Billing Out-of-Region Claims

If you have treated a TRICARE patient from another TRICARE region, please submit the claims to the TRICARE region where the beneficiary resides and/or is enrolled in the TRICARE Prime program for faster payment. TRICARE pays based on where the beneficiary resides or is enrolled (except when care is received overseas).

For example, if a provider in the West Region cares for a TRICARE Prime or TRICARE Prime Remote (TPR) beneficiary from Illinois (which is located in the North Region), the provider should submit the claim to Health Net Federal Services, the responsible contractor for that region, to expedite payment.

Here is the contact information for the contractors in the North and South regions:

North Region
Health Net Federal Services, LLC
Customer Service Line: 1-877-TRICARE (1-877-874-2273)
Website: http://www.hnfs.com/

South Region
Humana Military Healthcare Services, Inc.
Customer Service Line: 1-800-444-5445
Website: http://www.humana-military.com/

Wisconsin Physicians Service Insurance Corp. (WPS), the claims processor for the West Region, can forward the claim to the appropriate region, but it may result in a delay in payment. If the claim is filed electronically to WPS, the claim will be electronically forwarded to the appropriate region.

For more information, please refer to the Claims Processing and Billing Information section of the Provider Handbook at TriWest.com/Provider.