Tricare denied claim after approving surgery!

[topazz 4]

I'm going with the anesthesiologist thought. This happened to me where the surgery was covered 100%, but the anesth was not in my plan. So I got hit up for $1750. I had to pay it. It stunk, but I then realized that this was a drop in the hat to pay compared to what the entire procedure cost, and am fortunate to have insurance that did cover it.

[lovemysgt 4]

that just isnt right they should warn you ahead of time if you want to pay or not. not just do the proceedure and then bill you

[melzie_99 22]

I would follow up with Tricare on this; I have Prime as well as was covered 100%. As long as the provider was someone in the Tricare network, I don't see why you would owe anything (unless you've exceeded your yearly cap, I don't know what happens then...). In the meantime, I agree with everyone else: until you receive a letter from Tricare stating "This is a bill" then I would let them work out everything....

[melzie_99 22]

Oh, and if you click on the individual claim, it will tell you specifically who and what the charge was for...

[soon2bethin 0]

I have Tricare Prime also, but for Retirees. Anyway, shortly after the surgery I received a 3rd party collection form from Tricare. It seems that one of the codes that was used sent up a red flag that maybe it was an accident of some kind and that somebody else should be paying for it. As soon as they received the form back everything was approved. It only cost me a $25 copay! Just give them a call and find out what is going on.....Good Luck!

[jenn79co 13]

I was called by Tricare to tell me that my surgery was approved, Yeah! I went in for the surgery at the hospital and they told me I was clear and didn't owe anything for the surgery there. I assumed they had gotten approval through Tricare as well. I went on TricareWest online and to check my claims and found that Tricare had denied a $2000 claim by the hospital. It says patient responsibility $2000! They said that I was approved. Has anyone got any experience with this? I am so worried, this was sooo not in the budget! What will happen?!

Need advice please!

Just wondering if you have found out if there was a billing error or something else?