Bene hero

Provider claims

We’re committed to serving you with clear policies, efficient service and fast claims turnaround, so you can focus on your patients’ well-being.

PGBA, LLC is Humana Military’s partner for claims processing in the TRICARE South Region. PGBA's website is myTRICARE.com.

Check Claims Status: Quickly and easily check the status of your claims by using the secure Self-Service for Providers on our website or by calling the PGBA Interactive Response System at 1-800-403-3950.

TRICARE rates: Allowable charges for ambulatory surgery and information about durable medical equipment, prosthetics, orthotics and supplies. 

Other Health Insurance (OHI): TRICARE network providers must file their patients’ TRICARE claims, even when the patient has OHI.

National Provider Identifier (NPI): Providers must submit the appropriate NPI on all HIPAA-standard electronic transactions.

Fee schedule and no government pay procedure code list

TRICARE reimbursement methodologies

Billing and filing guidelines

PGBA may delay or deny claims for a number of reasons. These resources offer tips to help facilitate prompt claims payments.

Electronic Media Claims (EMC), Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT)
TRICARE network providers must file all claims electronically using one of our EMC options.

To help streamline claims, Humana Military also encourages providers to sign up for EFT and ERA.

    Guidelines

    Claim Forms

    Other Resources

    To contact PGBA by mail, submit correspondence to:

    TRICARE South Region Claims Department
    P.O. Box 7031
    Camden, SC 29021-7031

    Wisconsin Physicians Service (WPS)/TFL is the TRICARE For Life (TFL) administrator. Contact WPS/TFL at www.TRICARE4u.com or 1-866-733-0404.

    TRICARE.mil for providers

    National Institute of Mental Health

    Provider locator

    Find Humana-contracted healthcare providers near you.

    Find a provider
    Anxiety

    Provider resources

    Get access to the provider handbook, charts, flyers, newsletters, and education presentations.

    View provider resources