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TRICARE Operations Manual 6010.62-M, April 2021
TRICARE Medicare Eligible Program (TMEP)
Chapter 20
Section 3
Financial Administration
Revision:  C-12, August 14, 2024
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TRICARE requirements regarding financial administration shall apply to the TMEP unless specifically changed, waived, or superseded by this section or the TRICARE Policy Manual (TPM), TRICARE Reimbursement Manual (TRM), TRICARE Systems Manual (TSM), or TMEP contract.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  The TMEP shall follow contractor shall comply with the Financial Administration non-financially underwritten funds requirements in Chapter 3.
2.0  Payments to Beneficiaries/Providers
2.1  The provisions of TMEP contractor shall comply with the requirements in Chapter 3, Section 2 apply to TMEP. Chapter 3, Section 2, paragraphs 2.0 through 2.1.3 2.2 are superseded as described in paragraphs 2.2 and 2.3.
2.2  The TMEP contractor shall follow the contract requirements regarding provider Electronic Funds Transfer (EFT). Payments may be made by EFT The contractor shall not make EFT payments to beneficiaries.
2.3  NonThe contractor shall not make non-underwritten EFTs shall be done within two federal business days after receiving payment approval from DHA. Rejected The contractor may pay rejected EFTs may be made as with 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 contractor shall comply with the requirements in Chapter 3, Section 3 apply to TMEP, except for Chapter 3, Section 3, paragraphs 2.1 through 2.1.2.2.
4.0  Stale Dated, Voided, Or Returned Checks
The provisions of TMEP contractor shall comply with the requirements in Chapter 3, Section 4 apply to TMEP.
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