Quick links:

Claims - New

New claim definition:

A claim is considered “new” if it has not been submitted to TRICARE previously. New claims may have additional information attached or included within the claim data:

  • Third Party Liability (TPL) included
  • Other Health Insurance (OHI) payment included
  • With medical records attached

New claim submission:

EDI Payer ID: TREST (Preferred method)

Red optical character recognition (preferred) and black paper claim forms:
TRICARE East Region Claims
Attn: New Claims
PO Box 7981
Madison, WI 53707-7981

Fax: (608) 327-8522

Claims - Corrected/Revised

Corrected/Revised claim definition:

A corrected claim is used to update a previously processed claim with new or additional information. A corrected claim is beneficiary and claim specific and should only be submitted if the original claim information was incomplete or inaccurate. A corrected claim does not constitute an appeal.

Corrected/Revised claim submission:

EDI Payer ID: TREST (Preferred method)

TRICARE East Region Claims
Attn: Corrected Claims
PO Box 8904
Madison, WI 53708-8904

Fax: (608) 327-8523

Claims - Recoupment/Refund

Claim recoupment/refund definition:

Payer Recoupment Request: A claim recoupment is a request by the provider or the health insurance payer, to recover funds involved in an overpayment. A payer may identify an overpayment due to unknown other health insurance. If the provider sends claims electronically and receives payment electronically, the provider can initiate an electronic recoupment that will offset a future payment by the payer and eliminate the need for the provider to send a refund check which requires manual intervention. If the provider is not transacting electronically, the provider will need to send a refund check.

Provider Recoupment Request: A claim payment recoupment may also be requested by a provider if the provider identifies an error in payment. With notification, the payer will recover the overpayment on a future payment to the provider.

Claim recoupment/refund submission:

TRICARE East Region
Attn: Refunds/Recoupments
PO Box 7937
Madison, WI 53707-7937