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Electronic Media Claims Benefits
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TRICARE electronic claims submissions must be must be HIPAA compliant. Humana Military Healthcare Services suggests several options. Network providers are expected to submit 100% of their TRICARE claims electronically. Providers submitting claims to PGBA for TRICARE should consider electronic claims over paper submitted claims regardless of network status. Here are some of the benefits of submitting electronically.
- Saves time
Electronic media claims can be downloaded from your patient accounting system for a daily/weekly/monthly feed. Front end editing of electronic claims ensures the claim is complete and acceptable for processing allowing you the opportunity to correct or provide missing information without having to "do over" a paper claim that has been returned. A "batch claims process" is available to our network providers free of charge through our eZTRICARE claims at www. humana-military.com. XPress Claims offered by PGBA at www.mytricare.com and available to request on our site is a single entry option (per claim). Each entry pulls back the patient eligibility, patient copay/cost share responsibility, and provides you a view of the completed claim.
- Saves money
On average, TRICARE electronic claims using direct entry methods process within a week of being received at PGBA. This eliminates paper, mail, tracking of paper....reducing postage and paper handling.
- Increases office productivity and audit trails
By eliminating paper claim development, your offices decreases data entry errors, duplication of claims submissions, and potential "lost in the mail" issues. If your office chooses to elect (ERA) electronic remittance advice, and the (EFT) electronic funds transfers you also ensure the electronic record of payments for monthly or end of year audit trail, and the "check" is deposited to your bank of choice immediately at the same time.
Remember:
eZTRICARE Claims ( batch process) available at our secured provider portal for network providers free of charge.
XPress claims ( single entry) available at PGBA's secured provider portal for network and non-network providers free of charge.
You can also fill out the application for ERA and EFT providing you electronic remittances and automatic check deposit for all your TRICARE claims transactions.
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