In a continued effort to protect the privacy and security of TRICARE's 9.6 million beneficiaries, starting June 1, 2011, the Department of Defense (DoD) will no longer issue military ID cards with an individual's Social Security Number (SSN) as an identifier.
SSNs will be removed from ID cards and the DoD will issue new cards as individuals enlist or as a card expires. It is anticipated that there will be a four year transition time to issue all new cards.
SSNs will be replaced by two new numbers:
- DoD Identification Number (DoD EDI-PI or DoD ID): This unique 10-digit number is assigned to every person with a direct relationship with the DoD (as determined by having a record in the Defense Enrollment Eligibility Reporting System [DEERS]). This number already exists and is commonly known as the Electronic Data Interchange Person Identifier (EDI-PI).
- DoD Benefits Number (DBN): This 11-digit number will be used to determine benefits eligibility. The first nine digits are common to the sponsor; the last two digits identify the specific person, much like with a commercial benefit plan. The number can be found above the bar code on the back of the beneficiary's ID card.
The SSN is still a valid identifier and will not be removed from the government systems. As such, providers can still use their existing processes and forms to collect information from the beneficiaries including the sponsor's SSN.
With this change, providers will have additional options to check a TRICARE beneficiary's eligibility.
- TriWest's secure website will allow verification with either the SSN or the first nine digits of the DBN.
- EDI 270/271 can verify eligibility using all three options: SSN, DoD ID or DBN.
- TriWest's Interactive Voice Response (IVR) system can currently verify with the sponsor's SSN and will be changed to accept both the DoD ID and DBN. Please monitor the provider eNews for updates.
In case a beneficiary cannot recall their or their sponsor's SSN, providers who are secure website users may query the eligibility by using the following three data elements, which must be completed/entered in the same query:
- First nine digits of the DBN, placing this data in the SSN data field
- Individual's first name
- Individual's Date of Birth
TriWest will submit the information electronically to DEERS for validation. The provider will then receive the patient's/sponsor's SSN data from DEERS via TriWest's IT systems.
Providers submitting referrals/authorizations online may use the SSN, DoD ID or the first nine digits of the DBN to submit their claims. Those who submit using the fax process may also use any of the three ID numbers. Registered providers can use the sponsors' SSN or patient name and date of birth to view referral/authorization status.
Claims Submission and Claims Status
Providers submitting claims online at http://www.triwest.com/ may use either the SSN or DBN to submit their claims. Those who submit via EDI or by paper may use any three of the ID numbers. Registered providers may use the SSN or DBN to view claims status. Those submitting via EDI may use all three numbers to view claims status. Those using the IVR system may check claims status with the SSN. The IVR system will be enhanced to additionally accept the DoD ID and DBN.
For additional information, please refer to the Patient Eligibility section of www.triwest.com/provider for some frequently asked questions.