Filing Tips

Claims may be delayed or denied because the claim form wasn't filled out correctly or all the information wasn't provided.  Here are some tips to help you file your claims correctly:

Keep DEERS Updated  Incorrect information in DEERS could cause your TRICARE claim to be denied. Update DEERS now! 
Use the Right Form File medical claims on a Patient's Request for Medical Payment (DD Form 2642).
Fill in all 12 Blocks Include the sponsor's Social Security Number or Department of Defense Benefits Number, your home address and phone number, as well as any other pertinent information needed.
Use the Right Diagnosis Code Your provider should give you a diagnosis code for all services he or she provided. Include that code with the description in Box 8a.
Sign the Claim Form  Claims submitted without a signature will be denied payment.
Notify TRICARE if there's a Third Party Involved If you were hurt in an accident and someone else may bear responsibility, you have to let TRICARE know by submitting a Statement of Personal Injury-Possible Third Party Liability (DD Form 2527) along with your medical claim form.
File Claims with OHI First TRICARE pays second to most other health insuranceHealth insurance you have in addition to TRICARE, such as Medicare or an employer-sponsored health insurance. TRICARE supplements don’t qualify as "other health insurance." (OHI) programs. When you receive payment from your OHI, you can then file a claim with TRICARE. Include a copy of your explanation of benefits from your OHI with your TRICARE claim.
Make Copies  Keep copies of everything you submit to the claims processor.
Use the Right Claims Address Send your claim forms to the correct address to avoid delays. View claims addresses.
File Claims on Time Claims must be filed within one year of the date of service or within one year of the date of an inpatient discharge or three years if overseas, but you are encouraged to send your claim form to TRICARE as soon as possible after you receive care.
Submit Each Claim Separately Filing multiple claims together could cause confusion.

 

Last Updated 4/7/2016