Resources for Providers

Please explore below for the most commonly requested provider resources. Test-related information can be found in our test directory.

TriCore Claims Paid Out of Network

Recently, we were required to update our payer's systems with new corporate information which will allow claims to be processed and paid as an in-network provider. While this was occurring, we had claims on hold. However, a system error released some claims to payers that were not yet set up to accept these changes, causing claims to be processed as out-of-network. We are working with payers to have the impacted claims reprocessed as in-network. If you have any questions, please contact the business office at 505.247.0244 or toll-free at 877.267.2428.