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Electronic Claims Filing Options
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As providers move toward total electronic transactions in the healthcare arena, Humana Military offers two EMC options to network providers (free of charge). If you do not have a clearinghouse that files electronically for TRICARE or electronic data interchange with PGBA, and you file a number of TRICARE claims. You might consider our "batch" process for providers through eZTRICARE. Network and non-network providers have the option to file directly to PGBA at XPress claims by doing a single claim entry (meaning you must enter one claim at a time), however, much of the information is prefilled for you and provides immediate feedback on how the claim will process, including patient responsibility.
Why not begin realizing the many benefits of electronic claims submission by taking advantage of one of these easy-to-use internet solutions? The registration process is quick and easy. Choose the option that's best designed to meet your needs, then click on the button to begin.
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An internet-based claims management system that offers an easy-to-use, secure method for electronically submitting insurance claims rapidly, accurately, and cost-effectively. |
XPressClaim is an online self-service option designed specifically with the provider in mind.
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Choose this option if:
- you have a large volume of TRICARE claims, and
- you have a practice management system that stores your TRICARE claims data.
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Choose this option if:
- you want the claim results immediately, or
- you have a small volume of TRICARE claims, or
- you do not have a practice management system.
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Clearinghouses
We receive TRICARE claims from a large number of EMC clearinghouses. You should contact your clearinghouse in order to find out what you need to do to send your TRICARE claims to us. Depending on the clearinghouse, we may be listed in their payer listing as Humana Military Healthcare Services or as PGBA, our claims processing partner.
Electronic Data Interchange (EDI) Gateway
If your system can create HIPAA-compliant claims formats and you prefer to send your claims directly to the payer, than PGBA's EDI Gateway may be right for you. PGBA built the EDI Gateway to handle all of their inbound and outbound HIPAA-compliant EDI transactions. The communications protocols supported are Asynchronous Dial-up, File Transfer Protocol (FTP), and CONNECT: Direct/NDM. To enroll or learn more about the EDI Gateway, contact the EMC Help Desk at 1-800-325-5920.
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