<div class="faq-list__item"><h4 class="faq-list__question">Where can I find out more about TRICARE and my responsibilities as a TOP Network Provider?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>As the TOP Contractor, International SOS keeps you informed with the most up-to-date, relevant information pertaining to the delivery of quality care on behalf of TOP beneficiaries, including information about TRICARE policy requirements, procedural and policy guidelines, claims submission, care delivery nuances, and more. Please visit the following webpages for TOP provider education materials:</p> <ul> <li><a href="https://tricare.mil/" target="_blank">TRICARE.mil</a></li> <li>TOP 2021 Contract Updates: <a href="https://tricare-overseas.com/providers/resources/top-2021" target="_blank">https://tricare-overseas.com/providers/resources/top-2021</a></li> <li>COVID-19 TOP Provider Updates: <a href="https://tricare-overseas.com/providers/resources/covid-19-information-for-top-providers" target="_blank">https://tricare-overseas.com/providers/resources/covid-19-information-for-top-providers</a></li> <li>TOP Provider Educational Resources:&nbsp;<a href="http://www.tricare-overseas.com/providers/resources/educational-resources" target="_blank">http://www.tricare-overseas.com/providers/resources/educational-resources</a></li> <li>TOP Medical Care Briefs:&nbsp;<a href="https://tricare-overseas.com/providers/resources/medical-care-briefs" target="_blank">http://www.tricare-overseas.com/providers/resources/medical-care-briefs</a></li> <li>TOP Provider Newsletters:&nbsp;<a href="https://tricare-overseas.com/providers/resources/top-provider-newsletters" target="_blank">http://www.tricare-overseas.com/providers/resources/top-provider-newsletters</a></li> </ul> <p><br></p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">What if I forget to sign the Claim form?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>If you do not sign the Claim form, the claim will be returned and will NOT be processed. Once you receive the returned claim, you will be asked to sign the form and resend it to the TOP Claims Processor. This will delay your payments.</p> <p>International SOS recommends that you fill out a “Provider Signature on File” (SOF) form and return it to your TOP Regional Call Center (contact details are included on the bottom half of the form). The “Provider Signature on File (SOF)” form is available here:&nbsp;<a href="https://tricare-overseas.com/providers/resources/provider-forms" target="_blank">http://www.tricare-overseas.com/providers/resources/provider-forms</a></p> <p>If International SOS has a Provider SOF Form in our records, this will safeguard you and ensure your claim is processed.</p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">Who can I contact if I am unsure if a patient is authorized to receive care?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>Providers are encouraged to&nbsp;<a href="https://portal.tricare-overseas.com/wps/portal/osp/registration/!ut/p/z1/jY9BC4JAFIR_SweP-p4JIt32UIh5ECK0d4nVNl1QV9bNpX-f1DWtuc3wzcAAQQHU80nW3EjV83b2FwqvWRyHsR9hin66R5Zlp4Rto-B4CCB_A7gghkD_9FcAWp_PgX4hCVDdqvLzhvVlENVAWtyFFtp76DlujBl2DjporfWMlhXXwlWT0KPgo1epzsFBq0ne5uTbSKNGA8VSGYbuXKBL5dOyzQsqhQpV/dz/d5/L2dBISEvZ0FBIS9nQSEh/" target="_blank">register</a>&nbsp;on the Provider Online Secure Claims Portal, which offers an option to check patient eligibility and shows instant results. Additionally, if you have any questions regarding beneficiary eligibility or if a patient is authorized to receive care, please&nbsp;<a href="https://tricare-overseas.com/contact-us" target="_blank">contact</a>&nbsp;your TOP Regional Call Center and listen carefully to the prompts for the best option to serve you.</p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">What is the difference between my provider ID Number (TEPRV) and the authorization number?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>A <b>Provider ID Number (TEPRV)</b> is assigned by the TOP Claims Processor when your first TOP claim has been paid or reimbursed. This will always be your unique identifier with the TOP Claims Processor. You can find this number at the top of your Explanation of Benefits (EOB). It appears in the following format: GBR123456GBR A000 (usually 16-18 characters).</p> <p>The <b>Authorization Number</b> is the number issued by International SOS when we issue a new Authorization. You will receive a NEW Authorization Number for every Authorization issued. The Authorization Number can be found on the top right-hand corner of the International SOS Authorization.</p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">How often will I be asked to change my password on the Provider Secure Claims Portal?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>Passwords shall be changed&nbsp;every 150 days.&nbsp;</p> <ul> <li>You will automatically be prompted to change your password&nbsp;</li> <li>Do not include your username, first name, or last name in your password&nbsp;</li> <li>You will not be able to change your password until it is a least one (1) day old&nbsp;</li> <li>After three (3) unsuccessful login attempts, your account will be locked&nbsp;</li> <li>The system does not allow the following special characters: " []{}^\\|~()&lt;&gt;/=.:;')</li> <li>You will not be able to re-use a password from the last five (5) previous passwords&nbsp;</li> </ul> <p>Note:&nbsp;If your account has been inactive for over a year and a half, your account will be deactivated. If you have questions or need assistance, please&nbsp;<a href="https://tricare-overseas.com/contact-us" target="_blank">contact</a>&nbsp;the TOP Regional Call Center and listen carefully to the prompts for the best option to serve you.</p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">What if the TOP beneficiary had Other Health Insurance (OHI) at the time of the date of service, but no longer has OHI?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>By law, TRICARE pays after all other health insurance, except for:</p> <ul> <li>Medicaid</li> <li>TRICARE supplements</li> <li>State Victims of Crime Compensation Programs</li> <li>Other Federal Government Programs identified by the Director, Defense Health Agency (i.e., Indian Health Service)</li> </ul> <p>This means that a patient’s Other Health Insurance (OHI) should process the claim&nbsp;first. Any charges not paid by the OHI may be resubmitted to the TOP Claims Processor for reimbursement. The TOP Claims Processor will determine if the beneficiary had OHI at the time the service was delivered and process the claim accordingly. You can always verify a patient’s OHI status on the Provider Online Secure Claims Portal.</p> <p>Note:&nbsp;Claims for care received overseas must be filed within three years of the date of service or within three years of the date of an inpatient discharge; claims for care received in the United States or U.S. Territories must be filed within one year of the date of service of the date of an inpatient discharge.&nbsp;</p> <p>Note:&nbsp;OHI does not apply to Active Duty Service Members (ADSMs), as TRICARE is the primary payer for covered medical services.</p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">How do I identify a TRICARE patient?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>It is important to remember that not all U.S. patients are TRICARE patients. TRICARE patients who seek care from overseas providers will have one of the following ways to prove they are TRICARE eligible:</p> <ul> <li>TOP Providers registered to the Secure Claims Portal can use the first nine (9) digits of the DoD Benefits Number (DBN) (printed on the back of the beneficiary’s ID card above the bar code).</li> <li>Ask the beneficiary to provide his/her sponsor’s SSN verbally or in writing.</li> <li>TRICARE Prime Overseas or TRICARE Prime Remote Overseas Enrollment Cards or a valid DoD ID card or Common Access Card (CAC).</li> </ul> <p>We also encourage you to photocopy both sides of a patient’s Military ID Card or TRICARE Enrollment Card. TRICARE Prime Overseas and TRICARE Prime Remote Overseas beneficiaries will be issued an Authorization from International SOS, which should verify the patient’s eligibility to receive care from your facility. TRICARE Select Overseas and other TRICARE beneficiaries will only receive an Authorization for very limited types of medical care requiring prior authorization. If you have a question/concern about an individual patient, you may contact your TOP Regional Call Center (listen carefully to the prompts for the best option to serve you) to speak with a member of the International SOS Authorization Team.</p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">Why should I register on the Provider Secure Claims Portal?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>The Provider Secure Claims Portal allows you to view information about:</p> <ul> <li>Claims status for all submitted TOP claims</li> <li>Beneficiary eligibility</li> <li>TOP claims reimbursement (payment) and reconciliation information</li> <li>Returned or denied claims</li> <li>Ability to sign up for electronic explanation of benefits (EOBs)</li> <li>Easy-to-use, efficient claims submission methods</li> <li>Extensive and detailed claims reporting options available</li> <li>Faster TOP claims processing (Note: Paperless processing allows for digital mailing versus postal mail, offering a more green approach)</li> </ul> <p>You can access informative <a href="https://tricare-overseas.com/providers/claims" target="_blank">Quick Start Guides,</a> to learn more about how to register and use the Provider Secure Claims Portal for claims submission.</p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">I’m an Overseas Dental Provider already treating a TRICARE Prime Remote Overseas ADSM. How does the TRICARE Active Duty Dental Program transition to United Concordia Companies, Inc. (UCCI) affect me?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>If the dental care was authorized by&nbsp;International SOS<strong> before&nbsp;May 1, 2022, you should continue to deliver treatment</strong> as outlined in the Authorized Dental Treatment Plan until all care has been completed<strong>. </strong></p> <ul> <li>For dental care delivered to TRICARE Prime Remote Overseas ADSMs before May 1, 2022, please submit your claim to the TOP<strong> </strong>Claims Processor via the<a href="https://portal.tricare-overseas.com/wps/portal/osp/login/!ut/p/z1/hY69CoMwFIWfpYOj3msFK90ylIo4CB1q71KipCqokZvU0LdvoGvFs52fDw4Q1ECzXIdO2kHPcvT-QemzyvM0jzMsMS4vKKrqVohjllzxBPe9AfkaNyTQ87Q3KYC6UTe_N2JukqwDYvVSrDh6s497axdzDjBA51xkeWglq1Cvio2SJmr1FOA_uNfGQr3FwDLVGFLzceJw-AI_cnvG/dz/d5/L2dBISEvZ0FBIS9nQSEh/" target="_blank"> <strong>Secure Provider Online Secure Claims Portal</strong></a>. Alternatively, claims may be sent via fax or postal mail.<strong> </strong>Visit <a href="http://www.tricare-overseas.com/providers/claims" target="_blank"><strong>www.tricare-overseas.com/providers/claims</strong></a><strong> </strong>for more information.</li> <li>For dental care delivered to TRICARE Prime Remote Overseas ADSMs <strong>after May 1, 2022</strong>, please submit the claim to UCCI, the TRICARE Active Duty Dental Program (ADDP) contractor. Visit <a href="https://secure.addp-ucci.com/home" target="_blank"><strong>https://secure.addp-ucci.com/home</strong></a> or the <a href="https://www.tricare.mil/CoveredServices/Dental/ADDental" target="_blank"><strong>TRICARE ADDP webpage</strong></a> for more information.</li> </ul></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">As a TOP Provider, am I required to submit complete patient medical records to International SOS for all TRICARE Overseas beneficiaries?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>TOP Providers are REQUIRED to submit medical records for ALL AUTHORIZED CARE, including inpatient, outpatient, and telehealth services.</p> <p>Note: Durable Equipment (DE) is excluded from this requirement. International SOS ONLY requires medical reports for Active Duty Service Members (ADSMs) and Active Duty Family Members (ADFMs).</p> <p>For more information, visit <a href="https://tricare-overseas.com/providers/medical-records-collection" target="_blank">https://tricare-overseas.com/providers/medical-records-collection</a></p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">How can I obtain language assistance services during an appointment with a TOP beneficiary?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>Real-time telephonic language assistance services are available to TOP beneficiaries at the time of their medical appointment. International SOS’ telephonic language assistance service is meant to help facilitate interaction between beneficiaries and their overseas providers.</p> <p>These services are available in over 200 different languages and can be utilized at the time of a beneficiary’s medical appointment by contacting the TOP Regional Call Center.</p> <p>If a TOP beneficiary needs to use the telephonic language assistance service at the time of a medical appointment, please <a href="http://www.tricare-overseas.com/contact-us" target="_blank">contact</a> your International SOS TOP Regional Call Center and press Option 1.</p> <p>Please ensure that the following patient/beneficiary information is readily available when calling International SOS:</p> <ul> <li>Full Name of Beneficiary</li> <li>DoD Benefits Number (DBN)</li> <li>Social Security Number (SSN)</li> <li>Date of Birth (DOB)</li> </ul></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">What is the quickest way of being reimbursed for TOP Claims?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>To ensure TOP Providers receive payment for your services as quickly as possible, International SOS recommends registering for electronic bank payments. Currently, the TOP Claims Processor can make payments in over 100 currencies.</p> <p>Forms can be downloaded at <a href="https://tricare-overseas.com/providers/resources/provider-forms" target="_blank">https://tricare-overseas.com/providers/resources/provider-forms</a> and can be returned via email to the TOP Claims Processor at <a href="mailto:Intl.SOS.Provider.Inquiries@wpsic.com" target="_blank">Intl.SOS.Provider.Inquiries@wpsic.com</a>.</p> <p>If you would like to receive your Explanation of Benefits (EOB) electronically (not via postal mail) then you will need to register on the <a href="https://portal.tricare-overseas.com/wps/portal/osp/registration/!ut/p/z1/jY9NC4JAFEV_SwuX-p4JIu1mUYi5ECK0t4lRxg9QR2Ymh_59Utu03u5ezrnwgKAAGvncNdx0cuT9km8U3rM4DmM_whT99Igsyy4J20fB-RRA_gZw5RgC_eNvALQ9nwP9QhKgppfl5xs2lkHUAClRCyWU91BL3Roz6YODDlprPaO6iivhylkoLbj2Kjk4-E1upTZQrDkwDdcCXSqflu1eW47N0A!!/dz/d5/L2dBISEvZ0FBIS9nQSEh/" target="_blank">Provider Secure Claims Portal</a>. You can access informative <a href="https://tricare-overseas.com/providers/claims" target="_blank">Quick Start Guides,</a> to learn more about how to register and use the Provider Secure Claims Portal for claims submission.</p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">Who do I notify if my operating hours have changed or if a specialty is no longer available?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>Please notify International SOS if your operating hours have changed or if some specialties are no longer available.</p> <p>&nbsp;International SOS understands that TOP Providers may need to close their practice or adjust their services and/or operating hours. We also understand that circumstances and guidelines may change rapidly and often with short notice. If there will be a critical change in your operations, please notify International SOS as soon as possible by <a href="http://www.tricare-overseas.com/contact-us" target="_blank">contacting</a> your TOP Regional Call Center to speak with a member of the TOP Provider Support Services (TPSS) Team.</p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">How often does International SOS conduct site assessments and what is required as part of the visit?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p style="text-align: justify;">When signing the Standard Network Agreement, International SOS is contractually required to visit TOP Network Provider facilities at least every three years. The site visit includes a tour of the facility, an administrative meeting, and a face-to-face education session. Within a hospital/clinic, the tour will specifically include the ER, Imaging, ICU, Maternity, NICU and inpatient wards, specialist outpatient sections, and laboratories. Within a General Practitioner (GP) Practice, Group Practice, Individual Specialist, Imaging, or Laboratory Provider, International SOS will tour the facility and review such practices as handwashing, types of sterilization used, vaccination expiration dates, etc.</p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">Does emergency care require an International SOS authorization?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>It is not necessary for emergency care providers to contact international SOS before rendering emergency medical care to TRICARE Overseas beneficiaries. Authorization is required only if the emergency services result in an inpatient hospital admission. For additional information regarding delivering Emergency Care on behalf of TRICARE Overseas beneficiaries, visit the <a href="https://www.tricare-overseas.com/providers/resources/medical-care-briefs" target="_blank">Medical Care Briefs</a> page to download the Emergency Care: Procedural Guidelines for Providers fact sheet.</p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">Is the patient required to sign the TOP Claim Form before submitting it to the TOP Claims Processor?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>As a TOP Network Provider, you must obtain TRICARE patients’ signatures and keep a record of their signatures on file. The beneficiary’s signature confirms that medical services were delivered, and it also provides consent from the patient to release medical information to an Military Treatment Facility (MTF) or International SOS, to be used for medical care oversight, claims processing, and post-payment review purposes.</p> <p>The beneficiary signature is required for non-institutional providers (Group Practices, Doctors) unless the provider has a beneficiary signature on file (SOF). You must indicate “SOF” in the Patient Signature section of the claim form – otherwise, the TOP Claim will be denied.</p> <p>Institutional providers are not required to have the patient sign the form, but are required to have a permanent hospital record containing a signed release of medical information on behalf of the beneficiary.</p> <p>Please use the “Patient Administration Form (PAF)” provided to you by International SOS (sent to you with your Authorization) or your own admission forms to document the patient’s signature. Once obtained, the patient’s signature should be kept on file and used whenever they are admitted and/or scheduled for inpatient or outpatient medical treatment. The provider signature is always required.</p> <p>ALL these forms assist you in reducing the risk of claims being returned if signatures are missing on the TOP Claim Form. To access these forms, visit <a href="https://www.tricare-overseas.com/providers/resources/provider-forms" target="_blank">https://www.tricare-overseas.com/providers/resources/provider-forms</a></p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">How do I change the validity period or number of visits on the International SOS Authorization?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>For TRICARE Prime Overseas beneficiaries, please ask the beneficiary to contact their Primary Care Manager (PCM) and request that they submit an additional Authorization for care, to increase the validity period, or to add additional visits.</p> <p>TRICARE Prime Remote Overseas beneficiaries should <a href="http://www.tricare-overseas.com/contact-us" target="_blank">contact</a> the TRICARE Regional Call Center for assistance.</p></article></div></div><div class="faq-list__item"><h4 class="faq-list__question">How do I find out what is covered by an International SOS Authorization?</h4><div class="faq-list__answer" style="display: none;"><article class="faq-list__text"><p>An International SOS Authorization will only be issued for TRICARE Covered Services. If the beneficiary is not eligible to receive care, International SOS will not issue an Authorization. For more information about TRICARE Covered Services, Exclusions, and Limitations, visit <a href="http://www.tricare.mil/coveredservices" target="_blank">www.tricare.mil/coveredservices</a> Alternatively, <a href="http://www.tricare-overseas.com/contact-us" target="_blank">contact</a> the TOP Regional Call Center for assistance.</p></article></div></div>