I may not be around the forums for awhile.

     A community Care Provider and TriWest are in disagreement about a stress test I had. My approval letter stated "and all associated tests", so they had me do a stress test before surgery ( lots of risk factors ), TriWest says that test needed a separate approval and won't pay. I got a $5,000 bill for the test. They're all pointing fingers at one another, while I'm trying to figure out how to pull 5 grand out of my butt.

     And the saga continues...

Call the local state congress representatives and the local TV station. 

What is TriWest guys? Is it similar to TriCare? 

So sorry Wichman, there has to be a way out of this one.

https://www.triwest.com/

 

Apparently it is associated with TriCare.

TriWest better come to the table for Wichman, that's rediculous!

Will this info help-

https://tricare.mil/PatientResources/ContactUs/FileGrievance#:~:text=a grievance when:-,You have a complaint about the quality of care you,your own%2C in the grievance.

 

https://tricare.mil/SearchResults?search=billing disputes

Apparently Triwest is the new administrator for Tricare for about half of the country. Around here they have supposedly screwed things up so bad nobody can get the care they need. Big story on the local news.

 

Fortunately, I have the VA hospital nearby and don't have to rely on Tricare. But there's a LOT of folks around here that don't have that option. No word on when or if they will get things resolved.

     I took the bull by the horns and went to see the patient advocate at the hospital where I had the procedure done and got the bill from. She is very familiar with veteran issues and knows who to contact and how to navigate the various systems to get answers.

     The bottom line is: if the hospital preformed the test without proper prior authorization the financial responsibility for the test is on the hospital and not me. It may take a little time, but they will get it resolved. The billing has been removed from my account.  

Good news and good job Wichman!!!

I learned long ago that in the military there is a waiver for everything. The secret is to find the right person to approve it!