Behavioral health care providers in the South Region can ensure prompt payment of claims by knowing these important documentation procedures.

File Claims Electronically
You can file all claims electronically, even those that require hard copy support documentation. In these cases, you would file claims electronically and then follow the instructions on the FAXGATE procedures form to fax the supporting documentation. The form includes a toll-free fax number that is available 24 hours a day, seven days a week. It also instructs you to use the EMC Attachment Form as the fax cover sheet to ensure that your documentation will be matched to your electronic claim correctly.

Download the FAXGATE procedures from the Humana Military Web site. Scroll down to the question, “Q: How do I file hard copy documents that support my electronic claims?” If you click on the FAXGATE procedures link in the answer, you’ll open a page that explains the process. (Note: To view and print the file, you’ll need the Adobe® Acrobat® Reader, which you can download for free. Follow the link to the TRICARE Forms—Provider Web page to the link to Adobe’s Website.)

The EMC Attachment Form can also be downloaded from the Humana Military Website. (Note: Adobe Acrobat Reader is required to view the file.)

Transmit Consult Reports within 10 days
TRICARE requires that behavioral health care providers send consult reports back to the primary care manager (PCM) who referred the beneficiary for care. Your reports must be submitted within 10 days from the date of service.

Update Your Contact Information
One final way to ensure that all paperwork is handled properly is to ensure that your provider relations representative has all current information for you on file, including your mailing address, e-mail address, phone number and fax number. Call your provider relations representative at 1-800-700-8646 to make address and phone number corrections.

For providers seeking more information on TRICARE processes and procedures or making referrals and authorizations, one of the fastest ways to accomplish these and other tasks is to use the Humana Military Website.
In the portion of the Web site dedicated to Providers, you can access a host of links to other Humana Military and TRICARE resources, including PCM Central, other Online Provider Services, how to “Find a Provider,” Behavioral Health, TRICARE Resources, and Becoming a TRICARE Provider.

Among other information you will find online is the TRICARE Provider Handbook, a guide to TRICARE programs, policies and procedures. For ease of use, the option exists to print the entire handbook.

The site offers access to the referrals and authorizations and electronic claim filing sections. Not only can you use the Web to make referrals and authorizations, but also to check back later to see your referrals or authorizations.

The site also includes a list of upcoming seminars and information on how to reserve a seat for a seminar.

In addition, it’s possible to use the site to review the information TRICARE has on file for you. It’s important to review this information in case your postal or e-mail address or telephone numbers are wrong. Such incorrect information can slow reimbursement processing and other transactions. While online, you can also correct any inaccuracies in your record.

Best of all, a collection of useful forms from TRICARE and Humana Military, such as the Non-Covered Services Waiver Form, the Other Health Insurance Questionnaire and the EMC Attachment Form, are accessible on the site as well.

While you can always call your provider relations representative at Humana Military at 1-800-444-5445 with questions, now thanks to the Website’s Natural Language Question Answering Search tool, the site even answers your questions that are posed in plain English. Visit Humana Military today!

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