PGBA, LLC (PGBA) is Humana Military’s partner for claims processing in the TRICARE South Region. PGBA will provide administrative services, such as claims processing and claims customer service, for the entire TRICARE South Region. Visit the PGBA Web site for more information about PGBA and claims processing requirements. Beneficiaries may check their claims via the Humana Military Web site by obtaining access to HMHS Online Beneficiary Services.
You can check on the status of your claims by signing into “Online Beneficiary Services” under the “Beneficiary Resources”, by calling the PGBA voice response system at 1-800-403-3950 or visiting the PGBA Web site. The line is available 24 hours a day, seven days a week; however, calling before 10 a.m. or after 5 p.m. or on any day other than Monday will help you get answers faster. To check on the status of a claim in writing, or resubmit a claim, direct your correspondence to:
TRICARE South Region
Customer Service Dept.
P.O. Box 7032
Camden, SC 29020-7032
If you receive services from an MTF or network provider, you will not be required to submit your own claims. TRICARE Standard beneficiaries who receive services from a TRICARE authorized, non-network provider may be required to submit their own claims. There may be other situations where a beneficiary may need to submit his or her own paper claim.
In order for a beneficiary to file a claim, a DD Form 2642 (“CHAMPUS Claim—Patient’s Request for Medical Payment”) must be submitted. Instructions on completing the DD Form 2642 are on the first page of the claim form. Be sure to attach a copy of the provider’s itemized bill to the claim form. The itemized bill must contain the following information:
1.Doctor’s or provider’s name/address (the one that actually provided your care). If there is more than one provider on the bill, circle his or her name.
2.Date of each service
3.Place of each service
4.Description of each surgical or medical service or supply furnished
5.Charge for each service
6.The diagnosis should be included on the bill. If not, make sure that you’ve completed block 8a on the DD Form 2642.
Mail your claim to the following address:
TRICARE South Region
Claims Department
P.O. Box 7031
Camden, SC 29020-7031
