Claims
You can check the status of your claim online.
The Explanation of Benefits (EOB) will provide details as to why your claim was denied. You can view your EOB online (log in required).
Learn more about how TRICARE works with your other health insurance on our other health insurance page.
TRICARE network providers are required to submit claims on your behalf; however, TRICARE non-network providers may require you to submit the claim. All outpatient claims must be filed no later than one year after the services are provided. Inpatient care claims must be filed one year from the date of discharge. See our Submit a Beneficiary Claim page for more information.
You can update your other health insurance information with TRICARE online (log in required) or you may complete and submit the TRICARE Other Health Insurance Questionnaire. Updates submitted through the website will be processed in three business days. Updates submitted through the questionnaire will be processed in 30 business days.
Note: If you need immediate assistance with a prescription that denied due to OHI information, you may contact Express Scripts at 1-877-363-1303 for assistance.
When a payment error is discovered during the claims review process, Health Net Federal Services, LLC is required to process a correction and recover any funds paid in error (recoupment). In certain cases, a recoupment letter is sent requesting a refund. If you receive a claims recoupment letter, follow the instructions as provided. Please note cash payments are not accepted. All recoupment payments must be made by check or money order.
TRICARE requires beneficiaries access individual Explanation of Benefits (EOBs) online. To do this, log in and click on “EOB Summary.” If you would like paper copies of claim information, you can call customer service to request individual EOBs on a per-instance basis. You can also ask to receive monthly summaries of your EOBs through postal mail.
TRICARE beneficiaries are instructed to receive all routine care, when possible, from network providers in their designated region prior to travel. If care is required when traveling, you must verify your plan’s requirements for obtaining a referral from your primary care manager and/or Health Net Federal Services, LLC (HNFS). Providers are encouraged to submit claims on your behalf to HNFS. However, you may need to pay up front for services and file a claim for reimbursement. Your TRICARE claims must be submitted to the region in which you reside in or are enrolled, even if you receive care in a different TRICARE region. Learn more on TRICARE's Getting Care When Traveling page.
