Reimbursement Policies

These reimbursement policies apply to the TRICARE Prime^® Demo by CareSource Military & Veterans^™ plan. Reimbursement policies are designed to assist you when submitting claims to us. They are routinely updated to promote accurate coding and policy clarification. These proprietary policies are not a guarantee of payment. Payments for claims may be subject to limitations and/or qualifications. Payment will be determined based upon a review of the actual services provided to a beneficiary and will be determined when the claim is received for processing. Providers and their office staff are encouraged to use self-service channels to verify beneficiary eligibility.