Upcoming Payer Conversion for CPIDs 3552 and 7452 TRICARE - West Region
CollaborateMD Blog
Update: Providers need to be aware of Enrollment and Edit updates for CPIDs 6286 and 5648 TRICARE - West Region conversion to PGBA on April 1, 2013.

Enrollment Changes:
Payer agreements for electronic claims are required.

Providers already approved to submit transactions through the clearinghouse do not need to complete a new agreement.

New providers need to complete a new agreement.

Payer agreements for electronic remittances are required.

Providers already approved to receive remittance advice through the clearinghouse do not need to complete a new agreement.

New providers need to complete a new agreement.

United Healthcare requires credentialing prior to submitting claims for TRICARE West. If you have not received your credentialing packet or have questions regarding the credentialing process, please contact United Healthcare directly at 1-877-988-9378.

Edit Changes:
Other Subscriber Claim Filing Indicator Codes of MA, MB or OF are not allowed at this time at PGBA. The clearinghouse will reject claims that contain MA, MB or OF. PGBA plans to relax this edit as close to the conversion date as possible. The clearinghouse will remove the edit when notified by PGBA. Providers should be aware of possible rejects on or after 4/1/2013 until the edit is removed.

Invalid Procedure, Procedure Modifier, Diagnosis, Patient Reason for Visit, Condition and Zip Codes will be rejected.

To access the new claim and remittance agreement forms, please visit our website at http://collaborationcompass.com, click Payer, and Payer Agreements Library.

Action Required: Providers should be aware of these updates, take necessary actions and continue watching for future notifications regarding this transition.

If you have any questions, please contact Client Services at 1-888-348-8457, option 2.