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How to get help solving TRICARE problems



Article  
How to get help solving TRICARE problems
[1/24/2005]

Source: Army Family Publication

Maybe you called a TRICARE service center, and the person who answered the phone gave you incorrect information. Or, maybe you went to a provider who you thought was authorized to provide care under TRICARE Standard only to find out afterward that the contractor hadn't processed the provider's certification request in a timely fashion. Result: You got care from an unauthorized provider -- and now the government won't pay any of the bills.


 


 There are other kinds of problems that can occur -- lost claims, incorrect processing, and so forth. But the bottom line is you're angry, and you've got a complaint about TRICARE -- so what should you do about it? Speak up. Let someone know you're not happy. Tell someone what the problem is. Give the system a chance to help you solve it.


 


Who do I tell? One place to start is your nearest TRICARE service center (TSC), with whose staff members you can discuss the problem, or possibly file a grievance. TRICARE contractors have established TSCs throughout the regions they serve, and TSC staffers may be able to help you resolve the problem at that level, with only a phone call on your part. Depending on the problem, you might want to write a letter instead of calling, so a paper record of your attempts to resolve the difficulty will be established. Include all documents that are relevant to the problem -- and be sure to keep copies of everything for your own records. If your efforts at the TSC level fail, write a letter to the contractor's headquarters. Explain the problem, and tell them what sort of resolution you'd like to see. If these attempts at problem solving fail, you may call or write the TRICARE Management Activity's Benefit Services office. Phone: 1-303-676-3526 (regular long distance rates apply). Or, write: TRICARE Management Activity, Benefit Services Branch, 16401 E. Centretech Parkway, Aurora, CO 80011-9043. It's worth repeating!


 


Include all documents that are relevant to the problem -- and be sure to keep copies of everything for your own records. Additionally, if you need help in finding a phone number or address for the TSCs established in your region or for the TRICARE contractor for your region, call the Army Family Liaison Office Information Line -- 1-800-833-6622, Monday through Friday, 7 A.M.-4:30 P.M. Eastern Standard Time. We're also here to serve you! Health Benefits Advisors If you just have questions about what TRICARE covers and what it doesn't? About who's eligible? About filling out a claim form? About where to send the claim form after it's completed? The health benefits advisor (HBA) located at your nearest military medical facility can answer these questions and many more. The HBA can guide you to the most efficient use of your military health benefits. Talk to your HBA before getting care. Learn the rules and requirements ahead of time and, hopefully, avoid problems that can cost you time, money and headaches later. Internet Access If you have access to the Internet, you can also get answers to frequently asked questions about TRICARE and your military health benefits.


 


General TRICARE Information: www.ha.osd.mil


Active Duty Family Member Dental Plan: www.ucci.com


TRICARE Selected Reserve Dental Program: www.humana-military.com


Retiree Dental Plan: www.ddpdelta.org



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