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Make the Most of the Humana Military IVR (Article 10) |
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Humana Military’s Interactive Voice Response (IVR) system has just one purpose—to enable you and your staff to make the best use of your time. We want you to be able to focus more on what you do best: taking care of deserving TRICARE patients.
That’s why we’d like to help you make the most of each call you make, whether it’s to check on the status of a referral, to set up a referral, to activate an authorization or even just to make sure that your patient is eligible for TRICARE coverage.
When you call the TRICARE Service Line (1-800-444-5445) and connect to the IVR system, make sure that you always have the following information available:
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Your TIN or SSN
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The sponsor’s ID—not just the patient’s ID
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The patient’s date of birth
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The correct ICD9 diagnosis code
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Making certain that you have these simple facts at your fingertips will make your call go faster and usually will eliminate the need for you to make a second call. And having these items in-hand will help us provide you with the best customer service possible. It’s your time that you’ll be saving.
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TRICARE Reference Room (Article 11)
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Excluded Services |
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In general, TRICARE excludes services and supplies that are not medically or psychologically necessary for the diagnosis or treatment of a covered illness (including behavioral disorder), injury, pregnancy or well child care. All services and supplies (including inpatient institutional costs) related to a non-covered condition or treatment, or provided by an unauthorized provider, are excluded.
The following specific services are excluded from TRICARE under any circumstance. This list is not intended to be all-inclusive.
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Acupuncture
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Artificial insemination
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Autopsy services or postmortem examinations
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Birth control (nonprescription)
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Camps (such as for weight loss)
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Care or supplies furnished or supplied by an immediate family member
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Care that is not medically or psychologically necessary
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Diagnostic admissions
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Experimental or unproven procedures
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Megavitamins and orthomolecular psychiatric therapy
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Mind expansion and elective psychotherapy
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Naturopaths
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Psychological testing for learning disabilities
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Sex changes or sexual inadequacy treatment
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Telephone counseling consultation
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One of the quickest ways to determine if a service is a covered benefit is to check “Code Inquiry” online. You can look up a service by entering the code or by using key words. If the service is covered, you can request a referral or authorization directly from the Web site.
For more on excluded services, see the “Medical Coverage” section in your TRICARE Provider Handbook. Contact Humana Military at 1-800-444-5445 if you need a copy. You can also search the handbook online.
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TRICARE’s “Hold Harmless” Policy |
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TRICARE beneficiaries may choose to obtain services that are not covered by TRICARE, but they are “held harmless” from paying you for those services unless you inform them in advance and in writing that the specific service or procedure is not covered. Beneficiaries must sign a Waiver of Non-Covered Services Form, which explains that they agree to pay for non-covered services. |
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Last Reviewed: February 2, 2007
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