How do I fix a TRICARE billing error or denied claim?

Direct answer: First compare the provider's invoice against your Explanation of Benefits (EOB) from your regional contractor — if the provider billed more than the TRICARE-allowed amount, contact their billing office directly; if a claim was denied incorrectly, contact your regional contractor about a coding correction.

Applies to: All TRICARE plans · All regions

Details

If TRICARE denies a claim for a service you believe should be covered, you generally have 90 days from the date on the EOB to file a written appeal, including a copy of the EOB and supporting medical documentation from your provider. Billing errors typically come from one of three sources: provider coding mistakes, contractor administrative errors, or outdated information in DEERS — so if disputing the bill doesn’t resolve it, check that your DEERS record is current too. East Region (Humana Military): 800-444-5445. West Region (TriWest): 888-874-9378.

What to do next

Confirm this with your Primary Care Manager or regional contractor before scheduling — rules can vary by region and by service.