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TRICARE/CHAMPUS Operations Manual, Change 155, April 19, 2000

TRICARE/CHAMPUS Policy Manual, Change 13, April 19, 2000

Page Count: 0
Summary of Changes: This change adds the provision allowing the provider to appeal a determination if the beneficiary could not have reasonably known that the services were excluded as not medically necessary. It also clarifies Point of Service (POS) provision in referral management; how POS cost-shares will be paid under DRG-based payment system; and POS requirements when OHI is involved. This change is published in conjunction with Jul 1992 OPM Change 155.

ADP Manual, Change 10, January 19, 2000