PROVIDERS

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Welcome South 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.

 

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 Web site to find other helpful tools.

 

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