The contractor shall follow
the requirements listed in
Chapter 10.
2.1 Underwritten Health Care Refunds
and Collections
2.1.1 Collections Occurring on Active
Underwritten Health Care Contract Line Item Numbers (CLINs)
The contractor shall submit,
upon identification of debt, a credit TRICARE Encounter Data (TED)
record citing the CLIN/Automated Standard Application for Payment
(ASAP) Account Number the contractor originally billed within two
business days.
Note: Exception to this requirement:
credits related to good faith payments as defined in
Chapter 10, Section 3 may be submitted upon
collection of funds.
2.1.2 Collections Occurring on Closed
Underwritten Health Care CLINs
2.1.2.1 Closed underwritten CLINs are
defined in Section G of the contract (TED Underwritten CLIN Closure Procedures).
2.1.2.2 The contractor shall, upon
closure of the underwritten health care CLIN, process all collections
for debt incurred after CLIN closure in accordance with
Chapter 10, Section 3. Collections of debt
incurred prior to CLIN closure remain underwritten debt and shall
be collected in accordance with
Chapter 10, Section 2.
2.1.2.3 The contractor shall submit
credit TED records for all underwritten debt (
paragraph 2.1.1) prior to CLIN
closure.
2.2 Non-Underwritten Health Care
Refunds and Collections
2.2.1 The contractor
shall deposit refunds and collections to the applicable non-underwritten
bank account no later than close of the next business day upon receipt
of funds from beneficiaries, providers, or other entities.
2.2.2 The contractor shall submit,
upon deposit of funds from providers, beneficiaries, or other entities,
a credit TED record within two business days citing the appropriate
current fiscal year non-underwritten CLIN/ASAP Account Number. See
the TRICARE Systems Manual (TSM),
Chapter 2, Section 1.1.