Insurance reversal

[lafaye999 32]

I was banded April 11, 2012. I received an approval notice from Tricare Prime on March 17, 2012, my 38th birthday. Around August I start receiving cars from the doctor office and hospital reverifying my insurance information such as ID numbers. In September I was told as well as received letter stating my insurance company made an error. They were now reversing the charges. A whopping 47K with a 6K discount. Wtf/Wth. I don't have this kind of money.

Therefore at the end of October I declared bankrupt. Now my doctor refuses to see me.

Omg

[SageTracey 608]

Wow! That is horrendous! I am stunned that they can reverse a decision after the fact. Yo made medical decisions based on their advice and now they expect you to wear a whopping great bill like that!!!

I am really sorry for your situation and hope you are able to get some resolution quickly.

Thank goodness the Australian healthcare system does not operate like this!

[MiniMi 1,468]

Crazy!

[Blondie638 98]

Wow I would sue them. I know that sounds harsh but if you have the approval letter and u got the surgery thinking you could afford it bc they told you they'd approve u.. It just doesn't seem right that they can do that.

[pinkcess 12]

I don't understand... I have tricare prime and I thought it was pretty easy to get an approval from them. What was the problem... Why did they reverse? This makes me nervous considering I have the same insurance!

[♥LovetheNewMe♥ 1,216]

That really sucks, can you try and argue your case and have the doctor justify the medical necessity of the surgery. this is crazy!

[JennaSoto 85]

I have Tricare Prime also and have just finished all the steps today and now starts the waiting process to see if I am approved. What were their reasons for reversing the decision? I agree I think I would sue them- you have the approval letter and then they change their mind 5 months after the procedure.

[carlak 59]

Depressed fat and don't know what else to do about tricare

[lafaye999 32]

Well today I attempted to transfer to another doctor in Jackson. She refused to accept me because she is also apart of the same center but has another practice. I found another doctor in Hattiesburg, MS; roughly an 1.5 hour south of me. It will cost me more but I need a doctor to monitor me.

[lauradevans 52]

I'm in Hattiesburg and Dr Donald is my doc! He's AWESOME! I also deal with insurance and I know tricare can reverse for lots of reasons. I'm sure you've checked all this since you decided to declare bankruptcy.... Make sure they have you right in that system not just the Humana system.

Ready to change my life!

[lafaye999 32]

Thank you, glad to meet a patient of the doctor.

[lafaye999 32]

I'm in Hattiesburg and Dr Donald is my doc! He's AWESOME! I also deal with insurance and I know tricare can reverse for lots of reasons. I'm sure you've checked all this since you decided to declare bankruptcy.... Make sure they have you right in that system not just the Humana system.

Ready to change my life!

Well it seems as if I ready for new doc... Partial records have been transferred; hopefully I will be ready for my first visit; first of February

[Instyle98 240]

I am not a litigious person, but I would pursue legal action. Find yourself an attorney that specializes in medical issues and takes your case on the contingency that he only gets paid if you win (sue for court costs too, of course).

[carlak 59]

ya'll....you cant sue Tricare, its the government

[kazjim98 618]

Military members can't sue but dependents can...with that said, it would definitely be a long, tough road ahead suing the government...So glad you are on your way to having a new doctor.....I wish you well!