Claims for Dual-Eligible Beneficiaries (Medicare and TRICARE)
Wisconsin Physicians Service (WPS) is the claims processor for all claims for beneficiaries who are eligible for both TRICARE and Medicare. Claims are submitted on your behalf by your provider and you will receive an explanation of benefits (EOB) from WPS after the claims processing has been completed. The following chart contains important contact information for you regarding dual-eligible claims.
Claims Submission
WPS TRICARE For Life
P.O. Box 7890
Madison, WI 53707-7890
Customer Service
WPS TRICARE For Life
P.O. Box 7889
Madison, WI 53707-7889
Appeals
WPS TRICARE For Life
Attn: Appeals
P.O. Box 7490
Madison, WI 53707-7490
Refunds
WPS TRICARE For Life
Attn: Refunds
P.O. Box 7928
Madison, WI 53707-7928
Program Integrity
WPS TRICARE For Life
Attn: Program Integrity
P.O. Box 7516
Madison, WI 53707-7516
Toll-free 1-866-773-0404
Toll-free TDD 1-866-773-0405
Third Party Liability
WPS TRICARE For Life
Attn: Third Party Liability
P.O. Box 7897
Madison, WI 53707-7897
Submitting Claims While Transitioning to the TRICARE South Region
As the current TRICARE regions transition to the new TRICARE South Region, it is important that you and/or your provider pay careful attention to the dates of service, the current region in which you are receiving care, and the transition dates in order to file with the correct claims processor. The regions and transition dates are described below.
Since the claims processor remains the same in the following states, beneficiaries should continue submitting claims as they do today— Alabama, Florida, Georgia, Louisiana (east of the Mississippi), Mississippi, South Carolina, and Tennessee.
TRICARE South Region
Claims Department
P.O. Box 7031
Camden, SC 29020-7031
Those in the states of Arkansas, Louisiana (west of the Mississippi), Oklahoma, and Texas excluding the extreme western El Paso area) will change claims processors. All TRICARE claims with dates of service prior to October 31, 2004, should be sent to Health Net Federal Services, Inc. Claims must be submitted within 90 days of the date that care was provided or the date the primary payer has made payment or denied the claim. This will ensure that Health Net processes all claims efficiently and accurately. All claims with dates of service on or after November 1, 2004, should be sent to the following address:
TRICARE South Region
Claims Department
P.O. Box 7031
Camden, SC 29020-7031
If you need assistance with filing a claim or have questions, please call PGBA at 1-800-403-3950.
