Good news and challenges ahead for Tricare families

The good news is we were just informed less than 2 hours ago that Tricare West is finally paying claims. We verified for ourselves and can in fact see some claims showing paid. We still don’t have our status fully corrected but thankfully they are covering your claims so that calms some concerns.

The challenge news is they have not responded to our requests and took unilateral action on our contract. We accepted a specific reimbursement rate in 2019 to prove ourselves. This rate is not sustainable long term. The transition occurred before we could complete the process with East and now, we must start negotiations over with West for a more reasonable and sustainable reimbursement rate.

What this means in the short term is your services can continue and the request for security deposit is no longer needed. Furthermore, while we cannot see the information, we suspect everyone has fulfilled their remaining deductible so we will remove those from any automatic billing. As claims process in our system any refunds you are due will automatically be calculated in the system and we will arrange your preferred

What this means in the coming months. We are going to be negotiating with TriWest on our rate. Hopefully, we will be able to reach an agreement. If we are unable to reach an agreement, we will either become an out of network provider or withdrawal as a provider for Tricare. If we cannot reach an agreement, we have direct control of timetable so we will make sure to give you time to decide and act, if needed. During this time, we still will not be accepting new Tricare clients as we do not want to start care and possible have to end it just after starting.

We thank you for weathering this process with us and hopefully we will have nothing but good news in the coming months. Stay tuned!