{ "media_type": "text", "post_content": "Tricare insurance claims auditors. Who are they? Who are they accountable to? I am fighting some claims against them.", "post_id": "610229c52015b300207c6bf7", "reply_count": 3, "vote_count": 1, "bowl_id": "5e8e9c4339ac5a001bacc5db", "bowl_name": "Physicians" }

Tricare insurance claims auditors. Who are they? Who are they accountable to? I am fighting some claims against them.

like
Posting as :
works at
You are currently posting as works at

😠

These are folks designated to identify under or overpayments. They can certainly be held accountable . In your letters they are required by law to state who sent you the denial, how you can appeal and how many levels you can escalate your case.

Thank you so much it’s seems to been resolved for now. it was around mental health. I am a Family NP and I had psychiatric training in my program was filling well controlled tri care dependents anti depressant medications. Like 50mg of Zoloft and they denied the entire well visit. It is frustrating because these patient have to wait months to have their medications refilled by a psychiatrist who is annoyed I sent them in the first place.

Related Posts

Any salesforce implementation group in healthcare and life sciences hiring? My wife is actively looking. Prior work experience working at big 4. Due to visa reasons she had to leave.

I live with a healthcare professional on the front lines of treating C19. Both of us are fully vaccinated but I’m worried about being an asymptomatic carrier of the delta variant as we start to return to client sites where there might be unvaccinated folks. How are firms addressing this?

like

Are LIC Policies Jeevan Lakshya and Jeevan Labh good from an investment and insurance POV? 25 lakh rs policy pays 67lakh after 25y on maturity. Premium paid is 1.2 lakh for 23&16y resp. Suggestions

like

I am a clinical mental health counselor and a credentialed alcohol and substance abuse counselor and am ready to graduate Emory law in 2 weeks with my Juris Master in Health Care Law.

How difficult is it to pivot out of healthcare? Applied to be a business analyst for current company (1.5 years in) but am more interested in different industries. Thoughts?

like

Any advice on what health insurance I can get ? I'm self employed right now.

like

Looking to get into healthcare somewhere in the big 4! Someone point me in the right direction! No real preference what firm as long as the healthcare team is strong...any advice?

like

How are folks thinking about permanent life insurance? 45, making let’s say for example (not my exact numbers): $1M per year, not yet vested in pension. Was thinking need to replace the post tax take home, about $550k NPV’ed at 5% to age 55, so that’s like $3.2M. Maybe pension is worth $2.5M so I think that means I should have $5.7 total you want death to have no financial impact. Also was going to do $1M of that in perm w/ LTC rider. Sound right?

like

Hey all, dad is visiting and needs to get a heart condition checked out (procedure isn’t available in India). Employer health plan doesn’t cover parents. Anyone familiar with the options we have?

like

What’s the process after your weather insurance policy has been triggered?

Fellow PwCers. Are you on a firm health care plan, vision, dental, or legal plan. If for so, has it been valuable?

like

Has anyone taken a leave of absence for mental health/suicide/depression? I’m getting there but I’m also the primary earner in my house.

like

Any type-1 diabetics (in Big4) over here? How do you guys manage your health with so much work stress/hours?

like

How serious do PPMDs take mental health issues with folks below you?

like

Hi Fishes! I am moving to the Dallas area and I am looking for new opportunities in healthcare. I’d like to transition out of consulting into industry. If you know of any opportunities please...

like

Has anyone with EY's high deductible insurance plan gotten an IUD lately and know if its covered?

like

Nursing is the most trusted profession and we need to elevate the voices of our clients. What can we do to support BLM in the healthcare field?

like

Trying to invest more in my skincare. Is the best way to begin to go to a dermatologist? (I don’t have any specific skin issues though) Follow-up: are dermatologists generally covered by insurance?

like

Any recommendations for a online psychologist who knows how to deal with work place anxiety? My work place anxiety is impacting my focus and causing me to freeze at critical moments. Preferably someone who takes PPO insurance.

like

Additional Posts

Potentially silly questions but when people generally say that you have to be at MBB to make the jump to PE, are these folks doing PE type work like diligence or something relevant or are they doing more broad type of consulting and getting into PE because they have the MBB brand?

like

What's the TC range for the post MBA level? Specifically not just in year 1, but in years 2 and 3 in between post MBA and manager level? And what does the TC breakdown look like at the manager level over the years?

likefunny

I’ve now had 2 instances where a tech startup calls me the day after final round to tell me feedback is positive and ask logistics questions (relocation, start date, vague comp discussion). Then they reject me the next day saying “some discussions happened in the room that didn’t come up in written feedback” Wtf is going on.

like

So this might be a better place to post this and ask this question: Uncle D has announced explicitly that most people won’t get a pay raise & bonus this year except for those promoted and high performers. Amid this crisis, are companies including other big 3, MBB, FAANG, boutique consulting firms still giving high raises and issue stocks? Can you share the impact from your firm?

like

How’s the Fuqua interview? What kind of questions are asked?

like

Anyone have experience with CSR trip insurance? Need to move up flight back home given the impending hurricane. We’re here now. What’s the process? Airline or chase (booked with CSR points air+htl)?

like

How to best allocate time, from first to final round of MBB process for 2-3 weeks? Just keep doing cases daily / focus on behaviourals / read white papers/ relax a bit ?

like

I’ve only worked on tech transformations for clients in one specific industry throughout my whole career. All projects have been almost the same. Is this a disadvantage for mba applications, or is it a pro since I show deep expertise in a certain area? I only really stayed on these types of projects because that’s where my network took me.

like

Had an interview with Amazon last week. Interviewer mentioned I should hear back by this Monday and if not to ping him directly. I did not get his contact info since we used chime and can’t seem to find him on chime, where we interviews. Is it ok to send a message to his linked in?

like

Stop showing up in all my hotel rooms, Mario Lopez. Sick of your corny lines and never aging face.

like

DFW -> Houston. Drive or fly and why?

like

Some of my peers who are going for promotion got the call from our RP last week when I was on vacation. I haven't heat anything yet last/this week, does it mean I didn't get it? :/

like

Any PwC Managers have any advice on navigating the culture. I joined recently and already had to pull a director aside regarding how she was talking to me?

likehelpful

How does Accenture’s HR transformation practice compare to those in the B4 (e.g. presence in the market, content of typical engagements, strategic vision, etc.)? Accenture, PwC, EY, Deloitte

like

Does Big4 hire ACCA individuals from international countries (they will not need visa sponsorship and would be legally authorized to work in USA).

I’m on Coinbase & Binance - looking for a 3rd exchange. Anyone have a referral link they want me to use? Looking at Gemini / CEX since the others disabled new users

like

After 2 years I finally rolled off a stressful project and it feels great! My energy and my over all well being have significantly improved. This morning I feel like I’m ready to take on the world!

like

I have adhd and struggle with anxiety and depression. This year has been relentless. WFH and dealing with stress has destroyed my cognitive functioning. Im not as productive, work quality has suffered, I don’t interact as effectively as I used to. My performance has taken a hit - which my manager has noticed - and I can’t get back on track. I’m really trying. The fact that I’m worried about my job makes things even worse. Any advice for how to overcome this? (Beyond therapy/meds - already doing)

likehelpful

Passed BEC! Three down one more to go baby 💋

like
like

New to Fishbowl?

Download the Fishbowl app to
unlock all discussions on Fishbowl.
Download Fishbowl to see what others are saying
That was just a preview…
Sign Up to see all discussions
  • Discover what it’s like to work at companies from real professionals
  • Get candid advice from people in your field in a safe space
  • Chat and network with other professionals in your field
Sign up in seconds to unlock all discussions on Fishbowl.

Already a user?
Login here

Share

Embed this post

Copy and paste embed code on your site

Preview

Download the Fishbowl app

Get realtime notifications and see
what's happening in your industry
from the palm of your hand.

For account settings, visit Fishbowl on Desktop Browser or

General

Legal