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Understanding Your Role in Provider Data Accuracy


Despite streamlined electronic communication lines, ensuring the accuracy of provider data continues to require a focused manual effort. It is difficult to keep provider directories accurate due to the significant number of changes that can occur frequently for providers.
 
TRICARE, Humana Military Healthcare Services, Inc. (Humana Military), you—the provider—and, ultimately, the beneficiary are exposed to potential errors and poor customer service when your data is not current or accurate.
 
Examples of the types of errors that often occur include the following:
  • Provider’s address displays incorrectly on the Web locator.
  • Beneficiaries are sent to the wrong address.
  • Beneficiaries are unable to select a primary care manager or make a specialty selection when looking for a provider who is close to their home address.
  • Appropriate referral selection is prevented.
  • Claims or payments may be processed incorrectly and may not go to the correct site.
At Humana Military, we are proactively calling you to verify office information and determine any changes.
 
Changes to your file may include the following:
  • Addition of a new provider
  • Changed group or group name
  • Closed old office
  • More than one specialty
  • Name or address
  • New office
Please be patient with us when we call. We feel that this is a necessary step to market you with confidence as one of our preferred network providers and to ensure that our TRICARE beneficiaries get the information they need. In most cases, it only takes a few minutes to answer our questions and to confirm that we have correct information or if a change needs to be made.
 
If you are a TRICARE network provider and have not been contacted by Humana Military recently, please contact your local provider relations representative or call 1-800-444-5445. You can provide most information to the customer service representative or can ask to be transferred to your provider representative if you have a number of changes or other questions.
 
Last Reviewed: July 29, 2009