TRICARE

  ATTENTION ALL HUMANA (TRI-CARE) PROVIDERS! Member Craig Marrer recently had two re-authorizations denied by Humana as the clients did not have updated Vineland 3 or SRS-2 assessments. After seeking clarification, he was informed that it was his responsibility (as the BCBA) to acquire and complete these assessments. If you are serving clients with Humana […]

Humana held a Webinar on 2/8/18 to discuss the changes from HNFS to Humana for Tricare.  Click here for the slides. Here are some highlights. Check out the operations manual for all of your questions: Chapter 18; Section 4 The Autism Demonstration will continue until 2023 Certification is separate from credentialing.  Go to the Humana […]

Attention TRICARE ABA providers You are probably aware that providers in Virginia are no longer working through TRICARE North (managed by Health Net Federal Services) and are now in TRICARE East (managed by Humana). Here is some handy contact information: Humana: 1-866-258-0942 credentialing Claims, Eligibility, etc.  1-800-444-5445 2 (provider), 2 (not hospital), 7 (other) then […]

  In 2016, advocates worked for 9 months to fight the reduction in Tricare’s ABA reimbursement rates (that went into effect in April 2016). Congress voted to reinstate rates to previous levels, effective 12/23/16. The National Defense Authorization Act (NDAA) passed last year. Current rates for direct treatment, as of 1/8/17, are $125 for BCBA-level […]