TRICARE Manuals - Display Chap 20 Sect 3 (Baseline, Dec 5, 2022)

TRICARE Medicare Eligible Program (TMEP)

Chapter 20

Section 3

Financial Administration

Revision:

All TRICARE requirements regarding financial administration shall apply to the TMEP unless specifically changed, waived, or superseded by this section or the TRICARE Policy Manual (TPM), TRICARE Reimbursement Manual (TRM), TRICARE Systems Manual (TSM), or TMEP contract. See Chapter 3 for additional instructions regarding administration.

1.0 General

1.1 The provisions of Chapter 3, Section 1 apply to TMEP.

1.2 TMEP shall follow the Financial Administration non-financially underwritten funds requirements in Chapter 3.

2.0 Payments to Beneficiaries/Providers

2.1 The provisions of Chapter 3, Section 2 apply to TMEP. Chapter 3, Section 2, paragraphs 2.0 through 2.1.3 are superseded as described in paragraphs 2.2 and 2.3.

2.2 The TMEP shall follow the contract requirements regarding provider Electronic Funds Transfer (EFT). Payments may be made by EFT to beneficiaries.

2.3 Non-underwritten EFTs shall be done within two federal business days after receiving payment approval from DHA. Rejected EFTs may be made as checks. If payment cannot be accomplished as a check or EFT, an adjustment/cancellation TRICARE Encounter Data (TED) record shall be submitted within five business days or rejection of an EFT.

3.0 Claim Refund And Collection Procedures

The provisions of Chapter 3, Section 3 apply to TMEP, except for paragraphs 2.1 through 2.1.2.2.

4.0 Stale Dated, Voided, Or Returned Checks

The provisions of Chapter 3, Section 4 apply to TMEP.

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