Provider
Provider Initiatives
Claims
Health & Wellness
Tools & Resources
Find a Provider
Home
»
Provider
»
Tools & Resources
»
Handbooks and Materials
» Handbook Table of Contents
Handbook Table of Contents
Introduction Letter
Welcome
Provider Information
Eligibility
Program Options
Medical Coverage
Behavioral Health
Management & Administration
Claims Processing
Reimbursement Methodologies
FAQs
Glossary
List of Tables
Adjust Text Size:
Welcome Letter
Welcome to TRICARE and the South Region
TRICARE and Humana Military
MyHMHS for Providers Secure Services Portal
Provider Resources
Getting Started on Humana Military's Web site
Humana Military Disease Management Program
Warrior Navigation and Assistance Program
Important Provider Information
TRICARE Policy Resources
Social Security Number Reduction Plan
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
HIPAA Privacy Rules and Practices
HIPAA Rules
Signature on File Requirements
TRICARE Provider Types
Provider Certification and Credentialing
Provider Responsibilities
Primary Care Manager's Role
Specialty Care Responsibilities
Balance Billing
Informing Beneficiaries about Non-Covered Services
Updating Provider Information
Beneficiary Expectations
TRICARE Eligibility
Verifying Eligibility
Important Notes about Eligibility
Eligibility Rules
TRICARE Program Options
TRICARE Prime
TRICARE Prime Remote and TRICARE Prime Remote for Active Duty Family Members
Primary Care Managers and Point-of-Service Options
TRICARE Standard and TRICARE Extra
TRICARE For Life
TRICARE Pharmacy Program
TRICARE Pharmacy Tools and Resources
Dental Programs Offered by TRICARE
TRICARE for the National Guard and Reserve
TRICARE Reserve Select
TRICARE Retired Reserve
Cancer Clinical Trials
TRICARE Extended Care Health Option
TRICARE Extended Care Health Option Benefits and Costs
DoD Enhanced Access to Autism Services Demonstration
Supplemental Health Care Program
Transitional Health Care Benefits
Medical Coverage
Adjunctive Dental Care
Ambulance Services
Durable Medical Equipment
Emergency Services
Supplementary Services
Urgent Care
Inpatient Services
Clinical Preventive Services
Comprehensive Health Promotion and Disease Prevention Examinations
Cancer Screenings
Eye and Hearing Examinations
Immunizations
Ancillary Care
Hospice Care
Maternity Care
Limitations
Exclusions
Behavioral Health Care Services
Behavioral Health Providers
Referral and Authorization Requirements
Obtaining Referrals and Prior Authorizations
Accessing Behavioral Health Care
TRICARE Behavioral Health Programs Offered
Outpatient Services
Inpatient Services
Residential Treatment Centers
Substance Use Disorder Services
Court-Ordered Care
Behavioral Health Care Management
Appeals and Reconsiderations
Behavioral Health Care Medical Record Documentation
Billing and Claims
Non-Covered Behavioral Health Care Services
Behavioral Health Appointment Assistance is no longer available. For provider locator services you can use the Humana Military
provider locator
or contact TRICARE South Behavioral Health at 1-800-700-8646.
Health Care Management and Administration
Referrals
Prior Authorizations
Providing Care to Beneficiaries from Other Regions
Medical Records Documentation
Utilization Management
Quality Management
Fraud and Abuse
Grievances
Appeals
Claims Processing and Billing Information
HIPAA National Provider Identifier Compliance & Transaction Standards & Code Sets
Standards and Guidelines
Electronic Claims Submission
Filing Paper Claims
Other Helpful Hints
ClaimCheck
Billing with V Codes
Allergy Claims
Global Maternity Claims
Physician-Administered Drug and Vaccine Claim Filing
Processing Claims for Out-of-Region Care
Claims for Beneficiaries Using Medicare and TRICARE
NATO & CHAMPVA
Special Program Claims
Third Party Liability
Other Health Insurance
Avoiding Collection Activities
Reconsiderations
TRICARE Reimbursement Methodologies
CHAMPUS and TRICARE Allowed Charges
Anesthesia Claims and Reimbursement
Ambulatory Surgery Grouper Rates
Diagnosis-Related Group Reimbursement
Bonus Payments in Health Professional Shortage Areas
Pricing
Surgical Services
Hospice Pricing
Outpatient Prospective Payment System
Pricing Updates
Back to Top
Last Update: March 29, 2011