FALLS CHURCH, Va. – In just six years, almost a billion TRICARE Encounter Data records have been processed, a milestone event for the system that has come a long way in quickly and efficiently processing data records for TRICARE services around the world.
Civilian providers complement the direct care provided at military treatment facilities for TRICARE beneficiaries worldwide. Rapid data record processing, courtesy of TRICARE Encounter Data (TED), helps civilian providers get paid promptly for their services.
How quickly and easily claims are paid is an important feature for providers when they consider accepting patients from health care plans. The TED system gives providers an incentive to participate in TRICARE, and increased participation in TRICARE networks provides beneficiaries better access to health care.
“We all sincerely appreciate the hard work and innovation involved in this milestone,” said Rear Adm. Christine Hunter, deputy director of the TRICARE Management Activity. “TED has helped TRICARE provide outstanding health care around the world. The efficiency and ingenuity has strengthened the TRICARE network.”
TED allows TRICARE to process records for provider payments in less than 24 hours in most cases. Providers submit claims for payments to their regional contractors, who after processing the claim send a TED record to TRICARE. TED verifies and analyzes the information in each record, allowing payments to occur promptly.
Since it began in 2004, TED’s speed and efficiency has been constantly improved. It’s now one of the fastest claim processing systems in the world, able to process 700,000 records in just over three hours. TED collects, verifies and tracks purchased care claims for the Military Health System. TED has processed $140 billion of purchased care services for TRICARE beneficiaries worldwide since 2004.
In addition to faster purchased care claims processing, TED records prevent payment for duplicate, fraudulent or erroneous claims. The information in the TED records also provides data for developing health care trends and budget projections.
“TED’s simple, innovative global interface allows purchased care records to be transferred seamlessly from providers to TRICARE and back at remarkable speed and volume,” said John Arendale, chief of TRICARE Purchased Care Integration. “This milestone reflects the solid, tangible value of electronic claims processing in helping TRICARE provide the Military Health System and its beneficiaries the best possible health care.”
TED processed 189.5 million records for TRICARE in fiscal year 2009, representing $22.3 billion in paid claims. TED processing was built and is maintained by the Resources Division of the Defense Health Services Systems.
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The TRICARE Management Activity administers the worldwide health care plan for 9.6 million eligible beneficiaries of the uniformed services, retirees and their families. |
