TRICARE Medicare Claims Processing Services

The TRICARE Medicare Claims Processing Services subcontract involves providing end-to-end adjudication and payment of healthcare claims for prime contractors supporting the Defense Health Agency. The service provider is responsible for verifying eligibility through DEERS and ensuring all claims are processed in strict accordance with Title 10 USC Chapter 55, 32 CFR Parts 199.4 and 199.5, and the TRICARE Reimbursement and Policy Manuals. To qualify for this engagement, the contractor must maintain CMMC Level 2 certification and ensure full compliance with the HIPAA Privacy Rule. The primary objective is the delivery of accurately adjudicated claims and processed payments under NAICS code 541990. The response deadline for this opportunity is November 6, 2026.