PROVIDERS

Select your view:
Current Region: SOUTH Select a different region

Welcome South Providers


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.

 

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.

 

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.

 

Humana Military Logo 2012

 

 

 


BACK