TRICARE East Region Updates

 

Update on TRICARE Claims Payments

April 17, 2025

We want to inform you of a recently identified issue involving the incorrect processing of certain claims.

Due to a system error, some network provider claims were incorrectly processed as if they were from non-network providers, causing incorrect payments.

We are in the process of adjusting the affected claims for proper payment. We appreciate your patience and understanding as we work through this as quickly as possible. Once claims have been corrected, updated Explanation of Benefits will be sent.

 

---

 

Ensure Your Provider Accepts TRICARE

November 26, 2024

It is important for beneficiaries to use a TRICARE provider who accepts assignment on claims and will accept TRICARE reimbursement in full. Use the find care tool to locate a TRICARE provider.

Help ensure your provider accepts TRICARE with the below tips:

TRICARE certified providers who accept the TRICARE-allowed amount accept this as payment in full and will only collect copayments, cost-shares and/or deductibles. TRICARE certified providers who choose not to accept assignment on their claim are allowed to bill the beneficiary up to 115% above the TRICARE allowable chargeThe maximum amount TRICARE pays for each procedure or service.  This is tied by law to Medicare's allowable charges..

Utilize the Network Provider locator to find a provider who accepts TRICARE payment in full; Network providers are required to accept assignment on their claims and accept TRICARE allowable as payment in full.

Inquire if your provider if accepts assignment or accepts TRICARE payment in full at the time of the visit.