More civilian providers are accepting new TRICARE Standard patients. Findings from the Department of Defense (DoD) Survey of Physician Acceptance of TRICARE Standard show that in Fiscal Year 2007, 84 percent of physicians in 53 hospital service areas (HSA) were accepting new TRICARE Standard patients.

TRICARE is the DoD health care program for uniformed service members and their families. TRICARE patients, including active duty service members, their families and National Guard and Reserve members and retirees, live farther from military installations and often rely on civilian physicians for their health care. Because the DoD is concerned that it might be more difficult for these patients to find TRICARE-accepting providers, TRICARE leaders are reaching out to state officials, medical associations and individual physicians to educate these organizations and professionals about accepting TRICARE. Increasing the number and types of providers across the nation will remain a high priority, especially in remote areas. Today, more than 222,000 health care providers accept TRICARE.

Advantages to Becoming a TRICARE Provider

• With approximately 9.4 million beneficiaries, TRICARE offers a large pool of patients, and thus, a steady revenue stream.

• TRICARE is an industry leader in claims payment timeliness.

  • Ninety-nine percent of clean claims are processed within 30 days.
  • Ninety percent of claims are processed within 15 days.
  • Seventy percent of claims are filed electronically.
  • The average turnaround time for electronic claims is five days.
     

• By law, TRICARE pays amounts comparable to those mandated for Medicare.

  • TRICARE has some flexibility to pay more for specific services in certain locations.
  • If a provider participates in Medicare, a natural follow-on would be to participate in or become a network provider for TRICARE.
   
• TRICARE offers flexibility — providers can join the network or accept assignment on a case-by-case basis.

Table 1: Three Options for Providers

Source: Become a Certified TRICARE Provider

How to Sign Up

TRICARE has three geographical regions in the United States, each with a TRICARE regional contractor that sets the terms and conditions for credentialing and certifying a provider for whatever level of participation the provider chooses.

• To become a TRICARE-certified provider in the north region, please contact Health Net Federal Services
• To become a TRICARE-certified provider for the south region, please contact Humana Military Healthcare Services
• To become a TRICARE-certified provider for the west region, please contact TriWest Healthcare Alliance

TRICARE Health Service Regions

West 1-888-TRIWEST 1-888-874-9378 TRIWEST Healthcare Aliance North 1-877-TRICARE 1-877-874-2273 Health Net Federal Services South 1-800-444-5445 Humana Military Healthcare Services TRICARE Overseas 1-888-777-8343 WESTPAC Europe Latin America/Canada Puerto Rico/Virgin Islands www.tricare.osd.mil/overseas

As the nation enters its eighth year of war, Admiral Mike Mullen, the military’s highest ranking officer, says he is concerned about the health of the armed forces, “We have asked our young men and women to deploy in ways they never could have imagined. Whether they are active duty, reserve, or guard, they have stood up to the challenge.” The care of our soldiers — at war and when they come home—deserves our full attention.

Sources

¹More Civilian Providers Accepting TRICARE Standard; Officials Continue Work to Expand Network April 4, 2008.
²Become a Certified TRICARE Provider, last accessed 3/30/09
³Miles, Donna. “Mullen Encourages Troops to Seek Mental Health Care When Needed.” American Forces Press Service, February 5, 2009.

Additional Resources

• TRICARE Operations Manual
• TRICARE Policy Manual
• TRICARE Reimbursement Manual
• TRICARE Systems Manual
• TRICARE Fundamentals Course