Outpatient Prospective Payment System (OPPS): Centers for Medicare & Medicaid Services (CMS) implements quarterly updates to OPPS. Information related to the January 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.
Enhanced Recoupment Features: Sign-in to myTRICARE Secure now!
Revised Professional Claim Form: Beginning January 6, 2014, providers may begin submitting the 02/12 1500 Claim Form.
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.