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Medical claims are processed by the national Tricare Dual Eligible Fiscal Intermediary Contractor. Pharmacy claims are processed by the Tricare Pharmacy Contractor (Express Scripts) and Overseas Tricare for Life claims are processed by the Tricare Overseas Program Contractor (as of September 2010 this will be International SOS using Wisconsin ...
Under TRICARE, seven managed care support contracts were awarded covering DoD's 12 health care regions. [7] TRICARE has been restructured several times, with contract regions having been redrawn , Base Realignment and Closure, and by adding "TRICARE For Life" benefits in 2001 for those who are Medicare-eligible. [8]
Since 1956, WPS has continually served the Military Health System as a claims administrator. WPS managed the first regional plan for Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). WPS MVH provides claims administration, customer service, and related activities for the TRICARE Overseas Program and TRICARE For Life Program.
Express Scripts was purchased by New York Life Insurance Company in 1989 and became a publicly traded company in 1992. [19] In 1993, Express Scripts signed on both FHP International and Maxicare Health Care and corporate clients Lockheed, Service Merchandise, and Ingersoll-Rand.
The Center for Medicare and Medicaid Services (CMS) launched its version of Blue Button in September, 2010 on the My Medicare patient portal, giving 40 million beneficiaries online access to their Medicare claims. [30] The Department of Defense also added a Blue Button function to its Tricare Online patient portal in 2010. [31]
Defense Enrollment Eligibility Reporting System (DEERS) is a computerized database for United States Service members, military retirees, 100% VA Disabled Veterans, dependents, DoD active Contractors, and others worldwide who are entitled to Public Key Infrastructure and TRICARE eligibility.
Servicemembers' Group Life Insurance (SGLI) is a life insurance program available to all active duty and reserve members of the uniformed services of the United States. Supervised by the United States Department of Veterans Affairs , the program is administered by the Prudential Insurance Company of America.
It also serves as proof of eligibility for medical care delivered either directly within the military health system or non-military providers via the TRICARE medical system. [1] The modern military identification card is a smart card commonly known as a Common Access Card (CAC) used by servicemembers and DoD civilians. It works with specialized ...