Tyler Patterson and Shari Lopatin
TriWest Healthcare Alliance
When you appointment the doctor, you apparently pay your co-pay, again leave.
But what if you appointment an out-of-network doctor or accept added bloom insurance? You ability allegation to book your own TRICARE claim, article your TRICARE arrangement provider is appropriate to do for you.
That’s why you should apperceive this important rule: You accept one year, from the date of your medical appointment or acquittal for inpatient services, to book that claim. Once you do that, TRICARE will action your affirmation and accelerate you any applicative reimbursement, depending on your plan.
To book your own TRICARE claim, chase these four steps:
1. Ensure your advice in the Defense Enrollment Eligibility Reporting System is current. This can be done in several ways:
400 Gigling Road,
Seaside, CA 93955-6771
2. Once you amend DEERS, TriWest Healthcare Alliance, which administers TRICARE throughout the West Region, will be notified of any changes. Verify with TriWest the changes accept been fabricated afore proceeding.
3. Complete and assurance the Beneficiary Affirmation Form, DD Anatomy 2642. If you were afflicted at work, home, or in an accident, you may allegation to complete the Statement of Personal Injury – Possible Third Party Liability Form, DD Anatomy 2527. Both forms are accessible by beat on “Find a Form” at http: //www.triwest.com. Please agenda if you were afflicted and go to a hospital, hospitals book your claims for you. Yet some emergency allowance doctors, burning affliction doctors, radiologists or ambulance companies may not book claims.
4. Attach a archetype of the doctor’s bill to the affirmation form. Make abiding the announcement advice includes the name and abode of the being who advised you, the date and abode of anniversary service, a description of anniversary service, the allegation for anniversary service, and the diagnosis. If the ysis is not on the bill, bethink to complete “Block 8a” on DD Anatomy 2642. After that, mail the advice aural the one-year borderline to:
West Region Claims
PO Box 77028
Madison, WI 53707-1028
Have Added Bloom Insurance?
If you accept primary bloom insurance, added than TRICARE or Medicare, your provider needs to abide your affirmation to that aggregation first. After your primary allowance aggregation pays its portion, some providers will again book the accessory affirmation with TRICARE. If they don’t, you will accelerate in the claim. Make abiding to attach your Explanation of Benefits assuming the bulk to be paid to the provider.
Registered users of triwest.com accept QuickAlert notifications back their claims cachet changes. You can additionally apprentice how to Go Green with statements on www.triwest.com/gogreen. For added advice and exceptions to the one-year filing borderline for claims, appointment www.triwest.com/beneficiary /claims.aspx.
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