TRICARE Overseas Program Provider Manual

TRICARE overseas Program
Provider Manual
Using the Provider Portal: Claims Report: View Report
■ Removed claims will display the following claim-specific
information:
(Note: Actual field order will depend on the view
option selected)
— Account or Invoice Number
— Patient Name
— Sponsor Number
— Claim Number
— Dates of Service
— Reason for Return
■ Processed claims display the following summary
information:
(Note: Actual field order will depend on the view
option selected)
The reports are formatted as follows:
■ Claim dates of service are displayed in the month/day/year
format. The month will be the first 3 characters of the
alphabetic spelling and the year will be in a 4-digit format.
■ All currency values are displayed in the Provider's local
currency and are displayed without a currency symbol or
indicator. The 3-byte currency code will appear in the report
header.
■ In .html or web page format, claims data will be separated by
the Provider attributed to the claim. In Excel format, each
Provider and their corresponding claim data will display on a
separate tab.
■ In-Process claims will display the following claim-specific
information:
(Note: Actual field order will depend on the
view option selected)
— Account or Invoice Number
— Patient Name
— Sponsor Number
— TOP Claim Number
— Dates of Service
— Amount Billed
— Check Number
— Processed Date
— Check Amount
— Account or Invoice Number
— Patient Name
— Sponsor Number
— Claim Number
— Dates of Service
— Amount Billed
— Amount Allowed
— Patient Owes
— Paid to Patient
— Paid to Provider
— Denial Flag (Y or N)
■ If the ‘Display Individual Charges’ option was selected for
processed claims, the following fields will display as
applicable to the claim and line:
— Line Item
— Procedure Code
— Revenue Code
— Number of Services
— Dates of Service
— Amount Billed
— Amount Allowed
— Patient Offset
— Provider Offset
— Paid by Patient
— OHI Paid
— OHI Patient Owes
— Reject
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