Update by user Mar 02, 2016
Mistake made. I wrote Tricare but meant Triwest. My review is directed towards Triwest ONLY!
Original review posted by user Sep 10, 2015
Here’s how my story goes…
August 12, 2015
Spoke to Yen at Loma Linda VA and was told everything that the VCP needed had been submitted by her today.
August 24, 2015
Spoke to Lotoya at VCP, they have not received anything from the VA. I was told that they still need the VCL and authorization from the VA.
August 24, 2015
Talked to Jennifer (case manager) at the VA. She explained to me that I actually have a VCP rep at the VA. She gave me the VCP's rep number and also gave me the number to the Director of the VCP at the VA.
I called and spoke to that rep and was told that everything has been submitted and to call VCP directly in two days to follow up with them.
August 26, 2015
Called VCP, they confirmed that they now have the VCL and authorization needed to schedule the appointment with the surgeon outside the VA. They said that the appointment department will call within 5 days to give me my first appt time.
Note: I was allowed to give them the name of a doctor in my area that I'd like to see.
September 1, 2015
Spoke to Tiffany at VCP. It's been 6 days and I haven't heard anything from the appt dept. She at first said that they hadn't received the info from the VA I very nicely explained that I had confirmation from the VCP on 8/26/2015 that they had received everything required to schedule an appt. Upon further looking she did find the information the VA sent.
She then explained to me that the person I spoke to on 8/26/15 did not hit the save button so therefore my information never went to the appt dept. She was now going to save and it would be sent straight to the appt dept marked priority.
September 3, 2015
Spoke to VCP again to follow up on appt. They tried to tell me again that they were waiting on the VA to send the VCL and authorization. Feels like groundhog day all over again. So once again, I explained that I had confirmation from VCP that they received all information. Aha, she finds it.
She now explains to me, just like the other VCP rep that someone didn't hit save so it was never sent to the appt dept. Interesting wouldn't you say.
Never the less, I asked to speak to the supervisor. I spoke to April, Department Lead, and she confirms that the last two reps that I spoke with did not save the information, so it still hasn't been sent to the appt dept.
She has told me that she is sending my info to the manager of the appt dept and that I should hear back before the end of business tomorrow 9/4/15. She also said that she would call me at noon tomorrow to follow up.
September 4, 2015 – LIES…LIES…LIES…
As expected I received no call from April, Lead Mgr at VCP today. So I called and spoke to Ronada at VCP. I recapped the series of events that have taken place to date and that I had been expecting a call at noon from April, Lead Mgr. She said that she doesn’t even know who April is. This is just a call center. She said that I needed to wait a few more days. When I pushed to speak to a manager again, she said there is no manager here. I said then let me speak to whomever you report to. She then informed me that she just read in the notes that at 3:37pm yesterday (9-3-15) they contacted 5 physicians and were having no luck finding a provider that would accept the insurance. So the file shows pending because they are trying to find a provider. Again, said to wait a couple of daysl
As you get to know me better, you'll see that I've learned that you never can just wait. So I jumped into action.
I called Ms Jordan, VCP Rep at the VA and explained the above to her. She was very helpful and went to VCP (Tri Care) website and gave me the names of 5 providers in my area. She was very surprised that VCP was telling me that they were having a difficult time finding a provider when there were 5 listed on their own website.
Next I called the provider here in town and they confirmed that they do accept VCP (Tri Care) insurance from the VA and could get me in to see a PA in a weeks’ time.
I called back to VCP and spoke to Whitney. I again recapped and gave her the providers name and number. She reviewed the notes in my file and confirmed to me that there was no record of any providers ever been called. She said that a provider list would automatically be generated and that had not occurred yet. So there was no providers contacted.
So now I have confirmation that Ronada at VCP lied when she told me that they called 5 providers already. This makes me think that the other 2 VCP reps that said they never saved the file must have been lying also. On top of that there were the 3 occasions when I was told the VA had not sent the VCL and authorization. I wonder how true that was.
September 8, 2015
Talked to Laterrica at VCP, she said that since they didn't correct the situation regarding sending my info to the Appt. Dept on 8/26 or 9/1. I would have to wait 7-10 days, which will be Monday 9/14 or Tuesday 9/15 the latest. Everyone else told me a 5 day waiting period. I guess they change that timeframe whenever they want.
I questioned her regarding their previous attempts to call 5 providers and she said she sees 3 attempts on the 3rd. So which is it 3 or 5.
She couldn’t tell me the provider names that they supposedly tried to call. I explained that there are only 5 providers in this area on their website and that I’ve confirmed that all 5 accept this insurance through the VA. She had no explanation for that.
At this point, with everything that I’ve been through with the VA, it makes me afraid to have them cutting me open.
This whole process with my shoulder surgery originally began November, 2014 and we’re still going.
September 9, 2015
Called VCP and spoke to Glendale. She confirmed just like everyone else there, that they have all they need and that the Appt. Dept. is working on setting the appointments.
She said give it a few more days. She also added that she sees that they called some providers already. She counted out 7 providers called. Of course she can’t see the provider’s names so how does she know they called? I'm so confused. Why would they be calling 7 providers when I gave them the name of the one provider that accepts VCP in my area? Is this working smart? I think not. Who's running the show over there?
Still no resolve ! Now I wait.
Reason of review: Lies being told to me by TriCare.
Preferred solution: Let the company propose a solution.
I didn't like: Stories that this company tells i just want the truth.