NCHA sends letter to Congressman Jones requesting assistance with TRICARE issues

In early December 2017, NCHA began receiving numerous inquiries from our members regarding the transition to the new TRICARE East Regional Contractor, Humana Military. The inquiries outlined difficulties getting new providers enrolled, the inability to validate that current providers are properly enrolled and loaded into Humana’s system, the inability to obtain authorizations and referrals until Wisconsin Physicians Services (WPS) also loads the providers into their claims processing system (even if Humana has the providers loaded into its system), and problems reaching Humana staff for assistance. NCHA reached out to Humana Military in mid- December 2017 and early 2018 for assistance. We shared staff contacts and other information provided by Humana with our members.

NCHA reached out to Humana Military again in April 2018 requesting a specific individual within Humana to accept responsibility for putting together a team to resolve these issues quickly and to assist our members. While Humana recently assigned someone to look at the issues with certain hospitals, we are concerned, based on the lack of progress since Jan. 1, that these issues will not be resolved timely. Thus, we reached out to Congressman Walter Jones requesting assistance in working with Humana Military to develop solutions to its operational and resource issues so that our members can better serve TRICARE beneficiaries.

NCHA understands that a letter will be sent from Congressman Jones to Vice Admiral Raquel Bono, Director of the Defense Health Agency (DHA).  DHA is responsible for administering the TRICARE Health Plan. NCHA’s letter to Congressman Jones is attached.

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