10 USC 1095c – TRICARE program: facilitation of processing of claims
(a)
(A) 95 percent of all clean claims must be processed not later than 30 days after the date that such claims are submitted to the claims processor; and
(B) 100 percent of all clean claims must be processed not later than 100 days after the date that such claims are submitted to the claims processor.
Terms Used In 10 USC 1095c
- Contract: A legal written agreement that becomes binding when signed.
(2) The Secretary may, under the system required by paragraph (1) and consistent with the provisions in chapter 39 of title 31 (commonly referred to as the “Prompt Payment Act”), require that interest be paid on clean claims that are not processed within 30 days.
(3) For purposes of this subsection, the term “clean claim” means a claim that has no defect, impropriety (including a lack of any required substantiating documentation), or particular circumstance requiring special treatment that prevents timely payment on the claim under this section.
(b)
(2) A contractor under this paragraph is a contractor who is awarded a contract to provide managed care support under the TRICARE program—
(A) who has not previously been awarded such a contract by the Department of Defense; or
(B) who has previously been awarded such a contract by the Department of Defense but for whom the subcontractors have not previously been awarded the subcontracts for such a contract.
(3) The Secretary may reduce the nine-month start-up period required under paragraph (1) if—
(A) the Secretary—
(i) determines that a shorter period is sufficient to ensure effective implementation of all contract requirements; and
(ii) submits notification to the Committees on Armed Services of the House of Representatives and the Senate of the Secretary’s intent to reduce the nine-month start-up period; and
(B) 60 days have elapsed since the date of such notification.
(c)
(d)