Thursday, September 25, 2008

Misunderstandings....

I needed to clarify some things about Nathan's care today with the insurance company. So I called Tricare to double check on referrals, authorizations, claims, reimbursments.... all that jazz. I found out that Dr. Beck can charge us the 15% of her fee. That's allowed. But because she is the only one in the area that can treat Nathan, which is why Tricare approved her, Tricare pays the 15%. If we have to pay it up front, they will reimburse us. If we can wait, then they send us the check and we pay that to the doctor. Either way, becuase they approved her, there should be no out of pocket expenses.

Big sigh of relief.......

But we may not be able to see the doctor that Dr. Beck wants to do a special scope. She isn't a Tricare provider. We can only see her if there is no network providers in the area that can do it. Then it's the same referral procedure as Dr. Beck was, same payment stuff, all that. And I did check if the hospital was Tricare okay, and they are. So we won't have to worry about that.

Bottom line is that this stuff is medically necessary, so Tricare will pay for it, we just may have to go through lots of loopholes, red tape, and phone calls. But I have faith that the Lord will help us get it all done. I just need to have patience, and not stress out about everything that needs done. Just one day at a time. Do all that is in my power to make this work, and the Lord will do the rest...

3 comments:

Calista said...

It's so wonderful when the insurance actually covers the things you need when you need it! I'm really glad for you guys that everything will be taken care of that way :)

Rachel H. said...

See? Look, all better! I am so glad to see things working out so well. Red tape involved? No prob...that's my favorite color! And I bet it will soon be yours! :) jk!

Stephanie said...

Oh that's good to find out! I've found that Medicaid is very similar - they pay for pretty much everything, but you have to be willing to actually deal with all the problems, misunderstandings, and bureaucracy!