Join Early Retirement Today
Reply
 
Thread Tools Search this Thread Display Modes
Tricare rejected provider claim
Old 11-08-2010, 04:20 PM   #1
Recycles dryer sheets
Elderdude's Avatar
 
Join Date: Jun 2005
Location: Sacramento, Calif
Posts: 210
Tricare rejected provider claim

My mother-in-law received a bill from a lab for services provided to her skin cancer doctor. The lab stated that Tricare rejected the claim for insufficient data. MIL is a military widow approaching her 90's who has not had many complaints about Tricare before, (and, in my opinion, MIL's a hypochondriacal dingbat who makes plenty use this service.) My wife has seen the letter and I advised her to take it to the doctor who submitted the lab request and see if it was a clerical oversight either on the doctor's or the lab's submission.

Any retired military who have a comment about this?
__________________

__________________
Elderdude is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 11-08-2010, 06:20 PM   #2
Moderator Emeritus
Nords's Avatar
 
Join Date: Dec 2002
Location: Oahu
Posts: 26,620
Quote:
Originally Posted by Elderdude View Post
Any retired military who have a comment about this?
I don't have any solutions beyond what you're already doing, but two suggestions:

The lab might have made a formatting/code error on their claim, and they have their own set of Tricare phone numbers to call for solutions.

If your MIL is near a military clinic, they have a "Tricare ombudsman" on staff who can talk her through her options for letting the doctor handle it, calling Tricare, and so on.
__________________

__________________
*
*

The book written on E-R.org, "The Military Guide to Financial Independence and Retirement", on sale now! For more info see "About Me" in my profile.
I don't spend much time here anymore, so please send me a PM. Thanks.
Nords is offline   Reply With Quote
Old 11-09-2010, 07:59 AM   #3
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
braumeister's Avatar
 
Join Date: Feb 2010
Location: Northern Kentucky
Posts: 8,623
I had a claim from a visit to my primary care physician rejected by Tricare last year.
I emailed Tricare from their website and asked about it. They replied within 24 hours, explaining that the doctor's office used the wrong code. They told me what the right code should be, and I informed the doctor's office.

Problem solved.
__________________
Pas de lieu Rhône que nous.
braumeister is offline   Reply With Quote
Old 11-09-2010, 10:30 AM   #4
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2005
Posts: 13,290
Don't know if you can call... we had a dental claim rejected (obviously not this insurance) and after calling I found that the doc did not put down the birth date....


I kind of yelled at the girl on the phone... don't you have all the other info showing he (step son) is on the account Yes... then who CARES about a birthdate

Talked to the dentist office, they resubmitted with birthdate and it went through...
__________________
Texas Proud is online now   Reply With Quote
Old 11-09-2010, 01:15 PM   #5
Moderator Emeritus
 
Join Date: Oct 2007
Posts: 4,929
Quote:
Originally Posted by Texas Proud View Post
Don't know if you can call... we had a dental claim rejected (obviously not this insurance) and after calling I found that the doc did not put down the birth date....

I kind of yelled at the girl on the phone... don't you have all the other info showing he (step son) is on the account Yes... then who CARES about a birthdate
Once you realize that the claims processor's real job title is 'Loss Mitigation Processor', and what you call claims are what the processor calls losses, you'll understand why. The claim was probably initially rejected by machine, and it could be that the girl you talked to was the first human to look at the claim.

(Aeons ago, I did some on-site visits to look at machine vision problems, and one was to a claims processing back office. Sort of mind-numbing, and not in a good way.)
__________________
M Paquette is offline   Reply With Quote
Old 11-09-2010, 01:50 PM   #6
Recycles dryer sheets
Elderdude's Avatar
 
Join Date: Jun 2005
Location: Sacramento, Calif
Posts: 210
Thanks for your contributions everyone. Mother-in-law's lab work claim rejection by Tricare is no longer an issue. As we all suspected it was a clerical error. The dingbat is now happily schedualing her regular 30 or 40 doctor's appointments for the next two weeks.
__________________
Elderdude is offline   Reply With Quote
Old 11-09-2010, 04:18 PM   #7
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
haha's Avatar
 
Join Date: Apr 2003
Location: Hooverville
Posts: 22,387
Quote:
Originally Posted by Elderdude View Post
The dingbat is now happily schedualing her regular 30 or 40 doctor's appointments for the next two weeks.
She has discovered what to do all day.
__________________

__________________
"As a general rule, the more dangerous or inappropriate a conversation, the more interesting it is."-Scott Adams
haha is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
$500K income, 800 credit score -- rejected for home loan? Kabekew FIRE and Money 21 09-17-2010 02:04 PM
Can I claim her as a dependent? rec7 FIRE and Money 11 03-19-2010 06:19 PM
If not a professional, but getting paid, do I have to claim it? If yes, how? Fireup2020 FIRE and Money 5 03-09-2007 04:02 PM
Rental Car Liability Claim BigMoneyJim Other topics 12 05-18-2006 01:24 PM

 

 
All times are GMT -6. The time now is 12:03 PM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.