FAQs about the Military Medical Support Office at Defense Health Agency, Great Lakes
Frequently Asked Questions
Claims
Q18:
I am a Reservist with a Dental Line of Duty. What do I do?
A:
Defense Health Agency, Great Lakes does not handle dental claims. All dental claims and Line of Duty information must be routed through United Concordia, at:
United Concordia ADDP Authorization
P.O. Box 69431
Harrisburg, PA 17106-9431
Q23:
Why can’t my provider submit a claim?
A:
Sometimes providers are uncomfortable submitting electronically if the Defense Enrollment Eligibility and Reporting System says you are ineligible for care. If they are unable to submit electronically, then they need send claims to TRICARE via fax or mail using a CMS 1500 form or a UB04 form. These are official insurance claim forms that must be completed by the provider’s office ONLY.
The provider can manually enter the member’s information: name, sponsor ID/SSN, address, and phone number.
For more information the provider can contact TRICARE directly.
East Region: https://www.humanamilitary.com/provider/
West Region: https://www.tricare-west.com/content/hnfs/home/tw/prov.html
Q28:
I received a debt collection notice. What do I do?
A:
First, register for your regional contractor’s beneficiary portal to check if the claim(s) have been submitted to TRICARE. If the claim is in the portal, your unit can contact us to authorize TRICARE to reprocess the claim(s). If the providers have not billed TRICARE, you should provide them TRICARE’s billing information. If further issues persist, you can fill out a debt collection package located on our main website and in our process guide.
Eligibility
Q4:
I am a Reservist/National Guard in the Army. Why does my unit have to use MEDCHART?
A:
This is not a Defense Health Agency, Great Lakes mandate. All Army National Guard/U.S. Army Reserve requests are required by the National Guard Bureau and Office of the Chief of Army Reserve to be submitted via the Electronic Medical Processing System (eMMPS/MEDCHART). Defense Health Agency, Great Lakes will not accept Army Reserve Component eligibility packages submitted by mail, fax, or email.
** If you are a Unit Administrator seeking more information about MEDCHART access or instructions, please contact your chain of command.
Q5:
I am a Reservist on orders more than 31+ days. When should my eligibility be submitted?
A:
Your unit representative does not need to submit your eligibility. Your Defense Enrollment Eligibility Reporting System record should reflect your time as active duty which will prompt TRICARE to pay your claims as TRICARE Prime Remote. If you need follow-up care after your orders end, your unit representative should submit a pre-authorization request along with the required documentation.
Q8:
What does “eligibility on file” mean?
A:
"Eligibility on file" means we have verified and approved your eligibility documents. The claims sent to TRICARE that are associated with your line of duty injury or illness will be authorized for payment.
General Inquiries
Military Hospital and Clinic Care
Q5:
How can I track the status of my claims(s) or Line of Duty care authorizations?
A:
If you have questions or need more information about these portals, please contact your regional contractor.
Unit representatives may also sign up for access to the government portal at the web address above. Claims can only be paid if you have eligibility/Line of Duty on file AND claims have been sent to the regional contractor.
Tips
- Register to track claims and authorizations.
Make sure your unit has submitted your eligibility/LOD paperwork.
- Save your Explanation of Benefits, it is a receipt as proof of payment.
- Make sure your Defense Enrollment Eligibility Reporting System record is up-to-date.
Pharmacy
Pre-Authorizations/Referrals
Q8:
How long does my pre-authorization last?
A:
Pre-authorization is determined on a case-by-case basis, but typically should not exceed 365 days from the time of injury. Always be sure to check the expiration date of your authorization.
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