Electronic Claims Filing Options

      
Listed here are several options to review when choosing to submit your claims electronically.

XPressClaim
Imagine filing your TRICARE claims while your patients are still in your office and getting the payment results right away—that’s XPressClaim. It’s secure, easy to use, fast, and free. You can submit secure TRICARE CMS-1500 and UB-04 claims and receive instant results. You can also print a patient summary receipt on the spot, while your patient is still in the office. If you’re a member of the myTRICARE claims for Providers section of PGBA’s Website, you can access XPressClaim right now. (If you haven't already joined myTRICARE claims, follow the prompts for signing up.)

eZ TRICARE Claims
Don’t want to rekey your claims? Then you should consider using eZ TRICARE Claims. With eZ TRICARE Claims, you can upload batches of claims directly from your practice management system. There’s no software to install, no data entry, and no cost for your TRICARE claims. eZ TRICARE Claims can accept a variety of claims formats, including National Standard Format (NSF), ASC X12 837, and even a CMS-1500 print file.
      
Clearinghouses
We receive TRICARE claims from a large number of EMC clearinghouses.  You should contact your clearinghouse in order to find out what you need to do to send your TRICARE claims to us.  Depending on the clearinghouse, we may be listed in their payer listing as Humana Military Healthcare Services or as PGBA, our claims processing partner.

Electronic Data Interchange (EDI) Gateway
If your system can create HIPAA-compliant claims formats and you prefer to send your claims directly to the payer, then PGBA’s EDI Gateway may be right for you. PGBA built the EDI Gateway to handle all of their inbound and outbound HIPAA-compliant EDI transactions. The communications protocols supported are Asynchronous Dial-up, File Transfer Protocol (FTP), and CONNECT: Direct/NDM. To enroll or learn more about the EDI Gateway, contact the EMC Help Desk at 1-800-325-5920.

If you would like for us to contact you regarding the electronic claims submission options, you may print and send in this questionnaire, and an EMC support representative will contact you to provide assistance.