TRICARE Grants Additional Extension for Overseas Claims Filing

Falls Church, Va – TRICARE Management Activity (TMA) has extended its “timely filing waiver” for dates of service prior to Dec. 31, 2007, to allow providers, beneficiaries, and others living overseas additional time to submit overdue claims for reimbursement. The original deadline was Dec. 31, 2008 for services received prior to Dec. 31, 2007.
 
            Since the December deadline was announced, nearly 4,500 claims have been received and approved for processing and payment.
 
            The late filings from overseas occurred because some countries give host nation healthcare professionals as long as three years to file claims for reimbursement. TRICARE required beneficiaries to file claims within one-year from the date of service or inpatient discharge.
 
            The extension to March 31, 2009 also provides an opportunity for TRICARE area offices to continue educating providers, beneficiaries, and others about TRICARE claims filing policy.
 
            Extension of this timely filing waiver applies to providers and beneficiaries, overseas TRICARE area offices, remote points of contact and others with outstanding healthcare claims with dates of service before Dec. 31, 2007.
 
           

     Under the additional extension, overdue or “untimely” claims filed by providers and beneficiaries must now be received for processing no later than March 31, 2009 by Wisconsin Physician Services (WPS), TRICARE’s overseas claims processor.
 
            To file an overdue claim, beneficiaries must mail a completed DD Form 2642 with a copy of the itemized bill and receipts to WPS. WPS maintains several post office boxes for overseas claims, based on overseas area and beneficiary category. To find the correct address: check the TRICARE Overseas Program Handbook; enter a profile on the TRICARE Website http://tricare.mil/mybenefit/ and link to claims information; see http://tricare4u.com; or contact the appropriate overseas area office found on http://www.tricare.mil/contactus for assistance.
 
            Late claims without proper information will not be paid, however, WPS will record the date they receive the claim, which stops the clock until additional information is received and reviewed. Consequently, it is critical that WPS receive these claims before March 31, 2009.
 
            When WPS denies late claims, they will note this on the explanation of benefits (EOB) which also provides information on filing an appeal. Contact information is also provided for questions about appealing a denial.
 
            Beneficiaries who recently submitted untimely claims should allow WPS time to process these and post them on their website http://tricare4u.com.
 
            Although WPS added staff to process approximately 4,500 claims received so far, manual overseas claims processing requires additional time, so beneficiaries are urged to be patient and wait until February before contacting WPS about their claim status.
 
            TRICARE will deny claims with dates of service before Dec. 31, 2007 that are submitted after the new March 31, 2009 deadline.
 
            Ultimately it’s the beneficiary’s responsibility to ensure claims are submitted and processed according to TRICARE policy and federal regulations.

About TRICARE Management Activity and the Military Health System
TRICARE Management Activity, the Defense Department activity that administers the health care plan for the uniformed services, retirees and their families, serves more than 9.2 million eligible beneficiaries worldwide in the Military Health System (MHS). The mission of the MHS is to enhance Department of Defense and national security by providing health support for the full range of military operations. The MHS provides quality medical care through a network of providers, military treatment facilities, medical clinics and dental clinics worldwide.  For more about the MHS go to www.health.mil.