A TRICARE explanation of benefits (EOB) is not a bill. It is an itemized statement that shows what action TRICARE has taken on your claims. An EOB is for your information and files.
After reviewing the EOB, you have the right to appeal certain decisions regarding your claims. You file an appeal in writing within 90 days of the date of the EOB notice. (For more information about appeals, see the Information and Assistance section.) You should keep EOBs with your health insurance records for reference.
For a sample of the EOB in your region, along with instructions for reading the EOB, see the Figure 12.2 in the Appendix section.
Debt Collection Assistance Officers (DCAOs) are located at military treatment facilities (MTFs) and TRICARE Regional Offices (TROs). A DCAO is also located at the Military Medical Support Office (MMSO) for active duty service members and National Guard and Reserve members with service-documented line-of-duty injuries. DCAOs assist you with resolving health care collection-related issues. Contact a DCAO if you have received a negative credit rating or have been sent to a collection agency due to an issue related to TRICARE services.
When you visit a DCAO for assistance, you must bring or submit documentation associated with a collection action or adverse credit rating, including debt collection letters, EOB statements, and medical and/or dental bills from providers. The more information you can provide, the faster the cause of the problem will be determined. The DCAO will research your claim, provide you with a written resolution of your collection problem, and inform the collection agency that action is being taken to resolve the issue. DCAOs cannot provide legal advice or repair your credit rating, but they can help you through the debt collection process by providing documentation for the collection or credit-reporting agency to explain the circumstances relating to the debt. Visit the DCAO directory online to find a DCAO near you.
