"TWICE THE CITIZEN"
USAR ORGANIZATIONS
TRICARE speeds up payment of claims
WASHINGTON (September 10, 1999) -- New TRICARE initiatives will speed up payment of claims in order to protect soldiers from bad credit ratings due to unpaid medical bills.
The ultimate responsibility, however, still lies with soldiers to ensure that when they get a bill for health care from a civilian practitioner, they submit the bill for payment. Soldiers must not assume that bills will automatically be taken care of until they submit the claim for processing. Under the new system, getting the claim into the TRICARE system will ensure that soldiers will not be subjected to bill collectors or have their credit rating affected by disputed bills.
"The system works if bills and claims are submitted in a timely fashion," said Lt. Col. Rick Fisher in the TRICARE division at the Army Medical Command Headquarters.
Soldiers must make a copy of the bill for their records, then submit the original and a Claims Form DD-2642 (the claims form can be downloaded from the Internet at http://www.tricare.osd.mil) or obtain the DD-2642 from the TRICARE Service Center and send these to the claims processor in their regions.
Until Oct. 1, claims outside of Regions 1, 2, 5 and 11 should be sent to the Active Duty Claims Processor at the closest military medical treatment facility. After Oct. 1, responsibility for active duty claims payment will transfer from MTFs to civilian claims processors, who will be required to process to completion 95% of all claims within 30 days and 100% of all claims within 60 days. After October, claims will be sent to the following:
| Region 1 | TRICARE Region 1 Active Duty Claims PO Box 7015 Camden, SC 29020-7015 |
Region 2/5 | TRICARE Region 2/5 Active Duty Claims PO Box 7025 Camden, SC 29020-7025 |
| Region 3/4 | TRICARE Region 3/4 (Claims) PO Box 7031 Camden, SC 29020-7031 |
Region 6 | WPS/TRICARE PO Box 8999 Madison, WI 53708-8999 |
| Central Region | PGBA ATTN: TPR/SHCP PO Box 870019 Surfside Beach, SC 29587-8719 | Region 9/10 | PGBA/TRICARE PO Box 870001 Surfside Beach, SC 29587-8706 |
| Region 11 | WPS/TRICARE PO Box 8999 Madison, WI 53708-8999 | TRICARE Pacific | PGBA/TRICARE PO Box 870001 Surfside Beach, SC 29587-8701 |
"Under the new system, after 60 days the contractors will be charged a percentage of the claims they haven't processed. So we're holding their feet to the fire," Fisher said.
If the civilian claims processor denies a claim, it will be sent for review to the centralized Tri-Service Military Medical Support Office. If the claim is authorized by MMSO, then it will be paid within 60 days. If the claim is not authorized, such as for elective cosmetic care, then the claim will be denied and the soldier will be responsible for the payment.
Soldiers don't know they have a Health Maintenance Organization. If they get a bill, they have to get it to their insurance processor. It's an education process," Fisher said. "There's no reason whatever that active duty soldiers should have claims problems. There are many avenues to obtain help."
Any active duty soldier with a question or problem about his/her medical claims from civilian physicians can call toll free 1-888-MHS-MMSO, DSN 792-3950/3900; or commercial (847) 688-3900 anytime 24 hours a day, 7 days a week to get help. Information is also available at http://navymedicine.med.navy.mil/mmso/ on the World Wide Web.
Claims for family members have been and will continue to be handled by regional TRICARE contractors. The numbers for family members to call are:
Region 1: 1-888-999-5195
Region 2: 1-800-931-9501
Region 3 & 4: 1-800-444-5445
Region 5: 1-800-941-4501
Region 6: 1-800-406-2832
TRICARE Central: 1-888-874-9378
Regions 9 & 10: 1-800-242-6788
Region 11: 1-800-404-0110
TRICARE Pacific: 1-800-242-6788
Email Webmaster: webmaster@ocar.army.pentagon.mil
Revised: September 10, 1999