Going civilian and Steven's TriWest question

that 8 visit is for if you need psych help, not testing. I got so many different answers when doing this part. But I finally got the right info (right for when I went anyway, LOL). The testing auth. is done differently than regualr psych. visits.

I never had a problem with getting referrals....I went to my PCP...after I got a new one...and then told him what I wanted to do.that I had been overweight my entire life and that I needed his help in putting in for the referals...I gave him the list HAT provided for me...and said I needed all that before I could have the surgery. I made it clear to him why I didn't want to go to Madigan and he didn't see any problems with any of it. I know most of you know this but just for good times....if a military provider CAN'T see you within 30 DAYS they HAVE TO CHAMPUS you OUT...that means they have to allow you to see anyone provider who accepts our insurence....it's pretty easy to find providers who accept TRICARE...I don't do the waiting game with the Dr....I make my way to a new doc once they give me the run around...I got everything completed in like 2 weeks and from start to fini**** took me 5 months to get my surgery done...it could have been about 2 or 3 months shorter, but I decided to do this while they were changing over to a new provider service. HAT- They have to pay 100% of your bill NO MATTER WHAT. If you had an emergency while under the care of a champused DR. and he told you where to go and what not....thy have to pay it....don't pay any bills....if you are tricare prime they have to pay it....I went through this with my twins....I had them at Tacoma General and they sent me a bill for 50k....that was only 1/4 of the costs....I took care of it right away.....believe me Tricare has to pay it......

"I know most of you know this but just for good times....if a military provider CAN'T see you within 30 DAYS they HAVE TO CHAMPUS you OUT...that means they have to allow you to see anyone provider who accepts our insurence...." This is no longer true. When I was in the Tricare office the last time, they said that if the reason you were being seen was something like a sickness where you needed care soon or it would be really bad for you (loss of life or limb), then yes, they have to send you out. But, being over weight is not the case. Most people seeking WLS have been over weight all of their life. So, waiting on Madigan's list for another year or two isn't too long. It is still concidered a resonable amount of time. Now doesn't that suck? I was amazed at how quickly you got all of your appointments. Madigan just doesn't work as fast as your hospital. I didn't have any trouble getting my referrals because I avoided my own PCP. But, getting Madigan to give me an appointment took forever. If Dr. W wouldn't have canceled my sleep study, it would have taken me an additional two months. I spent a couple of hours looking at the Tricare website last night. I do think that Stevens isn't in the network. I looked it up several ways and while Ballard showed up, Stevens never did. But, I learned a few things too. There are two kinds of non-network providers. It is easier to just paste what the handbook says. I know this is boring, but might be helpful to someone else down the line. Network Provider A network provider is one who serves TRICARE beneficiaries by agreement with your region's contractor as a member of the TRICARE Prime network or any other preferred provider network or by any other contractual agreement. A network provider accepts the negotiated rate as payment in full for services rendered. Non-network Provider A non-network provider is one who has no contractual relationship to provide care to TRICARE beneficiaries, but is authorized to provide care to TRICARE beneficiaries. A non-network provider must be authorized. There are two types of non-network providers-"participating" and "non-participating." Participating Provider Providers who participate in TRICARE, also called "accepting assignment," and agree to accept the TRICARE-determined allowable cost or charge as the total charge for services-also known as the TRICARE allowable charge as the full fee for care. In the case of network providers, the negotiated rate is considered the full fee for care. Non-network, individual providers may participate on a case-by-case basis. Providers may seek applicable copayments, cost-shares, and deductibles from the beneficiary. Hospitals that participate in Medicare must, by law, also participate in TRICARE for inpatient care. For outpatient care, they may or may not participate. Nonparticipating Provider A nonparticipating provider is an authorized hospital, institutional provider, physician, or other provider that furnishes medical services (or supplies) to TRICARE beneficiaries, but who has not signed a contract with your regional contractor and does not agree to "accept assignment." A nonparticipating provider may balance bill. We were on the phone all day buying a new SUV from Idaho. So, I didn't get to go my the Tricare office. But, from what it looks like, they can bill me if they want for copayments, cost-shares and deductibles at the very least. And, since it was outpatient care, they could bill me for everything that Tricare doesn't pick up. The ER doc said I had 90 days to pay and it has been 30. So, I am going to wait it out a little longer and definately check with Tricare before I pay anything. So, other than really bored now, how are you feeling today? Hat