Electronic Claims for Tricare as of January 1st, 2018

Tricare has awarded the new Tricare East region contract to Humana Government Business Inc. to take effect for claims with dates of service 1/1/2018 forward.

FAQ:

Q: Will Providers be required to Enroll to bill for Tricare East?

A: Yes – Providers interested in serving TRICARE East members must submit an inquiry form to Humana GBA at http://bit.ly/2jlj0H4.

If you already have a current TRICARE contract on file with Humana Government Business/Humana Military, You do not then need to submit an additional inquiry. Your current provider’s network agreement on file with Humana GBA will be transitioned to the new TRICARE East Region.

Q: Will Providers wishing to bill Tricare East electronically for Claims and ERA services be required to enroll?

A: Yes.  Humana GBA has contracted with WPS to perform EDI delivery.  EDI Enrollment must be completed by all providers wishing to bill Tricare East through WPS EDI gateway.

Providers utilizing Change Healthcare should take the following action:

(2) Complete the EDI – Electronic Claims Submission (837) Provider EDI Enrollment for Claims Complete the ERA – Electronic Remittance Advice (835) Provider ERA Enrollment for ERA.

When completing the EDI registration you will need the following information:

Line of business: Tricare East

Submitter name: Change Healthcare

Change Healthcare Submitter ID: S000005 (ANNNNNN)

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