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Welcome North Region Providers

NEW! Annual Pricing Updates: The following claim types are subject to the latest rate updates beginning with discharge dates of service on and after October 1, 2016: DRG, OPPS, RTC, PHP and Inpatient Mental Health. These claims will be held temporarily until pricing updates are received from DHA. We expect the affected facility claims to be released by mid-November. We apologize for any inconvenience and thank you for your patience.


Web Protocol: myTRICARE will only accept internet traffic via the secure TLS 1.1 and TLS 1.2 protocols. If you are having issues accessing myTRICARE Secure, verify that your browser settings have TLS 1.1 and TLS 1.2 enabled.


Urgent Care Clinics: Beneficiaries should contact their PCM or family doctor first to best decide where and when to get urgent medical care.


Autism Care Demonstration (ACD): Check out the latest update to the ACD program.


TRICARE Appeal Rights: To submit a non-expedited reconsideration request to Health Net, specific instructions must be followed by the appropriate appealing party.


Outpatient Prospective Payment System (OPPS): Centers for Medicare & Medicaid Services (CMS) implements quarterly updates to OPPS. Information related to the July 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.


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


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