TriCare and the RE referral–Grrrrr!

The difference between perseverance and obstinacy is that one comes from a strong will, and the other from a strong won’t. 
~Henry Ward Beecher

Ah yes. TriCare. I both love it and hate it… but then, I both love and hate any health insurance I’ve been on because sometimes the easiest things–aren’t.

When last we left the saga of RE referral/infertility, TriCare had referred me to a regular OBGYN–which I already have–after my PCM wrote a referral for “infertility to Madigan Army Hospital.” They said they couldn’t refer me to Madigan because TriCare can’t do referrals to any bases and my PCM had to specifically put “reproductive endocrinologist” down… not just “infertility.”

So after arguing with my PCM (who is normally awesome) about how an RE is for infertility and not people who only have diabetes, they wrote me a referral. It came back approved from TriCare (yay!) and referred to Seattle Reproductive Medicine. I tried calling both Madigan and SRM to see what their wait lists were like. I left a message for Madigan.

SRM, on the other hand, informed me that they don’t take TriCare and that, while they do have many military patients, those patients have to pay out of pocket and then submit the claims to TriCare for some sort of reimbursement.

Wait a minute… TriCare referred me to a place THAT. DOESN’T. TAKE. TRICARE????  What the hell?

I decided then and there that there was no way in hell that I was going to go there (not because of SRM but because I know what a pain TriCare would be about reimbursements). So I waited for Madigan to call me back. Which they did, right away.

After being transferred back to their infertility appointment/referral specialist, I was told that I should get my PCM to write a referral to Madigan for infertility.

Yup. Exactly what my PCM had done in the first place.

I explained to the nurse what TriCare told me about not being able to refer on base. Her response? Bullshit. They do it all the time. That’s how they get their patients. She looked up my referral online to SRM and said she’d take care of it. She wrote a referral herself for me to go there based on the referral that I was sent to SRM. She then told me that I should be getting a call within the next 28 days to make an appointment.

Guess how long it took? Three hours. Three hours to call me back for an appointment when they had up to 28 days.

They only had one appointment available in November and the schedule for December hadn’t been released yet, so if I didn’t take it, I’d have to wait until it came out. I took it.

I will be driving the hour and a half to Madigan November 29th, just 12 hours before my flight to my bi-annual drill in Tennessee. I’m ready to start the process.

Bottom line: TriCare CAN refer you on base. If someone tells you they can’t, ask to speak to their supervisor.

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3 thoughts on “TriCare and the RE referral–Grrrrr!

  1. I can’t believe they told you they couldn’t refer on base. How do they think all the women’s center patients get referred? I swear, some of those Tricare reps need to be better trained. I’m glad you were able to get it all sorted out in the end.

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