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TRICARE Systems Manual 7950.3-M, April 2015
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Table of Contents
Table of Contents
TRICARE Systems Manual 7950.3-M, April 2015, Change 73 (September 8, 2023)
Foreword
Chap 1 -- General Automated Data Processing (ADP) Requirements
Sect 1.1 -- General Automated Data Processing (ADP) Requirements
Sect 1.2 -- Beneficiary Authentication Requirements
Addendum A -- Defense Finance And Accounting Service (DFAS) Allotment Record Layouts For Defense Health Agency (DHA) Contracts
Addendum B -- United States Air Force (USAF) Allotment Record Layouts For Defense Health Agency (DHA) Contracts
Chap 2 -- TRICARE Encounter Data (TED)
Sect 1.1 -- Data Reporting - TRICARE Encounter Data (TED) Record Submission
Sect 1.2 -- Data Reporting - Provider File Record Submission
Sect 2.1 -- Data Requirements - Overview
Sect 2.2 -- Data Requirements - Data Element Layout
Sect 2.3 -- Data Requirements - Header Record Data
Sect 2.4 -- Data Requirements - Institutional/Non-Institutional Record Data Elements (A - D)
Sect 2.5 -- Data Requirements - Institutional/Non-Institutional Record Data Elements (E - L)
Sect 2.6 -- Data Requirements - Institutional/Non-Institutional Record Data Elements (M - O)
Sect 2.7 -- Data Requirements - Institutional/Non-Institutional Record Data Elements (P)
Sect 2.8 -- Data Requirements - Institutional/Non-Institutional Record Data Elements (Q - S)
Sect 2.9 -- Data Requirements - Institutional/Non-Institutional Record Data Elements (T - Z)
Sect 2.10 -- Data Requirements - Provider Record Data
Sect 3.1 -- General Edit Requirements - Overview
Sect 4.1 -- Header Edit Requirements (ELN 000 - 099)
Sect 5.1 -- Institutional Edit Requirements (ELN 000 - 099)
Sect 5.2 -- Institutional Edit Requirements (ELN 100 - 199)
Sect 5.3 -- Institutional Edit Requirements (ELN 200 - 299)
Sect 5.4 -- Institutional Edit Requirements (ELN 300 - 399)
Sect 5.5 -- Institutional Edit Requirements (ELN 400 - 499)
Sect 6.1 -- Non-Institutional Edit Requirements (ELN 000 - 099)
Sect 6.2 -- Non-Institutional Edit Requirements (ELN 100 - 199)
Sect 6.3 -- Non-Institutional Edit Requirements (ELN 200 - 299)
Sect 6.4 -- Non-Institutional Edit Requirements (ELN 300 - 399)
Sect 7.1 -- Provider Edit Requirements (ELN 000 - 099)
Sect 7.2 -- Provider Edit Requirements (ELN 100 - 199)
Sect 8.1 -- Financial Edit Requirements
Addendum A -- Data Requirements - Country And/Or Islands Codes
Addendum B -- Data Requirements - State Codes
Addendum C -- Data Requirements - Provider’s Major Specialty Codes
Addendum D -- Data Requirements - Type Of Institution Codes
Addendum E -- Data Requirements - Other Special Procedure Codes
Addendum F -- Data Requirements - Place Of Service/Type Of Service Allowable Relationships
Addendum G -- Data Requirements - Adjustment/Denial Reason Codes
Addendum H -- Data Requirements - Revenue Codes
Addendum I -- Data Requirements - Contract Area Of Responsibility
Addendum J -- Data Requirements - Pay Plan Code Valid Values
Addendum K -- Data Requirements - Dependent Elements And Values For Rank Code, Sponsor Pay Category
Addendum L -- Data Requirements - Health Care Delivery Program (HCDP) Plan Coverage Code Values
Addendum M -- Data Requirements - Default Values For Complete Claims Denials
Addendum N -- UB-04/UB-92 Conversion Table - To Be Used For Reporting Non-Institutional TRICARE Encounter Data (TED) Records
Chap 3 -- Defense Enrollment Eligibility Reporting System (DEERS)
Sect 1.1 -- General
Sect 2.1 -- Referenced Documents
Sect 3.1 -- Beneficiary Identification
Sect 4.1 -- Defense Enrollment Eligibility Reporting System (DEERS) Concepts
Sect 4.2 -- Defense Enrollment Eligibility Reporting System (DEERS) Functionality
Sect 4.3 -- Defense Manpower Data Center (DMDC) Support
Sect 4.4 -- Test Environment
Sect 5.1 -- Defense Enrollment Eligibility Reporting System (DEERS) Functions In Support Of The TRICARE Dental Program (TDP) And The TRICARE Retiree Dental Program (TRDP)
Sect 5.2 -- Defense Enrollment Eligibility Reporting System (DEERS) Functions In Support Of The TRICARE Active Duty Dental Program (ADDP)
Chap 4 -- TRICARE Duplicate Claims System (DCS) - TRICARE Encounter Data (TED) Version
Sect 1.1 -- Overview
Sect 1.2 -- Duplicate Claims Data
Sect 1.3 -- Multi-Contractor Claim Sets
Sect 1.4 -- System Implementation And Operational Requirements
Addendum A -- Duplicate Claims System (DCS) Displayed Data Fields
Addendum B -- Report Descriptions And Examples
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