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I was being denied reimbursement over a 3 day difference filed several appeals with no results. This Opt Out occurred 3 day prior to my admission however had not been updated due to the holiday. The claim for $4000 was ultimately denied because the provider had opted out as a Tricare provider on January 1st due to problems getting paid through Tricare.
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My Claim was rejected 4 times for additional information which I provided each time. After my treatment I filed a claim with UHC.mil otherwise referred to as Tricare. Based on that I scheduled myself to be checked in on January 3rd. I was told that the service was covered and tricare would follow the rules of the Primary insurance. In setting this up I went to Luke Air Force Base and consulted with referral services. In Late November of 2014 I sought inpatient treatment for PTSD/Depression which was the result of the loss of my entire family (father, older brother, younger brother and mother) all to separate accidents while I was deployed. Let me provide you some details on the issues I have had.ġ.
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When we do get appointments, on almost every occasion I have had to make multiple calls to get billing issues corrected. Tricare Providers are dropping out due to extreme billing issues it takes months to get appointments for Specialty Care for myself as well as my family. The administration of Tricare health coverage has become a nightmare in comparison. There has been much attention given to the gaps in treatment for Veterans through the VA. I am Looking to anyone who can provide me direction and relief with the issues I have experienced getting my family and myself consistent and adequate health care coverage through Tricare since United healthcare assumed the administration of military healthcare benefits. With this in mind please continue to read. UHC is starting to make the VA look good.īefore reading this letter and deciding I am just bucking the system, Be advised that I have followed the directions provided to me, and have made many, many inquiries for directions with little to no success. It seems to me that they should be finding ways to address their members health rather than putting so much energy into finding ways to deny claims. As a retired Navy with Tricare (administered through United Healthcare) I also have insurance through ALLSAVERS (Another United Healthcare administered policy) Below is a statement which I sent to The office of Senator John McCain of Arizona United Healthcare sent me and the senator a response which they state justifies their reasoning for refusing payment.