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 such as:
New claim submission instructions
From January 1, 2025, to April 30, 2025, the current payer organization (WPS) will continue to process claims with a 2024 Date of Service (DOS). After April 30, 2025, claims with a 2024 DOS will no longer be accepted via 2024 processes.
For claims with 2024 DOS submitted before May 1st, 2025:
Submit claims online through the provider access claims center in provider self-service.
EDI claims payer ID is TREST.
TRICARE East Region
Attn: New Claims
PO Box 7981
Madison, WI 53707-7981
Fax: (608) 327-8522
For claims submissions with a 2025 DOS, or after April 30th 2025:
XpressClaims will be the online claims and claims related document submission system beginning January 1, 2025, and will be available in provider self-service.
EDI claims payer ID is 99727.
The payer ID will need to be placed in the following data elements within your X12 837 claim files: ISA-08, GS-03, NM1-09 (with 40 qualifier).
For the clearinghouse, new direct submitters must file a trading partner agreement and enrollment form to be assigned a mailbox/submitter ID. If your clearinghouse already files claims to PGBA for other lines of business, you need to ensure that the TRICARE EAST payer ID 99727 is made available as an option. If your clearinghouse does not submit to PGBA, providers, vendors or clearinghouses that can create an ANSI X12 electronic file, and have telecommunications capabilities, can upload files to PGBA directly. Batch claims processing is available through our EDI Gateway mailbox system. Providers must file a EDI Provider Trading Partner Agreement in order to submit claims electronically. Please contact the PGBA EDI Help Desk at (800) 259-0264, or email EDI.TRICARE@PGBA.com for assistance with EDI set-up.
Fax: (877) 489-0007
Humana Military Claims
Attn: New Claims
PO Box 202146
Florence, SC 29502-2146
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 instructions
From January 1, 2025, to April 30, 2025, the current payer organization (WPS) will continue to process claims with a 2024 DOS. After April 30, 2025, claims with a 2024 DOS will no longer be accepted via 2024 processes.
Corrected/Revised claim submission instructions:
For claims with 2024 Dates of Service (DOS), and submitted by April 30th, 2025:
EDI Payer ID: TREST (Preferred method)
TRICARE East Region Claims
Attn: Corrected Claims
PO Box 8904
Madison, WI 53708-8904
Fax: (608) 327-8523
For claims submissions with a 2025 DOS, or after April 30th 2025:
EDI Payer ID: 99727 (Preferred method)
Fax: (877)-489-0042
Humana Military Claims
Attn: Corrected Claims
PO BOX 202146
Florence, S.C. 29502-2146
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 submissions for a 2024 DOS, please complete the proactive recoupment form (a) before April 30, 2025:
Mail to:
TRICARE East Region
Attn: Refunds/Recoupments
PO Box 7937
Madison, WI 53707-7937
Claim recoupment/refund submissions for a 2025 DOS, OR After April 30, 2025, please complete the proactive recoupment form (b):
Humana Military Claims
General Correspondence
PO Box 202147
Florence, SC 29502-2147
To check the status of a claim, please log in or create an account:
Provider log in
Electronic submissions
To ensure your electronic submission is processed in a timely manner, please confirm you are submitting the information in the correct portal, inbox or web form. To avoid additional delays, please only include details on a single beneficiary and do not combine requests.
Fax or mail submissions
TRICARE may ask you to use the letter you received as the coversheet for the information you return. Using the letter as a coversheet allows Humana Military to quickly document and identify beneficiaries, speeding up the process.
To ensure your documentation is processed quickly, please send a single correspondence or fax with information regarding a single beneficiary. If multiple pieces of correspondence are mailed at the same time, they must be divided with coversheets.
Humana Military accepts HIPAA-compliant electronic faxes sent using HIPAA-compliant companies such as UpDox, Faxage or SRFax, etc., available through a web search.
