Medicaid Services (CMS) implements quarterly updates to OPPS. Information related to the April 2014 update is available directly from CMS. Please note: Medicare specific coding requirements must be followed (with the exception of DHA developed APCs) in order to receive TRICARE reimbursement under the OPPS.


Sole Community Hospitals: Important information regarding reimbursement.


Ambulance Fee Schedule: Effective October 1, 2013 TRICARE will reimburse ambulance claims using Medicare's Ambulance Fee Schedule (AFS). New billing guidelines can be located in the TRICARE Reimbursement Manual.


Applied Behavior Analysis (ABA): Learn the latest changes in TRICARE coverage for ABA Services.


Abortion Claims Coverage: New details about submitting abortion claims.


XPressClaim: Remember that you can submit corrected claims through XPressClaim too!


EDI Submitters - Prevent your TRICARE claims from rejecting with the Invalid Member ID (H65) edit. 




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