Triwest Patient Reimbursement Form

Help your Triwest clients get coverage.. provide a claim form and have then submit the Triwest reimbursement form.

Site:  https://tricare.mil/FormsClaims/Forms/ClaimForms/Medical

Form: http://www.esd.whs.mil/Portals/54/Documents/DD/forms/dd/dd2642.pdf

Claims Address: https://tricare.mil/FormsClaims/Forms/ClaimForms/Medical/Addresses

 

 

TRICARE Policy Manual 6010.57-M Chapter 11 Section 3.12

TRICARE Policy Manual 6010.57-M Chapter 11 Section 3.12

Certified Nurse Midwife (CNM)  Authority: 32 CFR 199.6(c)(3)(iii)(D)

1.0 ISSUE   Certified Nurse Midwife (CNM).

2.0 POLICY
2.1 A CNM may provide covered care independent of physician referral and supervision,
provided the nurse midwife is:
2.1.1 Licensed, when required, by the local licensing agency for the jurisdiction in which the
care is provided; and
2.1.2 Certified by the American Midwifery Certification Board (AMCB). To receive certification, a
candidate must be a Registered Nurse (RN) who has completed successfully an educational
program approved by the AMCB, and passed the AMCB National Certification Examination.
2.2 The services of a RN who is not a CNM may be authorized only when the patient has been
referred for care by a licensed physician and a licensed physician provides continuing supervision
of the course of care.
3.0 EXCLUSION
A lay midwife who is neither a CNM nor a RN is not an authorized provider, regardless of
whether the services rendered may otherwise be covered.

Triwest/Tricare Health Net Federal Services NO LONGER covering claims for LM, CPM…

It has certainly been tough switching all my providers from Triwest UHC to HN. I found out today while checking on claims (that I was required to wait until 5/1/18 to follow up on), that Triwest HN will not credential nor process claims for Midwives that are not CNMs. Please see the manual I was directed to.

http://manuals.tricare.osd.mil/DisplayManualPdfFile/TO08/174/AsOf/tp08/c11s3_12.pdf