Tricare Standard Issues/Payments

Re: Tricare Standard Issues/Payments

• Ilumine member

  March 2011

  katiebug388:

  Hello Ladies! This is my first pregnancy, and first real encounter with Tricare. I got married this June.  I am currently on Tricare Standard, as I am finishing grad school in a location that doesn't have any bases nearby. I will be graduating and moving out OK with DH in May, but until then, I have an OB here at school. 

  I just got a bill from LabCorp that they submitted under my SS#, so obviously that didn't go through. Call LabCorp and have them rebill your lab work with the proper id information.  This is not an unusual occurrance outside of a military catchment area.  MOST people's Insurance Id number is not a social security number and most definitly not a sponsors.   

  I called TriCare to check with them before calling LabCorp back and they said I have another $250 bill from my OB for my 8 week ultrasound. he lady said TriCare doesn't cover ANY  ultrasounds during pregnancy, unless it's a high risk pregnancy.

  This is incorrect.  Here is the link to the TRICARE website that details what U/S are covered.  If you need to, send a copy to LabCorp and then also to your OBs office.

  https://www.tricare.mil/mybenefit/jsp/Medical/IsItCovered.do;jsessionid=NtCMDPmfLq1r0KDnvLsyvkCKFpc5ct2yZS0PnVQtb4glLcvzNDtt!988369924?kw=Maternity+Care

  These criteria will usually cover a first U/S around the 8-12 week mark and another at the 20 week mark. 

  I have to question why LabCorp has your U/S information unless they actually DID your U/S.  They should have NO reason for having this information, since that procedure would have been done at the OBs or Radiologists office and billed DIRECTLY to TRICARE.

  This doesn't seem to match up with what I have read on here and talked to other military wives about.

  Also, apparently my OB coded other things in a way they don't accept, so that needs to be dealt with. 

  This is easily enough dealt with.  Just call them up and let them know that they may have coded something wrong.

  I guess I'm just wondering if this has happened to anyone else, and if so how did you deal with it? If not, why is this an issue for me? Really just looking for any advice! Thank you! 

  Incorrect coding happens EVERYWHERE.  God knows how many times a day in my civilian Patient Advocate days, we would have a coding issue.  There are THOUSANDS of codes and some are almost subjective. 

  cogradulations.

  file:///Users/Ilumine/Desktop/Family%20Portrait%20for%20gift.jpg

  Report0 Reply
• Loading the player...
• katiebug388 member

  March 2011

  Thank you, thank you! I knew I would have heard about the ultrasound thing if it was for real. I guess I didn't explain well, but the bill from LabCorp was for the testing. I called TriCare to check with them, and they informed me about the OB office and the ultrasound, both of which were submitted directly from the OB. Thank you again for your help. This is exactly what I needed to stop freaking out! 

  

  Report0 Reply
• Ilumine member

  March 2011

  katiebug388:

  Thank you, thank you! I knew I would have heard about the ultrasound thing if it was for real. I guess I didn't explain well, but the bill from LabCorp was for the testing. I called TriCare to check with them, and they informed me about the OB office and the ultrasound, both of which were submitted directly from the OB. Thank you again for your help. This is exactly what I needed to stop freaking out! 

  So someone from the TRICARE told you that they do not cover U/S unless medically necessary?  Which "TRICARE" did you call?  Because TRICARE Representatives are made up of a large number of organizations - from military to various contractors. 

  If this were ME, I would call back to which ever org you talked to and ask for a supervisor.  Explain that you talked to someone who told you that TRICARE did not cover U/S yadda yadda (try to give the Supervisor the exact wording). 

  If you talked to someone from the Contractors office, their system SHOULD (not sure if the new contractors do this, but all of the old ones did) track every call you make in, who you talked to and what was discussed. 

  I would ask that this representative be corrected, since she is giving out incorrect info to women who SHOULD NOT BE STRESSED OUT.  Medically speaking, pregnancy is not the time to be dealing with this carp. 

   Not to mention, this is a topic that is CONTINUALLY misunderstood by the military beneficiary population (I do not know HOW many times we get this question).  It is THEIR job to keep this info straight.

  But that is jsut me and what I did for a living for 8 years. 

  file:///Users/Ilumine/Desktop/Family%20Portrait%20for%20gift.jpg

  Report0 Reply