TRICARE will not be adopting 340B adjustments and will not pursue retroactive claims payments based on the 9/28/22 US Supreme Court decision about Medicare Organizations regarding outpatient prescription drugs.
We know your time is valuable. Save time and money by enrolling in electronic processing today.
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.
It will need to be placed in the following data elements within your X12 837 claim files:
Providers who use clearinghouses to process their claims need to enroll via Electronic Data Interchange (EDI) express enrollment in order to process claims and set up EFT/ERA.
To set-up EDI, providers (or groups where applicable):
Providers who do not use a clearinghouse to process their claims can submit claims through provider self-service.
