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In TRICARE Guiding the Claims Process in the West Region: Download brochure (PDF* 901KB) |
Payment of health care-related claims in a timely manner is important. TRICARE claims in the West Region, including claims for active duty service members, but not those for TRICARE For Life, should be sent to the following address:
West Region Claims
P.O. Box 77028
Madison, WI 53707-1028
If you have questions, please call TriWest at 1-888-TRIWEST (1-888-874-9378).
Claims submission depends on the TRICARE program option you use:
TRICARE Prime, TRICARE Prime Remote (TPR), and TRICARE Prime Remote for Active Duty Family Members (TPRADFM)When enrolled in TRICARE Prime, TPR, or TPRADFM, your PCM or care provider will file claims on your behalf in most instances. If you use a non-network provider or require emergency or urgent care outside your region, the provider may require you to pay out-of-pocket and file your own paper claims for reimbursement.
TRICARE ExtraWhen using network providers, providers file claims on your behalf.
TRICARE StandardIf seeking care from non-network providers, you may be required to file your own claims. Download a copy of the claim form (DD Form 2642) and instructions. You may be required to pay first for services. If you do, TRICARE will reimburse you directly for the claim. Remember that nonparticipating providers can charge you up to 15 percent above the TRICARE allowable charge for services in addition to your cost-share and/or deductible.
TRICARE For Life (TFL)Wisconsin Physicians Service (WPS) is the claims processor for all TFL claims. Your provider will file the claim with Medicare first. Medicare then processes the claim and forwards the claims to WPS TRICARE For Life for payment of the remaining amount. WPS TRICARE For Life automatically sends the payment to your provider. You will receive an explanation of benefits (EOB) indicating the amount Medicare and TRICARE paid. For information or assistance, contact WPS TRICARE For Life.
| Customer Service: WPS TRICARE For Life P.O. Box 7889 Madison, WI 53707-7889 Toll-free: 1-866-773-0404 Toll-free TDD: 1-866-773-0405 Web site: www.tricare4u.com |
Claims Submission: WPS TRICARE For Life P.O. Box 7890 Madison, WI 53707-7890 |
Appeals: WPS TRICARE For Life Attn: Appeals P.O. Box 7490 Madison, WI 53707-7490 |
| Third Party Liability: WPS TRICARE For Life Attn: Third Party Liability P.O. Box 7897 Madison, WI 53707-7897 |
Refunds: WPS TRICARE For Life Attn: Refunds P.O. Box 7928 Madison, WI 53707-7928 |
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Updated 03/14/2005
