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The Tricare logo. Tricare (styled TRICARE) is a health care program of the United States Department of Defense Military Health System. [1] Tricare provides civilian health benefits for U.S Armed Forces military personnel, military retirees, and their dependents, including some members of the Reserve Component.
The EDI Health Care Claim Transaction Set (837) is used to submit health care claim billing information, encounter information, or both, except for retail pharmacy claims (see EDI Retail Pharmacy Claim Transaction). It can be sent from providers of health care services to payers, either directly or via intermediary billers and claims ...
In the late 1980s, because of escalating costs, claims paperwork demands and general beneficiary dissatisfaction, DOD launched a series of demonstration projects. Under a program known as the CHAMPUS Reform Initiative (CRI), a contractor provided both health care and administrative-related services, including claims processing.
In 1996, TriWest Healthcare Alliance was established in order to compete for a U.S. Government contract to manage civilian health care benefits under the newly established TRICARE program within the 16-state TRICARE Central Region, also known as Regions 7 and 8. In 1996, TriWest was awarded the contract for the TRICARE Central Region and began ...
Qualified claims must be described in the HRA plan document at inception: before reimbursing employees for the medical expenses. Arrangements (medical services, dental services, co-pays, coinsurance, deductibles, participation) may vary from plan to plan, and an employer may have multiple plans in place, allowing much flexibility.
The settlement website says people who change their mailing address after submitting a claim are responsible for alerting the claims administrator about their new contact information. To do that ...
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.
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