TRICARE provider talking to beneficiary

Welcome healthcare providers

Please be advised:

Effective June 1, 2018, any TRICARE East claims submitted to PGBA will be rejected and not forwarded to WPS. Therefore, all TRICARE East claims, regardless of the dates of service, should be submitted to WPS.

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August 1, 2018: For faster claims processing, providers can now attach supporting documents when submitting electronic claims through self-service. We encourage providers to use the electronic claims process rather than using fax or secure messaging to submit additional documentation.

June 18, 2018: Humana Military would like to clarify some network contract terms associated with TRICARE claim reimbursement, use of the CHAMPUS Maximum Allowed Charge (CMAC) discount and the standard process to bill amounts. Learn more

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Autism & ABA services

Learn more about TRICARE's ABA certification requirements, Humana Military credentialing requirements,
referrals and authorizations, claims requirements, forms and other ABA resources.

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Labratory Developed Tests (LDTs)

Prior authorization is required for laboratory developed tests except for Cystic Fibrosis (CF) testing. Claims for genetic testing submitted without an approved authorization will be denied. Find out more

Cold therapy devices

Orthopedic cold therapy devices are not covered under TRICARE policy. Learn more

Provider self-service

Self-service for providers offers many features that will save you time,
ensure patient privacy and help manage your office more efficiently.

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Resources

Access materials that support provider education.
You can find the handbook, charts, newsletters, presentations, forms and more.

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