1.10.18  With so much confusion centering on Tricare East, it’s worth remembering that Tricare West also had an important change–not a new region, but a new contractor. Their MCS contractor has moved from UHC Military to Health Net Federal Services. West region providers who are not already contracted with Health Net Federal Services (HNFS) may need to fill out a new Tricare West enrollment packet.  However, doctors may still choose to see Tricare patients as a non-network provider, but Prime patients will need a referral or prior auth to go to a non-networking provider for care.  You’ll also want to register for the secure provider portal where you can look up eligibility, submit authorizations, and check claim status.

Below are some helpful links to get you started!

• Becoming a Tricare Provider:  Click here
• Health Net Federal Services enrollment packet:  Click here
• Non-Networking Provider Information: Click here.
• Registration for Secure Provider Portal:  Click here.
• Information on claims submission:  Click here
• EDI information:  Click here
• Frequently Asked Questions:  Click here

Claims for dates of services on or before December 31, 2017 should still be submitted to UnitedHealthcare Military.  In addition, myTRICARE.com will continue to be available for account information and claims submission through April 30, 2018.  However, all claims for dates of service on or after January 1, 2018 must be filed to Health Net Federal Services, but HNFS will honor all active referrals and authorizations issued by UHC Military prior to January 1.

Tricare West Region:  Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (except the Rock Island Arsenal area), Kansas, Minnesota, Missouri (except the St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (areas of Western Texas only), Utah, Washington, and Wyoming.

1.8.18  SUPERIOR VISION PAYMENT ISSUES: Some of our clinics recently received duplicate payments from Superior that were previously issued in September. When we called Superior we were told that their new payment system did not successfully issue the original EFT payments, which is why they are now being reissued with interest. However, we are also finding that some of our offices that get paper checks have received duplicate payments as well, so it appears Superior is reissuing ALL payments from that time frame. Some offices who get paper checks are truly receiving double payments that will have to be recouped. If you are an OBS clinic, please call your coordinator if you have questions!

1.2.18   2018 MEDICARE REMINDERS:  The Medicare Part B annual deductible will be $183 in 2018, the same as last year. As you start to see Medicare patients in 2018, you can check how much of their deductible has been met on most Medicare websites or IVR. Clearinghouses like Trizetto also offer this service, and you can often sign up to get this information on Availity. Secondary Medigap B, C, and F policies usually pick up the Medicare’s deductible, but collect the noncovered refraction!  Also, remember to always check seniors’ insurance cards at the beginning of the year since they may have changed to a Medicare Advantage plan. And finally, remember that Medicare patients will get new cards and ID numbers beginning in April. It will be critical for your staff to scan the new cards and update the new numbers in your software!