Getting referrals from Tricare

[drrosenrosen]

I've finally gotten on with Tricare, 6 months after applying. I'm trying to massage that referral base, but not really sure where to start. I'm in a huge military town (San Antonio), so it's a very large population of potential patients. Anybody have advice on how to get your name on the list for referrals out from the military and VA systems?

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[Baron Samedi]

Humanamilitary.com

This will likely be your best resource and includes information on how to manage referrals.

When primary care providers put in referrals it initially goes to the MTF clinic for right of first refusal. The MTF clinic either keeps it and assigns it to their own specialty clinic or defers to network. In network providers can then view referrals and determine whether to accept them or not.

I am on the military side so do not have visibility of how they're assigned once they reach that point, but the Humana website appears to have tutorials on it once you are registered.

 

[Agast]

Ask your wife to feign interest in joining some MLMs. Military wives love them some MLM crap.

 

[drrosenrosen]

Humanamilitary.com

This will likely be your best resource and includes information on how to manage referrals.

When primary care providers put in referrals it initially goes to the MTF clinic for right of first refusal. The MTF clinic either keeps it and assigns it to their own specialty clinic or defers to network. In network providers can then view referrals and determine whether to accept them or not.

I am on the military side so do not have visibility of how they're assigned once they reach that point, but the Humana website appears to have tutorials on it once you are registered.

Thanks. I got registered on that website

 

[10KHertz]

Tricare reimbursement can be very poor. They banned rfas for awhile but reversed course years ago. Not sure tricare pays a Medicare/medicaid rate now, dropped it long time ago.

 

[RoloTomassi]

Don't they reimburse for PRP?

 

[bedrock]

Don't they reimburse for PRP?

Tricare reimbursement can be very poor. They banned rfas for awhile but reversed course years ago. Not sure tricare pays a Medicare/medicaid rate now, dropped it long time ago.

Tricare pays poorly IMO. Basically barely Medicare rates for epidurals , and far less than Medicare for MBB/RFA. Don’t really cover stim.

However they do pay my surgeons well for implants and they pay for PRP. but only for lateral epicondylitis and knee OA.

 

[cowboydoc]

I've finally gotten on with Tricare, 6 months after applying. I'm trying to massage that referral base, but not really sure where to start. I'm in a huge military town (San Antonio), so it's a very large population of potential patients. Anybody have advice on how to get your name on the list for referrals out from the military and VA systems?

Nagpal is leaving/left UTHSCSA, so the shake up could help you. There was a ton more caid patients than military in that clinic, but 5 of the 8 listed “in network” docs on the tricare site are university affiliated.

The VA is going to refer internally, and they probably don’t have a backlog to give a waiver for outside consults.

This population is ubiquitous, so not sure about targeting docs to refer to you.

Follow drusso’s lead and go to a vfw or similar social group meeting to score some self-referrals.

These guys get coffee/play golf together (and &!+€# about their back and knee pain), so the patients referring friends could be great.

 

[Tramadeezy]

Speaking of Tricare…

Killeen-based pain clinic and surgery center to pay more than $836K after overbilling allegations

Two Killeen medical clinics are on the hook for more than $836,000 to the United States and the state of Texas, federal officials announced Tuesday.

kdhnews.com

 

[powermd]

A doc wanting to refer a Tricare patient to me told my assistant that if I take Medicare it's against the law not to take Tricare. I've never heard this before. Any truth the matter? I never applied to be in network with Tricare because of the low pay.

 

[drusso]

Nagpal is leaving/left UTHSCSA, so the shake up could help you. There was a ton more caid patients than military in that clinic, but 5 of the 8 listed “in network” docs on the tricare site are university affiliated.

The VA is going to refer internally, and they probably don’t have a backlog to give a waiver for outside consults.

This population is ubiquitous, so not sure about targeting docs to refer to you.

Follow drusso’s lead and go to a vfw or similar social group meeting to score some self-referrals.

These guys get coffee/play golf together (and &!+€# about their back and knee pain), so the patients referring friends could be great.

The Fraternal Order of Eagles group is a "target-rich environment" for that stuff. Good people. Strong drinks.

119 Years of People Helping People

 

[knoxdoc]

TC pays poorly and you need auth if you want to sneeze. Anyway, set up a lunch with the PCPs on base and let them know what you do. They will refer to you.

 

[Baron Samedi]

TC pays poorly and you need auth if you want to sneeze. Anyway, set up a lunch with the PCPs on base and let them know what you do. They will refer to you.

The PCPs don't have any say where the patient goes. The referral gets routed to a Medical Treatment Facility and if there is a pain clinic there, they get right of first refusal. The ones that are deferred out are then assigned to a civilian clinic by Tricare.