Hi all!
Quick intro - my hubby is a pilot in the Air Force. We have a 2 yr dd and I'm pregnant with our second.
I'm using a new OB practice with this pregnancy - referred off base. This office offers the NT scan at 12 wks as they have the equipment and trained personnel to do it. It was not offered at my previous OB. Will Tricare Prime cover this scan?? Anyone have experience with this? I called tricare, the lady I spoke with was about as helpful as tits on a bull (sorry lol that's my moms expression). All she kept saying was only scans that are "medically necessary" are covered. Soooo how does one determine that? Is it all in how the dr office codes the scan when submitting the claim?
Thanks in advance for any input!!
Married 8.1.2010
DD #1: Arrived 10.7.2011
TTC #2 Since March 2013
BFP 5.20.2013, EDD 1.26.2014, natural mc @ 5 wks 5.25.2013
BFP 6.21.2013, EDD 3.14.2014, Twins - missed mc @ 7w6d, D&C 8.6.2013
BFP 10.7.2013, EDD June 20 2014 - It's a GIRL!
Re: NT scan & tricare prime
That's a great suggestion, I'll talk to billing at the practice. I'm going in Thursday for my intake, so I'll try to get to the bottom of it then... Maybe they can tell me. It really seems like if they code it appropriately as medically necessary than it should be covered!
Married 8.1.2010
DD #1: Arrived 10.7.2011
TTC #2 Since March 2013
BFP 5.20.2013, EDD 1.26.2014, natural mc @ 5 wks 5.25.2013
BFP 6.21.2013, EDD 3.14.2014, Twins - missed mc @ 7w6d, D&C 8.6.2013
BFP 10.7.2013, EDD June 20 2014 - It's a GIRL!
Estimate gestational age
Evaluate fetal growth
Conduct a biophysical evaluation for fetal well-being
Evaluate a suspected ectopic pregnancy
Define the cause of vaginal bleeding
Diagnose or evaluate multiple gestations
Confirm cardiac activity
Evaluate maternal pelvic masses or uterine abnormalities
Evaluate suspected hydatidiform mole
Evaluate the fetus's condition in late registrants for prenatal care
Married 8.1.2010
DD #1: Arrived 10.7.2011
TTC #2 Since March 2013
BFP 5.20.2013, EDD 1.26.2014, natural mc @ 5 wks 5.25.2013
BFP 6.21.2013, EDD 3.14.2014, Twins - missed mc @ 7w6d, D&C 8.6.2013
BFP 10.7.2013, EDD June 20 2014 - It's a GIRL!
I'm having one on Jan. 2nd and I hope it'll be covered. My doc said most insurance companies will cover it when they submit the claim. I'm not even going to bother to call Tricarw about it because I know they'll give me a run around answer.