Wiki Tricare - encountered this denial

Create Wiki
M

mfranks

Contributor
Messages
22
Location
Puyallup, WA
Best answers
0
My Facility has been receiving claims for one specific patient that simply denies stating that the patient is on a do not pay list. Has anyone else encountered this denial?
 
No Pay List

Effective Feb 2016, Tricare changed many of the acceptable codes. We found this by Google No Pay List. It appears they are following CMS and not accepting some of the HCPCS codes.
 
I would call Tricare about the denial to get specifics. My scenario might be off topic but I recently dealt with a Tricare patient's claims which began denying for COB/OHI (previous claims processed with no COB/OHI issues). The patient called Tricare & was told that "they did a recent overhaul of their system & it must have pulled old OHI information" The rep told the patient that they had it updated to reflect no OHI & our claims could be rebilled.
 
You must log in or register to reply here.
Top