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The Basics about TRICARE Reserve Select (Article 4) |
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TRICARE Reserve Select (TRS) is a premium-based health plan offered by the DoD that provides comprehensive health care coverage to members of the National Guard and Reserve who meet specific eligibility requirements.
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Verifying Coverage |
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As a health care provider, it is helpful to know that members and their covered family members are issued aTRS card. Please make a copy of the front and back of the card for your files. To verify eligibility and coverage status, providers should call Humana Military at 1-800-444-5445.
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Accessing Care |
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TRS members receive the same comprehensive coverage as active duty family members under TRICARE Standard and TRICARE Extra. Members may seek care from any TRICARE-authorized provider, hospital or pharmacy network or non-network and are responsible for annual deductibles and applicable cost-shares. They may also seek care from a local military treatment facility on a space-available basis only.
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For more information about covered services, refer to the TRICARE Reserve Select Handbook online. Remember that you must collect the appropriate cost-share for office visits. A listing of TRS costs is available in the TRICARE: Summary of Beneficiary Costs Flyer.
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Certain Services Require Prior Authorization |
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TRS members may access care from any TRICARE-authorized provider, network or non-network, without a referral.
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Like other TRICARE coverage, prior authorization from Humana Military is required for certain services, such as: |
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- inpatient admissions for substance use disorders
- behavioral health
- adjunctive dental care
- home health services
- hospice care
- transplants and psychoanalysis
- psychotherapy after the initial eight behavioral health outpatient visits
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For a complete list of services requiring prior authorization and how to submit and receive authorization before rendering care.
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Submitting TRICARE Reserve Select Claims |
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As with all other TRICARE health plans, TRICARE network providers are required to file their claims electronically. Should a provider have to file a paper claim, it should be submitted to PGBA in the same manner as TRICARE Standard/Extra beneficiary claims. The claims address for submitting TRICARE Reserve Select paper claims is:
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PGBA South Region
Claims Department
P.O. Box 7031
Camden, SC 29020-7031
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TRICARE network providers should submit claims to Humana Military/PGBA the same way they do other TRICARE claims.
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Customer Service |
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Humana Military administers TRICARE Reserve Select in the TRICARE South Region. If you have questions or need additional
information about TRICARE Reserve Select, you may contact Humana Military at 1-800-444-5445.
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For more information on coverage offered by TRICARE Reserve Select, please visit TRICARE.
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OPPS Implementation Date Change (Article 5) |
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TRICARE Management Activity (TMA) has postponed the June 1 implementation of the TRICARE Outpatient Prospective
Payment System (OPPS). TMA anticipates OPPS implementation during the fall of 2007; however, no date has been
confirmed at this time. |
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Created: May 23, 2007
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