Ok so see my vent and you will find that my ped is trying to charge us for a hearing test that tricare denied. When talking with the rep about it the first time it happened she stated that more then likely they were double dipping. That the hearing test could be considered inclusive with the 5 yr check up. Soooo my question is what can i say to the dr's office when I call on Monday. I refuse to pay for this since we have prime it should be covered.and I am not going to be bullied into paying for it to get them off my back. I have already talked to this office once and got a lady stating that 'she deals with tricare daily :rolleyes and so she knows how to submit claims'. I just need help, being in this remote area makes it harder because I feel like I am the middle man ferrying info between the dr's office and tricare. :gaah

((hugs)) I dont have any advice. But if tricare denied it, I dont know what can be done. I am so glad we dont deal with them anymore!

:bump

I would flat tell her. If she "knows" how to deal with tricare, then she can deal with it. That you are prime and that their agreement with tricare is that you pay NOTHING. If she cant figure it out, then they need to write it off and quit billing you for something that she doesnt know how to bill tricare for to get payment.


***did that make sense?:giggle

I guess Im confused, do you mean they did something and then tricare denied it and didnt want to pay for it?

I dont think there is much to do...It was explained to me by our insurance company that our dr sends them a list of the things that were done, they approve it or not...IE-I need some special stuff for my back. My DR told me to do this step first so that the insurance doesnt deny something.

But had someone called tricare before hand and said something about the hearing test then I could see that its a crock.

If TriCare denied the test, you can petition it.

If the TriCare denied the request than your Pediatrician's office needs to either put the test in with the 5 yr check up or they need to send in a referral for it.

Your husband *should* have a Tricare rep at his NRD that handles claims that are unpaid. Have him call on Monday and get the name and number if he can't PM me and I'll get you in touch w/the Tricare rep that helped us.

I guess Im confused, do you mean they did something and then tricare denied it and didnt want to pay for it?

I dont think there is much to do...It was explained to me by our insurance company that our dr sends them a list of the things that were done, they approve it or not...IE-I need some special stuff for my back. My DR told me to do this step first so that the insurance doesnt deny something.

But had someone called tricare before hand and said something about the hearing test then I could see that its a crock.
the hearing test is covered, the doctor's office billed tricare for a 5 yr well check and another separate line that had the hearing test. When i called tricare I was told that tricare may consider the hearing test included in the well child check. Basically this Dr's office is double dipping. trying to bill twice kwim. I'm calling everyone on monday. they pissed off the wrong dependent.

We are having a similar issue with our provider. One, they didn't bother billing tricare for my son's surgery over 14 months later. We just NOW got the SOB from Tricare saying they are denying it. Haven't got a bill from the provider, so HOPEFULLY it's been fixed. Good luck getting it fixed. I'd rather be at an MTF than deal with Remote!

the hearing test is covered, the doctor's office billed tricare for a 5 yr well check and another separate line that had the hearing test. When i called tricare I was told that tricare may consider the hearing test included in the well child check. Basically this Dr's office is double dipping. trying to bill twice kwim. I'm calling everyone on monday. they pissed off the wrong dependent.

We JUST CAUGHT OUR DR DOING THAT!!! :yes