Quick, easy and reliable—three things every Humana Military network provider wants when they’re filing TRICARE claims, and when they’re waiting for the claims to be paid.

TRICARE requires all network providers to file claims electronically. There are several benefits to the process including:
         

• Improved cash flow to the provider—On average, TRICARE electronic claims process about two to three weeks faster than paper claims. With the elimination of mail time, you’ll receive your TRICARE payments much faster if you file your claims electronically.
• Reduced postage and paper handling costs
• Reduction of data entry errors
• Better audit trail—Electronic media claims (EMC) response reports are available to show you which claims were accepted for processing. Also, front-end EMC edits give you much faster feedback regarding problems with your claims, allowing you to correct and resubmit them quickly.
• Real-time claims processing if you are using XPress Claim
• Electronic remittance advice (ERA) and electronic funds transfer (EFT)—Network providers who file all of their TRICARE claims electronically are eligible to receive ERAs and EFTs. There are four options for filing your TRICARE claims electronically:
   
  •  XPress Claim —You can file your TRICARE claims while your patients are still in your office, getting the payment results instantly. XPress Claim is secure, easy to use, fast and free. View a demonstration of how to sign up for Xpress Claim.
       
  •  eZ TRICARE Claims —Want to avoid re-keying your claims? With eZ TRICARE Claims you can upload batches of claims directly from your practice management system. There is no software to install and no additional data entry for your TRICARE claims. A variety of claim formats are accepted with eZ TRICARE Claims, including National Standard Format and ASC X12 837. To accept sign up for eZ TRICARE Claims, visit Online Provider Services.
     
  • Clearinghouses—TRICARE claims are received from a number of EMC clearinghouses. Contact your current vendor to find out what you need to do to send claims to TRICARE.
     
  • Electronic Data Interchange (EDI) Gateway —If your system can create Health Insurance Portability and Accountability Act (HIPAA)-compliant claims formats and you prefer to send your claims directly to the payer, the PGBA, LLC EDI Gateway may be right for you. PGBA’s EDI Gateway handles all of their inbound and outbound HIPAA-compliant EDI transactions. To enroll or learn more about the EDI Gateway, contact the EMC Help Desk at 1-800-325-5920.
              

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Created: March 8, 2007