TriCare help? Total confusion.

[blackcherry2002 5]

Ok so I have a few questions about tricare. They aren't completely for the surgery. I have a set of claims that were actually one day of bloodtests for my hypothyroidism...they were denied because

136 - SERVICES DENIED BECAUSE WE CANNOT DETERMINE PRIMARY INSURANCE PAYMENT. PLEASE PROVIDE EXPIRATION DATE OR COMPLETE PAYMENT INFORMATION.

I also had a bill from a visit with my doc for the same reason.

Then I have a few claims from my surgery that originally came up as paid..they are now listed as RETURNED.

Can anyone make any sense from this?

[ccarter8219 0]

Ok so I have a few questions about tricare. They aren't completely for the surgery. I have a set of claims that were actually one day of bloodtests for my hypothyroidism...they were denied because

136 - SERVICES DENIED BECAUSE WE CANNOT DETERMINE PRIMARY INSURANCE PAYMENT. PLEASE PROVIDE EXPIRATION DATE OR COMPLETE PAYMENT INFORMATION.

I also had a bill from a visit with my doc for the same reason.

Then I have a few claims from my surgery that originally came up as paid..they are now listed as RETURNED.

Can anyone make any sense from this?

It sounds like your insurance company thinks you have other insurance that is primary. Do you have any other insurance? If not, then just call your insurance conpany to update your file to show you have no other insurance and they should adjust the claim.

Crystal

[JamieNP 20]

Yes, you will have to give them dates of your last insurance. Tricare is ALWAYS secondary.If you have a primary insurance and they will not pay for anything lapband related, it still has to go through the primary first. If you do not have another insurance, then Tricare will need the dates that your last insurance was terminated.

If you have any other Tricare related issues, let us know. There are several of us on here that have had to fight them.

[blackcherry2002 5]

not even close. I've been on tricare for all of my 19 years...no gaps in between so...who knows. All the ones that said they were denied, but then a week later say they were paid. Though I think I might have paid the full amount before they ran it through again so I'm wondering if the clinic doesn't have some money they need to give me. The returned ones however don't give a reason, just that they weren't able to be processed. And they were listed as paid, now they turned to returned....

[JamieNP 20]

Just call them and ask them what they mean by that or what they need.

[Tuger 1]

I have Tricare Standard, since I live in Missouri I go through TriWest. On the Triwest website there I can login and view my claims, payments and authorizations. I can also email there with questions so it's quite handy. Double check and see if your Tricare website has this feature.