How to file a TRICARE claim?
Quick Answer
Network providers file TRICARE claims automatically. For non-network care, submit DD Form 2642 with itemized bills to your regional contractor within one year of the service date.
Detailed Answer
Filing a TRICARE claim depends on whether you used a network or non-network provider. Network providers file claims directly with TRICARE on your behalf, so no action is needed from the beneficiary. For non-network providers, you may need to pay upfront and submit a claim for reimbursement. To file a claim, obtain a completed DD Form 2642 (Patient's Request for Medical Payment) from the TRICARE website or your regional contractor. Attach an itemized bill from the provider that includes the provider's name, address, and tax ID number, dates of service, diagnosis and procedure codes (CPT/ICD codes), and charges for each service. Submit the claim to your regional contractor (Humana Military for East Region or TriWest for West Region) by mail or through the contractor's online portal. Claims must be filed within one year of the date of service (or within one year of the date you paid the provider, whichever is later). For overseas claims, submit to International SOS. Keep copies of all submitted documents for your records, and follow up with your contractor if you do not receive an Explanation of Benefits within 30 days.
Related TRICARE Terms
Related Questions
What is an EOB in TRICARE?
An EOB (Explanation of Benefits) is a statement from TRICARE that details the services billed, amounts paid by TRICARE, and any remaining costs the beneficiary owes.
How to check TRICARE claim status?
Check your TRICARE claim status online through your regional contractor's website, through milConnect, or by calling your contractor's customer service line.