Tricare is the U.S. military’s health care program for current and former service members and their families and it functions as a government-managed health insurance.
- Claims denied by Tricare, TriWest and TriEast as NCS, the case should be ZBAL, escalate via SYNCRO CRM as a ZBAL request with detailed notes about the denial.
- If denied, agents must inform the patients that since Tricare denied their claim we will be canceling the balance but another statement could be on the way and to disregard.
- If Tricare, TriWest and TriEast leaves patient’s responsibility (deductible, co-insurance, copayment) the patient is responsible for the amount billed, and you must follow the walkdown.
Last update by: Claudia F (June 21, 2024)