Grrr

Cori T.
on 6/29/04 1:39 am - Neah Bay, WA
So, Triwest's approval for my Psych. eval was for 1 hour! Dr. said no way. I called Tricwest (after 3 transfers and being on hold for 10-15min. at ea. transfer) and they said oh no, that means 1 visit and to tell the Dr. to disregard that 1 hour notation on the approval form. Called Dr. back, he said sorry, he wants a new auth. form stating that as he's been burned before. Had to call Triwest AGAIN and they said Dr. has to request a revision to the auth. Call Dr. back, he said he did. But when I talked to his office about this on my very first call to them after getting an approval letter, they said he just wrote saying that it wasn't satisfactory and not cost effective seeing as these tests will take 4 hrs. Not sure if he sent it to the same place they send out for auths. Now it's the waiting game to see if Triwest sends another auth letter out. It was such a pain finding a Dr. that is on Triwest and going through the new requirement of having an interview first etc..that I don't want to have to start all over. Does anyone know if Dr's will send out these tests then I only have to go in for the eval of them? Trying to figure out that if I have to self pay for these tests a way to min. cost. (hrs. in the Dr's office.) How much does this eval. testing/office hrs etc... run?
JustHat
on 6/29/04 3:31 pm - NM
Right before TriWest was due to take over, they sent me a letter stating that they would pay for my psych eval since it happened before they took over. But, if I needed more than 3 hours, I would have to pay out of pocket because they wouldn't pay. The note had a tone that kind of said they they weren't happy about having to pay at all. I had to read it four times to make sure they were going to pay at all. By that time, I already had all of the appointments and the report in my hand. The first time I read it, I thought they were changing the rules on me and not paying. But, I finally realized they were going to start doing it differently in the future. I felt bad for all of you that hadn't gotten your psych eval in yet. What a pain in the rear. Why would they make things harder for us as well as them. I am really sorry. This should be one of the easier hoops. This is one of the reasons I feared the change over to TriWest. It is like a new boss coming in. They jump in and change things with big ideas in mind. To answer your question, my psych billed TriWest $790 for three house. Not a bad morning's work even if they only pay half of that. Good luck, --Hat
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