Originally Posted by
block30
Hello all, I'm looking for a little advice.
I was just wondering if anyone has had problems with Tricare? I'm a Guard guy using TRS and my wife and I are trying to get reimbursement for some care that our baby needs. Normally I have been quite satisfied with Tricare when the doctor's office is billed...they seem to know how to handle insurance companies.
However, now that my wife and I trying to get reimbursement for treatment we paid for out of pocket, we are getting the absolute run-around (to make a long story short). I'm honestly floored and angered at how much of a sh-- show it has been dealing with them and how long this has gone on.
Just curious if anyone has had problems and or has submitted a complaint about Tricare?
We had a point of service debate/debacle in 1995 (out of region asthma attack/ER visit) that took three years to settle...and we did everything by the book...no really...we did. I finally walked into a TRICARE office one morning and told them I wasn't leaving until it was fixed. I made sure they understood I was going to be a PITA all day everyday until they unscrewed what was wrong. 4 people on phones working the problem (initial input by someone was incorrect and they "can't" change it after the fact) for a couple hours...It was fixed by lunch.
After that, we go the extra mile to get the referral. Other than emergent situations (broken arm, viral meningitis, etc) we have forced the system to work within acceptable timelines. Word of advice - when seeking the odd referral make sure and have the doctor request more visits than you actually need. It limits the hoop jumping when procedures don't go as planned and you have to go back.
We just moved and our new PCM is awesome. They have a website where you can input referral request. They then determine if they even need to see you and will request the referral without an initial visit. We're 50-50 on them needing to see us to get the referral.