Claims Information
Submit and Check Claims Status
Medical Claims:
With dates of service up to March 31, 2013:
West Region Claims
P.O. Box 77028
Madison, WI 53707-1028
These claims must be received by July 29, 2013.
With dates of service starting April 1, 2013, click here.
The TRICARE West Region contract is transitioning to a new contractor effective April 1, 2013.
TriWest will process medical claims for TRICARE services with dates of service up to and including March 31, 2013. UnitedHealthcare Military & Veterans will process all TRICARE West Region medical claims with dates of service starting April 1, 2013.
Detailed Claim Filing Instructions
- Update your personal and family information in DEERS.
- Complete and sign the Beneficiary Claim form.
- Attach a Third Party Liability form (if needed).
- Attach a copy of your provider's bill to the claim form.
- Submit the claim to the appropriate address (at right).
Who Should Submit Claims?
Your provider may file the claim for you. You may have to file your own medical claim if you:
- use a non-network, non-participating provider
- have other health insurance, or
- are injured at work, home or in an accident.
View Claims Information Online
Login to your secure TriWest.com account so you can view your claims information and Explanations of Benefits for care received with dates of service on or before March 31, 2013 online, whenever you need.
Other Health Insurance
When you have medical coverage in addition to TRICARE, you have other health insurance (OHI). Medical (and pharmacy) claims must be coordinated with your other health insurance and with TRICARE. These claims can be filed with TriWest for dates of service prior to 4/1/2013.
Step 1: Make sure TriWest has the up-to-date information about your other health insurance. If this information is missing or incorrect, it could lead to claims delays and out-of-pocket expenses. You can update your OHI by by contacting United Healthcare. United Healthcare provides TriWest with updated OHI information upon receipt in their offices.
Step 2: Your provider should submit claims to your primary insurer first. Most providers will submit the claim for you. Once the claim has been processed, both you and the provider will receive an explanation of benefits (EOB) indicating the amount paid by your primary insurer.
Step 3: If TRICARE is the second payer, you must send a copy of the EOB from the OHI and a TRICARE claim form to TRICARE for processing. Learn how to file a TRICARE claim.
Claims Appeals
If you disagree with certain decisions made by TRICARE or TriWest regarding your benefits, you have the right to appeal that decision. There are specific benefit issues that are appealable and the appeal process varies depending on the type of benefit issue.
For issues that can't be appealed, a grievance process is available, which allows you to submit your concern or complaint in writing.