Recently, I submitted a claim to Tricare for payment of a medical bill. Tricare processed the claim and sent payment to the provider, whom I had already paid.
When I brought this to Tricare’s attention, it said I would need to coordinate with the provider regarding money owed. Tricare explained that the reason it could not fix the matter and/or reissue payment was because I did not write on the claim form something to the effect "Pay patient" or "Patient paid bill."
The Tricare claim form does not have a section that pertains to payment information (i.e., who should receive payment). Claimants are expected to just know that somewhere on the form they are supposed to write "Pay Patient."
I have checked other insurance companies’ claim forms, such as Cigna International, and guess what? They have a section dealing with payment information. You simply check the appropriate box, (pay patient or pay provider).
Tricare has left me to deal with a German-speaking billing company to get my money back. Let’s hope that company is more supportive than Tricare (it doesn’t seem to care). Lord help us if the government starts running health care if it can’t even create a common sense claim form.
Chief Warrant Officer 3 John Kampa (retired)Wiesbaden Army Airfield, Germany