Therapy Thursday: Tricare Changes to Renewing Therapy Services


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Between three children, there are 7 therapists. So there is never a shortage of company at my house. They no longer use the front door and don’t even knock when they walk in through the garage. I like it that way. If they are going to spend more time in my house than my husband, I want them to feel like family. So it was no surprise to me when I received a call after hours from a frantic therapist.

She was bewildered and confused. She explained that Bugs renewal of his referral was denied. Strange due to the fact he has had these services for the last four years and his prescribing doctor had just told us we needed to keep up with Bugs therapy services at our appointment only a week before. I told he therapist I would call our insurance first thing in the morning to figure out what is going on.

I did just that. Insurance explained to me that Tricare now has a new policy in effect for renewing or obtaining services. Before, a therapist would simply do an observation of the patient and send it into the insurance as proof they still needed services. Based solely on the therapists recommendations, Tricare would approve the renewal. However, due to abuse of that policy, Tricare now requires the doctor AND the therapists to both submit reports. This new policy that was not explained to us resulted in two weeks of missed services and numerous phone calls between the doctor, therapist and insurance to make sure everything was done properly.

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