Starting January 1, 2018, Tricare North and Tricare South will merge to become Tricare East. With this merger, new enrollments must be completed in order to submit claims electronically and receive ERAs. This change affects all Tricare providers and members.
What does this mean for you?
For all patients who currently have either Tricare North or Tricare South insurance, you will need to submit claims for all dates of service on or after January 1, 2018, to a “new” insurance called TriCare East. The payer ID for this insurance will be “TREST.”
Please note that you will submit all claims for dates of service prior to January 1, 2018, to Tricare North or Tricare South (payer ID “CH002”).
What about EDI and ERA enrollments?
You must complete new EDI and ERA enrollments for Tricare East in order to submit claims electronically and receive ERAs for dates of service occurring after January 1.
Please use this form to complete EDI enrollment for Office Ally. Unfortunately, this form lists the incorrect link for the EDI Self Registration portion, so use the information on the form to complete the enrollment but access EDI Self Registration using this link: https://edi.wpsic.com/edir/
Complete this form for ERA enrollment so you can continue to efficiently post your insurance payments.
How should I manage this in WebPT/Therabill?
To ensure successful claim submission to Tricare East beginning January 1, we recommend you take the following actions:
1. Add a new insurance profile for Tricare East in WebPT.
2. For any patient who currently has Tricare North or South, add an additional insurance card for the new Tricare East insurance to the patient’s chart.
3. Once that new insurance card flows into Therabill, be sure it maps to the correct payer ID for Tricare East (payer ID “TREST”).
So, you should have the following two primary insurance cards on file in Therabill for all affected patients:
- The existing card you had on file for Tricare North/South for claims with dates of service prior to January 1.
- An additional primary insurance card for Tricare East for claims with dates of service on or after January 1.
Note: It is important you do not remap your current Tricare North and South payer ID to the Tricare East payer ID, as this may cause mapping or secondary claim issues.
What about the existing Tricare East and West payers I used to submit to?
The contractor for Tricare East is now Humana Military. For more information on this transition, please review this page.
The payer ID for Tricare West (99726) will not change. However, you will need to complete a new ERA enrollment to receive ERAs. This is due to the contractor changing from UHC Military to Health Net Federal Services.
Please use the information below when completing the last section, titled “Electronic Remittance Advice Clearinghouse Information.”
If you have any questions concerning this change, we highly recommend contacting Tricare for the most up-to-date information.
Any WebPT + Therabill questions? Please contact us at 866-221-1870, option 2, or firstname.lastname@example.org.
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