TRICARE Rants
It’s all about trying to use healthcare benefits you have already earned and paid for.
It seems like the system is meant to be confusing.
When you are confused- you call in to try to get an explanation. The person you are talking to will speak in codes. The codes may not make sense to the average person. The explanation may create more confusion and frustration.
I was once authorized to see a provider- but only for a limited number of visits. How did I find out about the limited number? Payments stopped- I called in- I was told how to start over and clean up the mess.
Other businesses don’t just let this stuff happen- they will let a customer know if it is time to renew auto insurance, renter’s insurance, auto club memberships, etc.
It’s like there are little tricks to using the benefits, but the TRICARE rep on the phone is not going to help you learn the little tricks to stay out of trouble- you will learn them the hard way- after the train goes off the tracks.
The person you speak to will have only limited authority to solve a problem. You must be handed off to another department if the first person can not act on your situation. You may be told to file an “appeal” and send it off as a next step in cleaning up a mess- even though you did not skip any steps or do anything wrong.
One of the biggest lessons I have learned:
Let’s say a friend recommends a provider of some sort. You call and ask that person “Do you take TRICARE?”
“Yes” (This is code for: I will take a TRICARE check, but it will not cover my fees. You will not know until later, when you get a statement from TRICARE.)
This is not the fault of TRICARE, however, cleaning up the confusion can be tricky-
I get a statement and call TRICARE because it seems like I owe too much. After a long conversation, it seems the rep is able to adjust the claim or whatever the right words are.
Next statement comes out- still looks like I owe too much- have now accumulated more weekly appointment charges to deal with.
Call TRICARE- I explain that I called last time and was told that the claim would be adjusted, etc.
“Who did you talk to?”
I am not sure, I dialed the same number as this time...
“Yes, but we have different departments that take care of different things, etc.”
Put on hold- the rep comes back- “The person you spoke to last time did not have authorization to tell you that they could adjust the claim, etc.
Why ask me who I talked to last time when all that info was logged and appears on the screen in front of the new person I am talking to today?
Lesson learned- do not take anyone’s word that they “take TRICARE” verify that they are in the network on the web, then call TRICARE to verify that they are a contracted provider. Ask TRICARE to send written authorization with the providers name on it.
Standard business procedure-
We can pick up the phone and book a weekend trip to Vegas in minutes- air travel, rental car, rooms, etc. We will deal with a business person who wants to make us happy. We will pay with a credit card and be on our way. Ditto for going on the web and ordering a big screen TV.
The health insurance people come off more like they want to wear you down, confuse you, burn up a few more weeks time by telling you another step to take- then you wait until the next statement comes out and find the mess- or a new one- is still there. Your mental health and blood pressure will be worse off after you call 1-800-please-help-me and find out the latest turn of events.
I have a credit union I have been a member of for about 20 years. I have called them about 6 times total. I don’t have problems with them- checking, savings, credit card- things work well- it is a very low maintenance relationship. The credit union saves money by not needing as many reps to conduct high-intensity hand holding with customers.
Health insurance- about a 75% chance there will be problems with any new transaction.
