Retro-active retirement. Large bill is on the way. Help!!!

[ikory]

Last year (2012) I was retroactively retired going back to 2004. I used “All Kids” Illinois Medicaid for my children’s births in 2009 and 2010 and leading up to us getting on Tricare. Also my wife used “All Kids” for maternity care. When I took the kids for wellness check today the woman at the doctor’s office noticed that proof on Tricare dates back to their births. The doctor’s office found this troubling because they have been billing “All Kids” since 2009. She said “All Kids” has no responsibility because it’s not considered a secondary insurance. She will send out a Bill to Tricare and whatever they do not pay from 2009 to present she will charge my debit card. I explained to her several times I did not get Tricare until 2012 but the paper contradicted this I guess. Just her whole attitude made it seem as if I was committing some kind of fraud and she was sending this information to “All Kids” that I did have insurance in 2009.

So what to do? I cancelled my debit card. I have a feeling Tricare will first reject this bill because it dates back more than a year. I am even more scared will the state of Illinois come after me now.

 

[Josh Martsch]

I have no idea what you'll have to go through, but legally here's something, I guess. Tricare will list kids as covered from birth once the insurance starts (assuming coverage pre-dates birth...as in this case). I seriously doubt they'll back-pay anything as you didn't have Tricare at the time, but I don't know for sure. Either way, legally you are fine...you just might have to go through the hassle of the system to prove your innocence. I know, messed up in the country we're in where we're all supposed to be innocent until proven guilty...but it is what it is. Since you were retroactively retired, there is a chance Tricare will pick it up...regardless, you'll be fine in the long run. You did do the right thing in cancelling your debit card to stop these frivolous charges, though. Doctor's offices aren't supposed to be acting as judge/jury/executioner...just providers/billers/reporters.

Just my 2 cents of support.

 

[ceilingfan]

Last year (2012) I was retroactively retired going back to 2004. I used “All Kids” Illinois Medicaid for my children’s births in 2009 and 2010 and leading up to us getting on Tricare. Also my wife used “All Kids” for maternity care. When I took the kids for wellness check today the woman at the doctor’s office noticed that proof on Tricare dates back to their births. The doctor’s office found this troubling because they have been billing “All Kids” since 2009. She said “All Kids” has no responsibility because it’s not considered a secondary insurance. She will send out a Bill to Tricare and whatever they do not pay from 2009 to present she will charge my debit card. I explained to her several times I did not get Tricare until 2012 but the paper contradicted this I guess. Just her whole attitude made it seem as if I was committing some kind of fraud and she was sending this information to “All Kids” that I did have insurance in 2009.

So what to do? I cancelled my debit card. I have a feeling Tricare will first reject this bill because it dates back more than a year. I am even more scared will the state of Illinois come after me now.

If you didn't have Tricare, you didn't have Tricare. The doctors office will call Tricare and figure this out. You are fine.

As for the lady at the office...she has no idea what she is talking about. Let her try to make an unauthorized charge to your debit card...pretty sure that's a felony. i would inform the doctor next time in about this lady, her behavior and what she said.

If you call and speak with someone from Tricare they should be able to put your mind at ease, and give you advice on possibly filing a complaint against billing department at docs office for improper billing practices.

 

[pittpan2005]

If you didn't have Tricare, you didn't have Tricare. The doctors office will call Tricare and figure this out. You are fine.

As for the lady at the office...she has no idea what she is talking about. Let her try to make an unauthorized charge to your debit card...pretty sure that's a felony. i would inform the doctor next time in about this lady, her behavior and what she said.

If you call and speak with someone from Tricare they should be able to put your mind at ease, and give you advice on possibly filing a complaint against billing department at docs office for improper billing practices.

Tricare will most likely tell you to have the doctors office submit a new EOB (statement of care received) to them. Once Tricare has it you can work it out with them (Tricare). In the meantime the hospital/doctor needs to work it out with you and/or Tricare. Personally we are going on four months of a Tricare billing "game." Completely different situation, but I am sure you will be just fine.

If you want help with this I am more than happy to three way call with the office and you. We can then also three way call Tricare.

Tricare seems quite helpful in these situations and smart move on the debit card.

 

[ikory]

Tricare will most likely tell you to have the doctors office submit a new EOB (statement of care received) to them. Once Tricare has it you can work it out with them (Tricare). In the meantime the hospital/doctor needs to work it out with you and/or Tricare. Personally we are going on four months of a Tricare billing "game." Completely different situation, but I am sure you will be just fine.

If you want help with this I am more than happy to three way call with the office and you. We can then also three way call Tricare.

Tricare seems quite helpful in these situations and smart move on the debit card.

Thank you for the support/help . I talked to tricare at the AFB today and they were helpful. They did say they would be considered primary insurance going back to my discharge date. They think the doctors office told me misinformation on I am unable to use "All Kids" as secondary insurance. They also said doctors office is looking at this issue as more money for them. Tricare told me to make sure the doctors claim is not denied to please submit a "timely filing-waiver" with the claim explaining the retro-active retirement. So it seems like in the end of this "game" I will win, unless the billing department at that doctors office is right and I cannot use medicaid as the secondary insurance than I am screwed.

I called the doctors office today and I am waiting on a call back.

 

[pittpan2005]

If Tricare is primary (retroactively), I don't see why it would matter if All Kids was/is secondary unless you're worried about deductibles and copays. Worst case, All Kids would send you a bill, which you would forward to Tricare.

*I would fight any and all copays/deductibles.

 

[ikory]

If Tricare is primary (retroactively), I don't see why it would matter if All Kids was/is secondary unless you're worried about deductibles and copays. Worst case, All Kids would send you a bill, which you would forward to Tricare.

*I would fight any and all copays/deductibles.

Yeah I was worried I could not use it as secondary, if they can even legally do this, and would tricare cover this. I kept seeing standard only covers 80% on a lot of things. So over 4 years with 2 kids and a wife with hospital stays, emergency visits, surgery; this stuff adds up. The doctors office insisted on Monday you cannot use "All kids" as secondary insurance. They did not have the debit card until this Monday because they would not let the kids see the doctor without a debit card as they claimed we are not allowed to use "All Kids". I guess I am really pissed the doctors office said they are going to report us to Illinois as if we have been committing fraud. Also, they will send this 4 years of bills to tricare and whatever they do not pay they are going to charge the debit card. What they did to me was use scare tactics. If I talk to billing tomorrow I will record the conversation just in case.

Yeah I would never pay any bills because of this. I would fight to the end.

 

[pittpan2005]

There are many situations where 100% is covered; example: preventative medical care for children. Even when not covered, there is a max co-pay and deductible for the year per person and family.