I am writing on behalf of multiple patients that we see in our off base specialty office. We live in an area that is heavily populated with military members, both active duty and their dependents, as well as retirees and their dependents.
It is sad to say that after more than 20 years of providing healthcare to our military members and their families, we may have to start closing our doors to Tricare Prime patients due to the lack of payment from Tricare for multiple claims from January to present.
We have been given conflicting information each time we call Humana (we are Tricare East) and when we are able to request reprocessing, the claims continue to be processed incorrectly.
As a medical professional AND a military spouse I find this absolutely appalling. The customer service representatives, as nice as they are most of the time, usually have no idea why/how our patient claims have been processed the way they are processing and don't have clear and concise steps to get the issues resolved.
Reason of review: Problems with payment.
Monetary Loss: $10000.