December 1, 2008

Understanding TRICARE and Other Health Insurance (OHI) Claims Processing

TRICARE is the Uniformed Services’ Federal health care program (not insurance) for active duty Service members and their families, retired service members and their families, members of the National Guard/Reserve and their families, survivors, and others who are eligible. Other health insurance (OHI) is considered by TRICARE to be any non-TRICARE health coverage not considered a TRICARE supplement.

TriWest’s Prior Authorization List Updated

TriWest Healthcare Alliance Corp. has revised the Prior Authorization List (PAL) effective January 1, 2009. The only change is the addition of one drug.

Two TRICARE Provider E-Seminars Updated

TriWest Healthcare Alliance has recently updated the Medical/Surgical Provider E-Seminar and Behavioral Health E-Seminar. Developed with busy providers and their staff in mind, these E-Seminars contain the same content as our live Fall 2008 provider seminars.

Wrong Information Being Communicated about Prevnar Vaccine Coding

It has come to TriWest’s attention that representatives from a pharmaceutical company may have been inappropriately contacting providers in California regarding the Prevnar vaccine and communicating inaccurate coding information.