Humana Military & TRICARE 2018 Update

To bring in the new year, TRICARE Select replaced TRICARE Standard and TRICARE Extra on January 1, 2018.  TRICARE Standard and Extra beneficiaries will be enrolled in a TRICARE Select plan and TRICARE Prime plan enrollees will remain in their TRICARE Prime plan.

This change will be applied to the TRICARE East Region, which includes Alabama, Arkansas, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa (Rock Island Arsenal area only), Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri (St. Louis area only), New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas (excluding the El Paso area), Vermont, Virginia, West Virginia and Wisconsin.

Things to Know…

  • Wisconsin Physicians Service (WPS) is currently providing outreach to ensure preparation of transition to the new Fiscal Intermediary (FI)/claims processor-WPS. EDI-required applications are to be completed and on file before January 1, 2018.
  • EDI interface includes new trading partner agreements.
  • Electronic Media Claims (EMC) applications will be available electronically for self-registration.
  • ERA and EFT options will follow once the EDI interface and EMC connectivity applications are established.
  • If you use a clearinghouse, please coordinate efforts with your current service for all necessary applications and agreements.
  • Connectivity testing will begin January 1, 2018.

 

Other Health Insurance (OHI) Reminder:

TRICARE is the secondary payer to all health benefits and insurance plans, apart from Medicaid, Indian Health Services and other public programs identified by the government. Always check for OHI and status of OHI with the patient at each visit.

 

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Resources & Credits:
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