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Module 4: TRI CARE Prime Remote Module Objectives After this module, you should be able to: ? Describe some key features of TRI CARE Prime Remote ? Note charges associated with TRI CARE Prime Remote
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Obtain a copy of the module 4 tricare prime form.
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Carefully read and understand the instructions on the form.
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Provide accurate and complete personal information, including name, address, and contact details.
04
Review the eligibility requirements for tricare prime and ensure you meet all the criteria.
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Provide information about your primary care manager and any dependents you wish to enroll.
06
Indicate whether you wish to have automatic monthly premium payments or if you will make manual payments.
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Who needs module 4 tricare prime:

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Active duty service members who want to enroll themselves and their family in tricare prime.
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Certain retired service members and their family members who are eligible for tricare prime.
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Family members of active duty service members who want tricare prime coverage.
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Survivors of deceased active duty service members who are eligible for tricare prime benefits.
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National Guard and Reserve members and their family members who qualify for tricare prime.
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Module 4 Tricare Prime is a form used by providers to submit claims for healthcare services rendered to Tricare Prime beneficiaries.
Healthcare providers who have provided services to Tricare Prime beneficiaries are required to file module 4.
Module 4 Tricare Prime can be filled out electronically or manually following the instructions provided by Tricare.
The purpose of module 4 Tricare Prime is to facilitate the processing of claims for healthcare services provided to Tricare Prime beneficiaries.
Module 4 Tricare Prime requires information such as patient demographics, provider information, diagnosis codes, procedure codes, and charges.
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