Tricare cheated my Specialist...
By missybal
@missybal (4490)
United States
May 26, 2009 12:05am CST
I get my statements from my Military Health Care and it always shows what the amount is the doctor requests and what they actually pay them. Well the doctor not only spent a good 45 minutes with me but after that we had all these problems getting Tricare to fill the prescription so he had to be on the phone with Tricare on my behalf for over an hour just to get some silly form that they needed him to fill out and it was such a mess. He was going to be leaving the office for the day at noon but stayed so he could fix this for me I felt terrible for him going to all that trouble. And you know how much Tricare paid him??? $34.50! Yup that's it... for a specialist! With tricare I do have a copay that says the office can only charge me up to 15% of what they pay him, that being like $6 but I feel he deserves so much more. I've noticed this a lot lately that Tricare is ripping off my doctors office. I think the reason this doctor got hit so hard is he didn't ask a lot. He only requested Tricare to pay him $55.00. This is small town America and these doctors around here are so good about no overcharging for services but this is why more and more doctors don't want to take Tricare... or even Medicaid for that matter. They get ripped off for this and then yes they do have to get more money from others to make up for it because otherwise they couldn't afford to keep their business going. They got to pay for their office building, property taxes, utilities, staff, supplies, ect. How is it that Tricare figures out how much their time is worth? I don't get it. I'm going to try to get through to Tricare tomorrow. I doubt I can get the doctor to take any more of my money, I think he's legally bound that he can not except anything more than the max copay from me. This just seems so wrong to me.
1 person likes this
1 response
@CatsandDogs (13963)
• United States
30 May 09
It is wrong and you should tell them so because how else are they going to know if you don't tell them. I have tricare too so I know what you're talking about and it's no wonder we can't find doctors that accept it. We hate our PCM because he's an arrogant @ss but he's much closer than the next one on the list so we bear with him to a point and if he becomes too much, we'll give it back just as good as he gives.
@missybal (4490)
• United States
30 May 09
Come to find out the doctor only got $27.57 from tricare... my co pay was $6.93... So there is the $34.50 they got paid. This doctor went through so much for me... I called Tricare and they said that the doctor signed a contract... any doctor who signs this contract must take the amount they give them... even if it is 40% less than what the doctor asks for. I told them how I felt it was wrong especially because I am not allowed to pay the doctor the rest of the amount because it is forbidden by law for him to accept any more than the max of that co-pay. I went down to the doctors to pay my co-pay directly to them so they didnt' have to waste so much as another cent on paper or a stamp to send me the bill. I shook the doctors hand and said thank you for your service... because he is serving his country by taking this deal in order to help our military members. He admitted that if it wasn't for the fact that we are in an area that is not highly military and not many have Tricare he could not afford to accept Tricare as a private doctor / business owner... but he was happy that I realized this issue and was so nice to actually want to pay more understanding the financial strain Tricare has on those who do accept it. If I was a doctor I would never enter such a bad deal... who really would... I am lucky to live where really not many people are military so for the most part they do accept tricare... I did notice that it wasn't as bad before ... it seemed tricare didn't short them as much last year... it must be that the government is so broke they are cutting back this way I don't know.
I wish that the military would just give me the money to purchase health care. You know how it is with Tricare if you have the Standard package you know you work for that health care. It's part of our pay as far as I see it. Payment for my husband's service which quite often doesn't pay as much as he works... 6 days a week 12 hours a day shifts overseas in the desert away for months at a time... the Tricare is included in that deal as much as the paychecks. This is why I fear universal health care.
