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Why does TRICARE do this?

I had a referral for my keloid from my thyroid surgery. I get a letter from TRICARE that none of it is covered and I owe my provider 204 dollars. Then it has footnotes and one of the footnotes says 0 has been added to your catastrophic cap of 3,000 dollars. Um, isn't it 1,000? 

Let's just bask in the stupidness of Tricare and how much money they could save by sending these 4 page papers. This isn't the first time this has happened and if I didn't know any better I would be freaking the eff out. 

30 Rock Pictures, Images and Photos

Re: Why does TRICARE do this?

  • Call them.

    Both of my boys have skin conditions and had outbreaks. I got a referal to see a dermatologist because the out breaks were so bad.  We went to the doctor, got RX and everything cleared up. 

    Fast forward.  I got bills for both boys saying $0 was covered and owed the Dr $180 for each boy.  Hello?  What?  I called Tricare and was told that it was only covered with a referal.  I told her I had a referal from our Pedi.  She checks again.  Oh, I apologize.  I'll see this is taken care of.  Gee, thanks.  Now I only owe $30 per kid.

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  • Okay. Last time this happened I just waited for the bill to come to my house but it never did and was covered. I just went back to the dermatologist on the 1st and got my second set of injections. I would assume if my account had a balance, they would have told me and made me pay before another treatment.

    It says the claim was filed under the wrong SS number. So I assume it has nothing to do with the referral. 

    30 Rock Pictures, Images and Photos
  • imageKiller Cupcake:
    imageLemonLover33:

    Okay. Last time this happened I just waited for the bill to come to my house but it never did and was covered. I just went back to the dermatologist on the 1st and got my second set of injections. I would assume if my account had a balance, they would have told me and made me pay before another treatment.

    It says the claim was filed under the wrong SS number. So I assume it has nothing to do with the referral. 

    Don't assume too much.

    My dermatologist scheduled me for another appointment knowing that I had no referrals left. They also let me be seen once without a referral. I would have seen them a second time without one had I not asked the receptionist how many more I had. That's when she informed me that they actually expired two months ago.

    Oh, thanks wench. Now this visit is coming out of my pocket at full price. I appreciate it! 

    I'll give Tricare a call. My dermatologist office wouldn't treat me without seeing my referral. I have been keeping track of the appointments because I've heard of people getting screwed on that front as well.   

    30 Rock Pictures, Images and Photos
  • If you can, go to the local office on base.  I used to work in the referral management office (a base in the Triwest region), and I could call and ask the same exact answer twice and get two totally different answers.  Our local Tricare reps were always way more helpful.  They can explain the EOB to you as well.
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