What do I do if I receive an incorrect TRICARE bill?
Quick Answer
Compare the bill to your EOB, contact the provider billing department first, then call your regional contractor if the issue isn't resolved.
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Key Takeaways
- Compare bill to EOB
- Contact provider first
- Network cannot balance bill
- Document all communication
Detailed Answer
Billing errors can occur and should be addressed promptly.
Steps to Resolve:
1. Compare bill to your EOB 2. Verify services match what you received 3. Check TRICARE-allowed amounts 4. Contact provider billing department 5. Call regional contractor if needed
Common Billing Errors
- Billing for covered services
- Wrong patient information
- Duplicate billing
- Incorrect coding
- Balance billing (network)
What to Check
- Date of service
- Service description
- Charged amounts
- Your responsibility amount
- Insurance applied correctly
If Provider Balance Bills
- Network cannot balance bill
- Some non-network protections exist
- Document communication
- Contact TRICARE if needed
Dispute Process
- Write to provider
- Request itemized bill
- Provide EOB as proof
- Escalate to TRICARE
Related TRICARE Terms
Related Questions
What is an Explanation of Benefits (EOB)?
An EOB is a statement from TRICARE showing services billed, amounts TRICARE paid, and any amount you owe. It is not a bill.
How do I appeal a TRICARE decision?
Appeal denied claims or coverage decisions within 90 days by submitting a written appeal with supporting documentation to your regional contractor.
What do most military families add to their TRICARE coverage?
Supplemental health insurance is the most common addition — it covers dental, vision, and out-of-pocket costs that TRICARE leaves uncovered. Life insurance and a legal will are also highly recommended.
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