PROVIDERS

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Welcome South Providers


 

NEW! Delayed Payment Cycle: The last non-underwritten and underwritten cycles for fiscal year 2014 will occur on September 25. The next cycle for both will occur on October 1. During this time frame, payments will be delayed. We apologize for the inconvenience and thank you for your patience.

 

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

 

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

 

Outpatient Prospective Payment System (OPPS): Centers for Medicare & Medicaid Services (CMS) implements quarterly updates to OPPS. Information related to the July 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.

  

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

 

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

 

Payment cycle information: EFT payments are processed five days a week. The payment cycle for providers who elect to have either paper checks and/or paper remits is once a week. Go 100% electronic and get paid faster! Sign up for EFT today.

 

Home Infusion: Check out the home infusion therapy billing guidelines.

 

Referrals and Authorizations: For all referral and authorization needs (build a referral/auth, check status or update existing referral/auths), go to Humana Military or use the IVR line at 1-800-444-5445 and listen for the prompts.
 

 


 

  

Our Prime Partner

Click here to go to our Prime Contracting Partner's website to find other helpful tools.

 

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