I'm ticked off at tricare.
By writersedge
@writersedge (22563)
United States
February 27, 2012 2:39pm CST
They are not going to reimburse me for my wig. I didn't use a tricare certified wig place. $109.50 I can't get back.
1st they said that one part of tricare didn't send the form to them at this other part of tricare, so I asked them what exactly they wanted me to do about that? I filled out the form and sent it to where it said to go on the form.
2nd, they said the hospital should have submitted it. Now how was the hospital involved? They don't provide wigs? They wanted to know if I wanted to call the hospital or if I wanted them to call? Well, since nothing I've done according to you guys has worked out well, why would I want to call?
So I'm on the phone for an hour to get told that the hospital said that that D-n-D salon is not a tricare certified person. So the hospital figured this out and tricare didn't? What to H was that run around! Yourf govenment dollars at work. Tricare is a government health insuranced for the military and their dependents. It's been since December, no one ever got back to me and the hospital determined that they weren't certified. D-n-D gets their wigs from a National supplier. Somebody in the National supply somewhere must be certified.
I was going to put that money toward my husband's teeth. He needs $700 for his teeth. Then they said I could go get another wig from a certified supplier. Where do they think that money is coming from? I don't have any money. The money I had went to the wig. Besides, you have to sign that you don't have a wig. If I had money I wouldn't need them to reimburse me. What am I supposed to do, put it on my charge card? I'll pay for that wig many times before I pay it off.
4 responses
@francesca5 (1344)
•
27 Feb 12
you sound very annoyed, and rightly so, writersedge.
when we, in the uk, have a problem with a government organisation we do one of two things, we either contact our local member of parliament, i don't know, in your case who would fulfill that role, but a politician who does case work, a member of the house of representatives i suppose. or we contact the local press, but you may not fancy the publicity.
or consumer watchdog programmes on television, or in a newspaper are quite good.
sorry, i just used to do a job solving these sorts of problems, so i just can't help it.
i would write an official complaint to tricare, and then get in touch with a politician, or someone who will give them bad publicity, or is there a local organisation that helps with this sort of thing?
it is incompetent, you should have been told right at the beginning who was and who wasn't certified, and that is their failure not yours, as how would you know that the funding was conditional on the place you bought the wig from being certified. so unless you were specifically told that you had to go to a certified seller, and given a list, i would suggest you have a right to complain, and get it paid for.
vague verbal advice doesn't count.
the failure is there's, complain.
1 person likes this
@writersedge (22563)
• United States
27 Feb 12
They gave me a list of people who provided wigs, but I thought they were American CAncer people and I wasn't going through the American Cancer Society.
@francesca5 (1344)
•
28 Feb 12
giving a list of providers of wigs is not the same as specifically telling you that there were only certain providers you could use, that, it would seem to me is the important point, whether or not it was made clear to you that there were only certain people you could use.
1 person likes this
@writersedge (22563)
• United States
28 Feb 12
Very good points. I'm also going to do some investigating. See what is under Gardengerty's and Celtic Eagle's.
@celticeagle (189944)
• Boise, Idaho
28 Feb 12
Another OMG moment! Sorry you have to go through this crap. I had a problem with my Pharmacy and Doctor's office. I was trying to get an okay from my doc to prescribe my pills since I was at 0 refills at the pharmacy. So I called and asked the PharmaCY how much it will because I have a $250 deductible to pay this year. (It was about half that last year)They couldn't tell me until they get an authorization from the doc. So about six hours later I call the doctor's office to see if they had gotten the fax yet. No, nothing. So I call the pharmacy and they tell me they show it was sent and that it did go through. (Funny the Doc's office supposedly didn't get but someone from there called to see how I was doing and see about getting an appointment set up for me to come in. Coincidence? So, I called the Doc's office back and talk to another woman and she said 'Oh, yes we got that this morning!' OMG! So I know what you are going through. I also have to pay for my teeth. I have real bad ones and they just keep getting worse. I can't see fixing the problems in my mouth now when I would like to get dentures so I hope someday i come into some money so I can get the dentures. I have about half the amount of teeth you are supposed to have. I can barely chew!
@writersedge (22563)
• United States
28 Feb 12
I had similar with a pharmacy. We didn't get the script from the Dr. Dr.'s office, we sent the script. Call the pharmacy, oh it's printing out now.
I wanted the $109 to put toward my husband's dental work. Our insurance will pay for all but $700 worth of it. But now I won't have it.
1 person likes this
@writersedge (22563)
• United States
28 Feb 12
D-n-D said all the customers they had before , the insurances honored it.
I have a conspiracy theory. I think the companies that pay a kickback to the hospital or Tricare or both are part of their wig thing. Or maybe they give money to the American Cancer Society.
I think I found a wig conspiracy. Why didn't National Tricare send the bill to my Regional Tricare? Did they think I would forget about over a hundred bucks? Why did I have to send it to National when Regional is supposed to process it? Why did Regional call the hospital that prescribed it? Why did they have the hospital tell them no?
All very suspicious. Why was I on the phone for an hour?
1 person likes this
@celticeagle (189944)
• Boise, Idaho
28 Feb 12
they need to communicate better. I would be sure the company I am dealing with is okay with your insurance company. Getting down to basics with them and asking all kinds of questions. They know they have ya by the tiny hairs.
@GardenGerty (169538)
• United States
27 Feb 12
Insurances can be the pits. I went through stuff like this with my little sister. I hope the wig is attractive, but D-n-D should have told you that they were not certified. I think too many people are playing ignorant here and are not making sure you get the information you need to take care of things.
@GardenGerty (169538)
• United States
28 Feb 12
Around here, and in other parts of the country, sometimes a local news station will investigate situations like this for people, is there someplace like that that will help you? At this point I can see you donning your investigative reporter hat, er wig and checking the injustice out yourself. It would be nice, however, if you had a powerful voice joining with you.
@writersedge (22563)
• United States
28 Feb 12
My friend at D-n-D said she never had a receipt refused by an insurance company. I gave her the phone number where the salon can become certified. I'm on it. My friend will tell me if they want a kickback per wig or if they want an outrageous sum to be certified. Don't worry, GG, I'm on it!
@writersedge (22563)
• United States
28 Feb 12
They said all the other insurances accepted their receipts.
I don't understand why I was supposed to send the form to National. Had to call Regional to check on it. Then Regional called my prescribing hospital. Why did the hospital have the last say on it or any say beyond my physician prescribing it?
I wonder about this certification process. Do these salons have to pay some kind of kickback to them to stay on their list? My wig fitting/stylist person is NYState Certified. I'd like to know how far this goes. You've heard of Watergate. I think I may have stumbled onto Wiggate.
Maybe there is a conspiracy theory here. Not sure.But I will be contactingD-n-D and see if they got "hit-up for cash" to be certified.
1 person likes this
@JenInTN (27514)
• United States
28 Feb 12
Perhaps they could have given you a few more details before they said they couldn't pay for it. I hate the way that insurance companies work sometimes. They won't pay for anything they can get out of paying and businesses try to suck them and the members dry.
@writersedge (22563)
• United States
28 Feb 12
Not in their list of providers. I think their list has people who give the hospital kickbacks.
