I'm surprised (and pleased) that Tricare agreed to pay the claims that were resubmitted with them as primary. There is usually some sort of 'timely filing' rule that applies even when trying to re-process mistakes from other insurance companies. It is good that this veteran had someone to fight for his rights. All too often, I see the insurance companies taking advantage of the patient and their lack of experience.
In NY, insurance companies have 2 years to demand payments back from providers. We get those requests constantly usually with little to no explanation even when we have pre-authorized ahead of time. If we refuse to repay the insurance, they withhold future payments from future claims of other patients.
People just don't realize that even when their insurance bills are paid by the insurance company, there is essentially a years long waiting period whereby the insurance can demand the money back and the patient will be billed by the provider. Absolute scam.
I'm surprised (and pleased) that Tricare agreed to pay the claims that were resubmitted with them as primary. There is usually some sort of 'timely filing' rule that applies even when trying to re-process mistakes from other insurance companies. It is good that this veteran had someone to fight for his rights. All too often, I see the insurance companies taking advantage of the patient and their lack of experience.
In NY, insurance companies have 2 years to demand payments back from providers. We get those requests constantly usually with little to no explanation even when we have pre-authorized ahead of time. If we refuse to repay the insurance, they withhold future payments from future claims of other patients.
People just don't realize that even when their insurance bills are paid by the insurance company, there is essentially a years long waiting period whereby the insurance can demand the money back and the patient will be billed by the provider. Absolute scam.