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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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

Due to additional quality checks to ensure proper processing, there may be a temporary delay in claims payment. This is to ensure proper claims payment and prevent further disruption. Once claims have gone through these additional checks, they will be released and paid appropriately.

You can submit claims online or by mail. Claims submitted online are processed faster than those received via mail. If you choose to submit claims by mail, please send to:

TRICARE East Region
Wisconsin Physicians Service
Attention: Claims
PO Box 7981
Madison, WI 53707

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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