29 September, 2010

If you call Tricare, ask to speak with Kristen

First and foremost...


To my new followers, I'm glad you're here!

Now on to Kristen...


I didn't get her last name, but she's got the cutest accent (She sounded like the mom from Bobby's World. Remember that show?).


Seriously. She's amazing. 


So I got all my stuff together to call Tricare and duke it out about whether or not the doctor I saw was in network. I left my class and called on the drive to Nellis (I had to run to the pharmacy. Yay for free scripts!). 


As soon as she answers, I request a supervisor. She tells me that she sees that I'm in the cue for a super. call and asks if there's anything she can help me with. I think what the hey and say "sure". At this point, what do I have to lose?


I give her the date of service in question and I hear her thinking out loud as she reads the information on the claim...


"Huh... the remarks state that you were using the point of service option because the provider was out of network... Wait. This doctor is in your network..."


At this point I'm thinking "Oh my word, is it possible I found one of the few people at Tricare that is ready, willing, and able to help me?"


Kristen continues: "Well, let's get this taken care of. I actually got an email over my lunch, which I literally just got back from 5 minutes ago, about coding issues..."


She explains to me that a lot of the claims have been coming back the same way as mine for various treatments due to an error in their system. She tells me that she's going to check if preventative care is on the list of incorrect codings. Guess what! IT IS!


She's running it back through and if all is well (Which Kristen believes it is), Tricare will pay it and if something comes back for whatever reason (Which Kristen doesn't believe will happen), she will personally call me and handle it with me. For real. She took my number and everything! ha!


Now I realize that they were not made aware of the coding issue until today, but the lady I spoke with TWICE yesterday was a hag. Plain and simple. She obviously barely looked at my claim. I asked about the remarks about the out of network provider after she told me that my doctor had incorrectly coded for $20.00 in supplies which is the real reason why I had to pay a $170.10 deductible (Yeah, I don't get it either). I asked why that remark about a POS provider was there instead of an incorrect coding remark. 


You want to know what she said to me?


"Oh, well sometimes they just put remarks down there."


Really? Like they put all that stuff down there because they needed to fill the paper in a little more? It needed a little more decor before they mailed it? Or they just like to put random information down there because they felt like it? 


Yeah. If you get an older sounding woman with a smokers voice around the end of the work day, it's probably her. Hang up and try again. 


Anyway. Kristen at Tricare, you are amazing and have restored my faith in Tricare. 

6 comments:

  1. I see you have changer your blog a bit! Looks awesome :D

    I had a good day with TriCare today too! I called to get the list of shrinks available to me and it went off without incident and no long wait on hold!

    Yay for good days with TriCare!!

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  2. It's always refreshing to speak to a customer service rep who actually knows what they're doing and wants to help, especially dealing with things like Tricare! I'm glad everything was taken care of for you :)

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  3. I am always shocked when I get someone helpful and nice, it happened to me last time I called to change my primary care provider.... othertimes, not so much.... :P

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  4. 1. I loved your post on Goodnight Moon! You did such a great job outlining everything, L. And seeing all of those "don'ts" made me very relieved that I was on your "do" list instead :-)

    2. I love the new blog look! It's so clean and fresh and inviting.

    3. I love Kristen for you. Seriously. I'm SO glad that's all getting worked out and that you'll have one less headache on your plate.

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  5. This is good to know. I swear if you call back several times you will get a different anwser each time. Which frustrates me to all heck!

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