PROVIDERS

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Welcome West Region 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.

 

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.

 

Performance: check out the West Region Report Card!

 

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

 


 

 

Our Prime Partner

 

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

 

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