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TRICARE

TRICARE. Using Unlisted Codes Secure Provider Portal Referrals. TRICARE (cont). Unlisted Codes Prior approval required Submit with a description of the service. TRICARE (cont). Secure Provider Portal Registered users can: Verify patient eligibility

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TRICARE

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  1. TRICARE • Using Unlisted Codes • Secure Provider Portal • Referrals

  2. TRICARE (cont) Unlisted Codes • Prior approval required • Submit with a description of the service

  3. TRICARE (cont) Secure Provider Portal • Registered users can: • Verify patient eligibility • Research covered benefits and checking referral/authorization and medical review requirements for specific codes • Submit referrals/authorizations online and check their status regardless of how the request was submitted • Submit claims online and check claim status regardless of how the claim was submitted • Download remittance advices • Download claims status reports • Submit claims correspondence/Webmail • Participate in Electronic Funds Transfer (EFT)

  4. TRICARE (cont) Outpatient Referrals • Effective December 1, 2010 • list of common outpatient-only procedures and corresponding codes. • Registered users can determine whether a procedure is outpatient or inpatient by • researching benefits and checking referral/authorization and medical review requirements by using the West Region Benefit Lookup Tool. • The tool will display benefit exceptions, if applicable, based on search criteria. • The “Place of Service” link will display different POS options and their descriptions, in numerical order.

  5. Referral and Authorization Letters New online tool Available 24/7 Allows the provider to print copies right from their computer, which can help expedite the care to our beneficiaries! TRICARE (cont)

  6. TRICARE (cont) Online Claims Correspondence/Webmail • Registered users can electronically submit claims-specific issues and other general website inquiries directly to TriWest. • To learn how to correspond with TriWest regarding claims issues/inquiries and your secure account at www.triwest.com, view the claims correspondence and Webmail tutorial.

  7. Questions?

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