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NEW! Urgent Care Clinics: Eligible TRICARE Prime beneficiaries can obtain urgent care twice per fiscal year from an authorized provider without a referral under the Urgent Care Pilot Program.
Autism Care Demonstration (ACD): Check out the latest update to the ACD program.
Outpatient Prospective Payment System (OPPS): Centers for Medicare & Medicaid Services (CMS) implements quarterly updates to OPPS. Information related to the April 2016 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.