Reserve Component: Reserve Component Beneficiaries are entitled to TRICARE coverage while performing military duties or for medical conditions resulting from military service. If a patient record indicates this may be the case, please file your claim with TRICARE.
PGBA is a Certified Center of Excellence, awarded by BenchmarkPortal!
Applied Behavior Analysis (ABA): BLS Certification enforced for ABA Providers.
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: Eligible TRICARE Prime beneficiaries can obtain urgent care twice per fiscal year from an authorized provider without a referral under the Urgent Care Pilot Program.
Autism Care Demonstration (ACD): Check out the latest updates to the ACD program.
Outpatient Prospective Payment System (OPPS): Centers for Medicare & Medicaid Services (CMS) implements quarterly updates to OPPS. Information related to the July 2017 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.
XPressClaim: Remember that providers can submit corrected claims through XPressClaim too!
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.