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Thread: Tricare Standard MRI

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    #1

    Tricare Standard MRI

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    I am feeling so dumb right now. I switched over to Standard because with my new work schedule I could never get into a military base doctor. I found a lump in my throat and was having severe headaches so I went into see an in-network doctor who ordered an MRI. Tricare did a pre-authorization. I just got the bill from the hospital and it is saying that I owe a lot of money, most of what was charges for the total MRI. I am just in shock. My husband is ETSing and we just paid pretty much everything off.

    I have yet to get an explanation of from Tricare and can not call today of coarse. Has anyone had an MRI through Tricare Standard and got a high bill?
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    #2
    I just had two MRI's done since January. I had already met my $300 family deductible for the fiscal year. My MRI's were just under $100. But if you didn't meet your deductible it could be higher. You can always call Tricare and make sure the Tricare amount matches what they are telling you.
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    Last edited by gunsgirl; 09-10-2014 at 08:27 AM.
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    $3600 the total bill was $4900 and I had pre-authorization. It was with a civilian doctor and hospital that was in network
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    When I called the automated system yesterday and it went through the claims processed for me in the past 30 days. That one was on there and what the computer said matched what was on my bill.

    I had technically 4 MRIs one of my brain with and without contrast and one of my neck with and without contrast. The amount that was paid is pretty close to be 1/4 of the entire bill so I am wondering if tricare only covered one of those. I just dont understand why the hospital wouldnt have told me though since I would assume they would have wanted me paying up front for the MRI if my insurance wasnt going to cover it.
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    Last edited by gunsgirl; 09-10-2014 at 08:26 AM.
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    Either way the catastrophic cap is $1000 for AD and $3000 for everyone else so it sounds off. It should be an easy fix, I'd try not to stress too much.
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    #8
    Thank you all.

    I am just a blubbering mess for all of this. Not only am I dealing with all of these swollen lymph nodes appearing throughout my body and doctors telling me its completely fine but other information saying its not. Now I have to deal with telling my husband that we may owe $3600 because of supposedly nothing and not having him here with me makes it so much worse. And then we are off Tricare soon due to his ETS and ugh....its just nothing I have ever wanted to deal with.

    I am calling in the morning and will hopefully figure it out.
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    #9
    If it was put in incorrectly for pre-authorization as in only 1 pre-authorization instead of the 4 that it was needed, do you think I should be held accountable? Or should the doctor who put in the pre-authorization be held accountable because he did not put it in correctly?

    I had been waiting a week for the doctor's office to call to schedule when my doc said it would only be 2 days. Tricare called me about an unused referral for my daughter and I happened to ask them about the pre-auth and they were like, "oh yeah, that was approved on such and such date" so I called the hospital and gave them the authorization number and scheduled my appointment. I just can not help but think that with everything else going bad for me that I did something to screw up the billing.
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    Last edited by gunsgirl; 09-10-2014 at 08:26 AM.
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