TRICARE, Your Military Health Plan

In This Section:

• Completing the Claim Form
• Filing Tips
• Claims Addresses
• Check Claim Status
• Philippines Itemized OHI Claim Checklist
• Proof of Payment for Overseas Claims
• Denied Claims
• Third-Party Liability
• Explanation of Benefits (EOB)

Claim Filing Tips

Many times claims are delayed or denied because the claim form wasn't filled out correctly or all the information wasn't provided.  Here are some tips to help you file your claims correctly:

1. Make sure your DEERS information is correct. Outdated or incorrect information in DEERS could cause your TRICARE claim to be denied. Update DEERS now!
2. Use the correct claim form. Submit medical claims on a Patient's Request for Medical Payment (DD Form 2642). 
3. Fill in all 12 blocks of the claim form. Include the sponsor's Social Security number, your home address and phone number, as well as any other pertinent information needed. >>Learn More
4. Provide correct diagnosis codes. Diagnosis codes are required on all claim forms submitted to TRICARE. Your provider should give you a diagnosis code for all services rendered.
5. Sign your claim form. Claims submitted without a signature will be denied payment.
6. Alert TRICARE of possible third-party involvement. If you were hurt in an accident and someone else may bear responsibility, you have to let TRICARE know by submitting a Statement of Personal Injury-Possible Third Party Liability (DD Form 2527) along with your medical claim form.  >>Learn More
7. File claims with your other health insurance (OHI) first.  TRICARE pays second to most OHI programs. When you receive payment from your OHI, you can then file a claim with TRICARE.  Include a copy of your explanation of benefits from your OHI with your TRICARE claim.  >>Learn More
8. Make copies. Keep copies of everything you submit to claims processors.
9. Use the correct claims address. Send your claim forms to the correct address to avoid delays.
10. Submit your claim as soon as possible. In the U.S. and U.S. Territories, claims must be filed within one year of the date of service or within one year of the date of an inpatient discharge. In all overseas areas, claims must be filed within three years.
11. Submit each claim separately. Filing multiple claims together could cause confusion.
12. Get your questions answered. Visit a local TRICARE Service Center for help with filing medical claims.

Last Modified:September 4, 2012