tci ED Coding & Reimbursement Alert - 2017 Issue 9

Reader Question: Know When Tricare Pays First

Question: We had a patient present with Tricare and Medicaid. We know that Tricare is always the secondary payer so we billed Medicaid first and the claim was denied, saying that Medicaid is not primary. Now we’re confused. Can you advise? Sueprcoder.com Subscriber Answer: This is an area of billing complexity. Tricare is typically the secondary payer — but there are a few exceptions to that well-known rule, and one exception involves Medicaid. If a particular patient has Tricare as well as insurance through another source, you should almost always consider the other insurance primary, but that...

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