Provider application
Please correct me if I am wrong!!The non-network application is just for the doctor to get paid by Tricare. It does not mean that the doctor is PAR with Tricare and will be getting inundated with...
View ArticleTricare non participating provider
Hi Team,My doctor is a non participating ER provider with Tricare. Tricare is paying 100% of its allowed.In this case, the balance between the billed and the allowed/Paid has to be billed to the...
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3 Stars
Any idea what those 3 stars in the Tricare symbol mean? Do they denote Army, Navy & airforce.. just a wild guess...This was asked by a friend of mine.Would appreicate your inputs on this!
View ArticleTricare Locum Tenens
Sorry - New to the board, posted in wrong section.I understand the Q6 coding guidelines for Medicare but cannot locate any guidelines for Tricare Locum Tenens.Please direct me to guidelines for...
View ArticleTriCare
If a doctor is out of net with Tricare, do they have to have a referral from a primary care physicians. I am getting conflicting info. Thanks for all helpgopher
View ArticleTriCare Credentialing
Hi All,Does anyone know of any regulation regarding the time limit for TriCare to complete credentialing? I thought it was 3 months, and they say they have 6 months. This has a bunch of pregnant women...
View ArticleTriCare Credentialling
Sharon,This is for an OB/GYN, and they are under the impression that they must be contracted to be reimbursed for deliveries. I will have them check with TriCare - I think the same thing you do, but I...
View ArticleTricare "Standard Transitional" and COB
Hi all, I'm hoping someone can help re a COB situation I have. Our patient's claim was paid by X insurance, which he has through his current employer, a major airline. We billed him the 20%...
View ArticleList of allowable amounts
I've been floundering on the various websites trying to find the allowable amounts for Tricare. I'm specifically looking for Physical Therapy.Thanks for any help.
View ArticleCan Tricare patients pay cash
If we do not want to bill Tricare, can our patients opt to not go through their insurance?In other words, can our patients choose to pay our full rates ... or do they have to see another provider that...
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Tricare south and ndc
Little confused in florida. Just recently Tricare started denying my vaccines for no national drug code, ya know the ones 90700, 90713 ect.. However it seems they are picking and choosing which ones....
View ArticleHumana Veterans Healthcare Services (HVHS)
HVHS is a brand new healthcare business that is sponsored by the US Dept. of Vetrans Affairs (DVA) that will serve military veterans. They have been awarded the contract by DVA to develop specialty...
View ArticlePPD Question
Would anyone know how to code a PPD skin test reading? Is it even something that should be coded?
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Allowed amounts
Hi!Do you know where can I find the allowed amount for drugs?(or a reference at least).Some topical prescriptions and syrups have been paid partially (about a 10% of the AWP only) After the appeal...
View Articlecredentialing question
I have a unique situation and was wondering if anyone could help me... I work in a Military Clinic and recently came across something I have never seen. I have a FNP that is working with an FNP...
View ArticleMedicare Carrier
As far as I know that every state has a medicare carrier. Anyone knows the medicare carrier in Arizona? Do we have specific site for the list of medicare carrier in different state??? Thank you very...
View ArticleC9358 and maximum units
I had a case where a surgeon used a large amount of Surgimend. I billed the code C9358 to Tricare with 600 units. Tricare made payment on the code, but only allowed 4 units. I have called PGBA, and...
View Articledenial - non-covered services
hello..i'm having trouble with my Physical Therapy billings... they've been coded as 032-non covered services, but Tricare used to pay these services..what do i need to do?thanks a lot...
View ArticleTricare code 173
hello, i've been getting a lot of denial for my professional fees.. code 173: documentation does not support the frequency of visits billed, even though the patient only comes in once a month for his...
View ArticleTriWest loses West Region Contract - Eff 4/1/13
TriWest Healthcare Alliance Not Selected for Third TRICARE Contract - 3/16/2012Per TriWest eNews - Despite this news, TriWest will serve West Region families through March 31, 2013, as April 1, 2013...
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