Claims Clearinghouses

If your clearinghouse already files claims to PGBA for other lines of business, they will receive a notification from PGBA and an EDI FAQ on how to submit claims under TRICARE.

New direct submitters can establish clearinghouse services to transmit TRICARE claims electronically to PGBA for processing. Please get started by reviewing and submitting the forms below. The TRICARE West Region Payer ID is 99726.

Availity’s Basic Clearinghouse

Providers can use Availity's Basic Clearinghouse to submit electronic claims without a clearinghouse account. This option is free to TRICARE providers. Log in to Availity. Go to Payer Spaces and choose the TRICARE West tile. Click on the Resources tab, select the PGBA EDI Provider Trading Partner Agreement, complete and follow the instructions to submit the agreement form by either fax or mail.

EDI Provider Trading Partner Agreement

PGBA Payer ID for TriWest

Ensure your clearinghouse or vendor uses the correct Payer ID when submitting claims to PGBA, LLC, our claims processing partner for TriWest. Contact them using the contact information below for any specific IDs or questions regarding submissions.

  • TriWest Payer ID: 99726

Additional Assistance with EDI

For further assistance with EDI or specific inquiries, contact the TRICARE EDI Help Desk for the West Region by phone at 1-800-259-0264 or via email at EDI.TRICARE@PGBA.com.

Benefits of Using Availity Essentials

To assist you with your electronic claims submissions, register on Availity to:

  • Enroll in EDI claims submission. Electronic submission is encouraged!
  • Check claim status.
  • View/print a TRICARE Remittance Advice.
  • Enroll in Electronic Funds Transfer and/or Electronic Remittance Advice.