Many providers are unaware that they may be entitled to bonus payments of 10% when providing services to TRICARE beneficiaries.\u00a0 The process for determining eligibility is not simple, but the possible upside of eligibility is significant.<\/p>\n
Providers that are eligible to participate in the bonus program include podiatrists, physicians, oral surgeons, and\u00a0optometrists.\u00a0 In order for eligible providers to quality for these additional\u00a0payments, the provider needs to be rendering the underlying\u00a0health care service in a geographically approved health professional shortage are.\u00a0 If an eligible provider is located within a qualifying area, the provider then needs to take the additional step of appending the appropriate modifier to the claims for which the additional payments are being requested.<\/p>\n
Providers are, as a general rule, not allowed to apply for these payments retroactively, and therefore it is imperative that claims are appropriately billed at the time of initial submission.\u00a0 A wrinkle may arise if the provider is contracted with one of TRICARE’s managed care support contractors.\u00a0 In these situations, providers should review applicable contract terms, as well as applicable policies and procedures, to determine if the provider can seek retroactive corrections of claims billed which omitted the applicable modifier.<\/p>\n","protected":false},"excerpt":{"rendered":"
Many providers are unaware that they may be entitled to bonus payments of 10% when providing services to TRICARE beneficiaries.\u00a0 The process for determining eligibility is not simple, but the possible upside of eligibility is significant.<\/p>\n","protected":false},"author":113,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"ppma_author":[923],"class_list":["post-413","post","type-post","status-publish","format-standard","hentry","category-health-law"],"authors":[{"term_id":923,"user_id":113,"is_guest":0,"slug":"gabrodek","display_name":"Gregory A. Brodek","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/acf0e1397240ae03ac2bdf3bd607a2ba33a3d650512669e271e16bc5cf705b3a?s=96&d=blank&r=g","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/posts\/413","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/users\/113"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/comments?post=413"}],"version-history":[{"count":0,"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/posts\/413\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/media?parent=413"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/categories?post=413"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/tags?post=413"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/ppma_author?post=413"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}