TRICARE WEST REGION
Useful Documents
Forms
- Tricare West Region Provider Agreement
- Electronic Remit Advice
- West Region Billing Service/Clearinghouse Contractor Agreement
General Information
Companion Documents
- American National Standards
Institute X12N 837 Health Care Claim, versions 004010X096A1, 097A1, & 098A1, Wisconsin
Physicians Service Insurance Corp. TRICARE Companion Document
- American National Standard
Institute X12N 835 Health Care Claim Payment/Advice, Version 004010X091A1, Wisconsin
Physicians Service Insurance Corp. Tricare Companion Document
- National Council For
Prescription Drug Programs Batch Standard Verson 1.1 Using Telecommunications Standard
Implementation Guide, Version 5.1, Wisconsin Physicians Service Insurance Corp. Tricare
Companion Document
- American National Standards Institute X12N Health Care Eligibility Benefit Inquiry And Response, Version 004010X092, Companion Document
TRICARE West Region
Wisconsin Physicians Service Insurance Corporation (WPS) is TriWest’s claim processing partner for West
Region claims. All claims are processed using current industry standards.
WPS accepts direct submission of EDI claims 24 hours a day, seven days a week. EDI claims are processed quickly, which means you’ll get reimbursed sooner. And you’ll experience lower administrative costs and reduce your postage costs and mailing time by using EDI. You will also receive immediate feedback with every step of the electronic claims processing cycle. Electronic claims submission (also known as “Electronic Data Interchange” or EDI) is the perfect solution!
Wisconsin Physicians Service Insurance Corporation (WPS) offers the following electronic filing options:
- Providers may choose an electronic data interface (EDI) software program from a vendor, clearinghouse
or billing service whose software has already been approved for TRICARE electronic claims submission.
WPS' EDI Connection publication (PDF), provides information
providers need to make an informed vendor or clearinghouse selection.
- Providers may choose an EDI software option supplied by WPS called PC-Ace
Pro32. This is a "stand alone" software package that creates a patient database
and allows claims entry and claims transmission to WPS. WPS’ print-file software converts
print-image claim files from a practice management system into an electronic format for submission
to WPS.
- Professional, hospital, and other providers may enter and submit TRICARE claims online over the secure TriWest.com Web site, and receive an immediate processing response. The claim entry screens have been designed to contain only the data that TRICARE requires for claim processing.
Did you know your TRICARE Secondary Claims can be submitted electronically?
The paper explanation of benefits you receive from a previous payer does not need to
be sent with your TRICARE electronic claims, although certain information from the explanation
of benefits (e.g. payer amount paid and allowed amount) will need to be reported in the electronic
transaction.
The X12 837 professional and institutional implementation guides provide instructions for submitting secondary claims electronically. Our WPS-TRICARE West Region Companion Guide provides additional information.
Your practice management system vendor or clearinghouse should be able to assist you with electronic submission of these claims.
If you will be submitting your West Region claims through Triwest.com, you may also submit your secondary claims through this claim entry method.
Did you know your TRICARE For Life claims may be submitted electronically?
You may also elect to receive Electronic Remittance Advice (ERA) and
Electronic Funds Transfer (EFT) for TRICARE For Life.
If you are ready to learn more about the submission of your TRICARE secondary claims, or TRICARE
For Life electronic claim submission, please contact our EDI department at 1-800-782-2680,
and select option 4 from the menu.
