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Frequently Asked Questions for Healthcare Providers

 
I have a discrepancy on my invoice. Whom should I contact?
 
Please contact your client collections specialist immediately. Clients A-L: contact Teresita Aguilar at 505-938-8062 or toll-free at 800-245-3296 Ext. 8062. Clients M-Z: call Renee Mehring at 505-938-8873 or 800-245-3296 Ext. 8873.
 
Why was I billed for this patient’s test on my client invoice?
 
When the requisition is marked to bill “client” the charges will fall onto your TriCore Client monthly invoice. Please contact your client collections specialist immediately to provide patient billing information. Due to contract limitations for filing limits, TriCore will only accept corrections within 15 business days of the original invoice date.
 
How often does TriCore send invoices?
 
We send our clients monthly invoices.
 
When is my payment due?
 
TriCore appreciates payment within 30 days from the original invoice date.
 
We ordered a test in error. Can this be removed from my invoice?
 
No. It’s our policy to bill for all tests for which we provide results.
 
Whom do I contact to provide purchase order details?
 
If you require a purchase order number listed on your invoice, please contact your sales representative directly with this information.
 
What information does TriCore require to bill my patient’s insurance directly?
 
We bill the patient’s insurance company directly for tests we perform when the following information is provided:
  • Patient’s name
  • Patient’s date of birth
  • Patient’s gender
  • Patient’s current address, including city, state, and zip code
  • Patient’s current phone number with area code
  • Patient relationship to subscriber
  • Insurance carrier details (name, address, phone number)
  • Subscriber name, policy number and group number
  • Ordering physician’s name and NPI
  • Valid ICD-9 diagnosis code pertaining to the date of service and meeting medical necessity. (TriCore will accept a narrative diagnosis on paper requisitions.)
 
Where can we locate Medicare’s LCD/NCD Local Coverage Determination/National Coverage Determination information?
 
Click here for Medicare's LCD/NCD information

Can I change a patient’s diagnosis to reflect a ‘routine’ visit so the patient’s claim will be paid at 100% by insurance?
  • Diagnosis codes cannot be assigned on the basis of increasing reimbursement.
  • If you saw your patient for a routine visit and discussed any other ailments with them during that visit, please send all diagnosis pertaining to that visit to TriCore.
  • TriCore will accept additional diagnoses information in writing. Please contact our patient billiing representatives at 505-247-0244 or toll-free at 877-267-2428 to get additional details and fax information.
  • TriCore will not remove previously submitted diagnosis information from a patient’s account without the office notes to support our submission of a changed/corrected claim to the payer. 
 
Why is my invoice so much?
 
While TriCore performs many routine clinical laboratory tests, we also perform many complicated esoteric tests such as genetic testing and molecular diagnostic testing. These complicated tests can be expensive. If you have questions regarding a specific test, please contact your sales representative or your client collections specialist.
 
Can I pay my invoice online?
 
Not at this time. In an effort to enhance our website, we’re planning to add this capability in the near future.
 
If you wish to make a credit card payment over the phone, please contact our Billing Department and our representatives will be happy to assist you.
 
My patient does not have insurance. Does TriCore offer any self-pay discounts?
 
TriCore does offer an uninsured discount on qualified laboratory tests. Please contact our Billing Department within 14 days after receiving your first bill for more information.
 
What insurance plans do you accept?
 
TriCore accepts most major health plans.
 
What are TriCore’s hours of operations and locations?
 
Click here for our list of Patient Care Centers
 
If you need help finding the closest Patient Care Center, please call the TriCore Client Services team at 505-938-8922 or toll-free at 800-245-3296.
 
Our address or contact information has changed. Whom do we notify?
 
Your client collections specialist can help you with these updates. Clients A-L: please contact Teresita Aguilar at 505-938-8062 or toll-free at 800-245-3296 Ext. 8062. Clients M-Z: please call Renee Mehring at 505-938-8873 or 800-245-3296 Ext. 8873.

 

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1001 Woodward Place NE
Albuquerque, NM 87102

505-938-8888 (24 hours)
800-245-3296 (24 hours)
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TriCore Reference Laboratories, 1001 Woodward Place NE, Albuquerque, NM 87102
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