TRICARE Overseas Program Provider Manual

TRICARE overseas Program
Provider Manual
Using the Provider Portal: The Provider Dashboard: Returned Claims View
Returned Claims: The Returned Claims tab shows claims that
you have submitted but were returned to you by the TOP Claims
Customer Service Department because information was missing,
which was needed for accurate claims processing and payment.
The Returned Claims view provides the following information:
■ Claim Number: This is the TRICARE Overseas Program
control number assigned to your claim for processing and
tracking on the Secure Claims Provider Portal.
■ Patient Name: Displays the last name and first name of the
patient on the claim.
■ Billed Amount: This field displays the sum of all charges that
were submitted on this claim.
■ Currency: This field displays the code representing the
currency in which the claim transaction was processed.
■ Provider Name: Displays the name of the individual provider
or the facility name.
■ Tax ID: Displays the 9-digit tax identification number of the
Provider. For Providers outside the 50 United States and the
U.S. territories, this is an identification number assigned to the
Provider by the TRICARE Overseas Program.
■ Date of Service: This field displays the earliest date of
service on the claim.
■ Invoice Number: If you added an invoice or record number to
your claim during the ‘Online Claims Submission’ process or
when you submitted a claim via postal mail, this number will
be displayed here.
■ Claim Status: This will display ‘Returned.’
You can also click the ‘Plus’ (+) symbol at the start of each line to
expand additional details about the claim. Some additional
information you will find in the expanded view includes the
‘Reason Returned’ field, which is a brief summary explaining why
the claim was returned to you, and a link to a .pdf version of the
letter sent to you (along with the returned claim) explaining in
detail why the claim was returned.
SECTIoN 6
The Provider Portal
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