Electronic Filing (EDI)

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Electronic Filing (EDI)

Electronic Claim Submission

WPS Health Solutions wants you to know that your TRICARE For Life claims can be submitted electronically directly to WPS. While most TRICARE For Life claims are electronically crossed over from Medicare, some are not - including situations such as the beneficiary having a Medicare Advantage Plan. We also understand that provider's practice management systems/software require claim submission in certain situations (i.e. if claim payments are not received within a certain number of days etc.). When these situations occur, WPS encourages you to take advantage of the benefits of electronic claim submission. Please visit the WPS Electronic Claim Filing page for more information and registration.

You can continue to submit your claims electronically through our online Internet claim entry application when logged into your account at TRICARE4u.com.

 

Electronic Funds Transfer (EFT)

Electronic Funds Transfer (EFT) is also available for TRICARE For Life. EFT replaces the paper checks you currently receive for TRICARE For Life claim payments and provides a more secure way of receiving timely payments. When you enroll in EFT, you will need to receive your Explanation of Benefits (EOB) data through either Electronic Remittance Advice (ERA) or our TRICARE4u website, as your paper EOBs will cease 45 days after EFT activation. Optum (formerly Change Healthcare) Payer Enroll Services (PES) is available for TRICARE For Life EFT registrations. For more information and to register, please visit the Optum PES Website or WPS' Electronic Transaction Enrollment. If you need assistance with the registration process, Optum is available to help at 800-956-5190. Their support hours are Monday through Thursday, 8 AM to 5 PM CST. WPS encourages your office to take advantage of the benefits that EFT payments offers to protect your healthcare information and payments from mail fraud.

 

Electronic Remittance Advice (ERA)

Electronic Remittance Advice (ERA) is also available for TRICARE For Life. When you choose to receive Electronic Remittance Advice or ERA, your files will be sent to you in the ANSI (American National Standards Institute) X12 835 format (version 5010A1) and can be downloaded from the WPS Gateway Express or from your clearinghouse/billing service depending on how you choose to enroll. Optum PES is available for TRICARE For Life ERA registrations. For more information and to register, please visit the Optum PES Website or WPS' Electronic Transaction Enrollment. If you need assistance with the registration process, Optum is available to help at 800-956-5190. Their support hours are Monday through Thursday, 8 AM to 5 PM CST.  WPS encourages your office to take advantage of the benefits that ERA enrollment offers to decrease paper waste and protect your healthcare information from mail fraud.  

 

If you are interested in learning more about TRICARE For Life EDI claim submission, ERA and EFT, please contact us at 1-800-782-2680, option 1 for the EDI Help Desk, option 2 for the EDI Marketing staff, or visit our EDI Enrollment page

 

 

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