TRICARE Providers Continue to Face Problems With Payment, Credentialing, Communication, and Claims

In mid-February, ASHA members began reporting problems with TRICARE West and TRICARE East, which provide health insurance to active-duty service members, retirees, and their family members. Many providers haven’t received payments since January 1, 2025, face credentialing delays and errors, and are running into problems with the claims portal. On top of that, providers report hours-long hold times or no response when emailing for support.

TRICARE’s problems go beyond ASHA members. Several thousand TRICARE providers from many different specialties are struggling to provide care while patients deal with long wait times and delayed authorizations.

What ASHA Advocacy Is Doing

The ASHA Advocacy team is deeply concerned about this situation and knows that providers cannot continue to provide services when they cannot get paid or file claims. We are working to help ASHA members resolve these issues.

ASHA Advocacy collected stories from over 150 ASHA members and used this information to send letters to TRICARE West, TRICARE East, and the Defense Health Agency. ASHA met with TriWest Health Alliance on March 5 and stressed that these problems are putting providers in dire straits. Many have had to discontinue services for TRICARE patients and are unable to accept new TRICARE patients. Others are taking out personal loans to make payroll and in some cases shuttering their practices.

TriWest Health Alliance shared that it has hired hundreds of new employees to clear the claims backlog and respond to provider inquiries. ASHA Advocacy will continue to push for timely and efficient claims processing.

We are working closely with other health care provider associations to elevate our voice on this issue. We’re also sharing your stories with interested lawmakers who are tackling the issue in Congress.

What Providers Can Do

Share your story with ASHA.

ASHA is collecting member stories to use in our ongoing advocacy. Please fill out this form or click the link below to share your story. Please also share with your colleagues so we can prove how widespread the problems are.

File a grievance.

There are a few ways providers can do this:

• They can file a grievance directly with the contractor in their region.
• They can file a grievance with the Defense Health Agency.
• They can contact their members of Congress.

Questions?

Please contact ASHA’s health care and education policy team at reimbursement@asha.org.