I have been seeing a lot of people sharing their struggles with Tricare on Facebook lately. Earlier this year marked a major triumph in my life. It marked the end of a year long battle with Tricare. And I won (for the most part)!
You see, The Boy gets civilian health insurance through his civilian job. But while he was deployed, we used Tricare. When The Boy came home, his job reinstated his insurance immediately, but didn’t tell us for a very long time, so we thought he was earning it back with time on the job. So, a little over a year and a half ago, I got a letter from Tricare saying that they had decided that we owed them for every visit they paid for since they did an audit and discovered we had double coverage.
Here’s what I learned in this Tricare Debacle:
- Tricare doesn’t bother to bill your other insurances. Instead, you will get a random $2,000 bill in the mail and have no idea why.
- Your civilian insurance is probably full of pretty nice people who will allow your doctors office to rebill those visits.
- Your civilian insurance will gladly pay their portion of the bills.
- Tricare will tell you to do the same.
- Tricare will then send you a denial letter for untimely filing of a claim.
- Tricare will send you this letter after each time they tell you to ask the doctors office to rebill them and they will pay.
- Tricare will then only pay for a few of the visits and then deny you again for untimely filing.
- You will repeat steps 4 through 8 about 19,000 times.
- You will call Tricare and speak with a manager of some kind who will review your file and agree that Tricare should pay since the bill was originally filed in a timely fashion but Tricare demanded you rebill them 19,000 times.
- You will then repeat steps 4 through 9 for an additional 6 months or what equals about 16,000 re-billings.
- A year later you will get a call from your doctors office saying that Tricare had finally paid every single visit… except one.
- You will spend thirty minutes debating if that one $100 bill is worth another year of fighting Tricare.
- You will ultimately decided that getting them to pay $1,900 is still a victory and you can eat that $100 purely to maintain your sanity.
- You will have a stiff drink to relax after a year of battling your insurance company.
And these, my friends, are the 14 steps to dealing with Tricare when it comes to rebilling visits. Luckily, I have found Tricare’s employees to be friendly and helpful. Sadly, there are some unseen, secret employees, who (in my mind) sit in a stone jail cell that is musty, moldy, and damp and click the denial box all day long purely out of the desire to make others as unhappy as they are. The Trolls of Tricare will wreak havoc on your claim every time. Persistence is key, as is a good stiff drink every now and then.