TRICARE/HMHS Debt Collection Assistance Office

[mastergunner]

Has anyone used TRICARE/HMHS (South) or for that matter any TRICARE/HMHS Debt Collection Assistance Office?

 

I have 3 Medical TLs on CRs and have had great success removing other TLs (37 down to 4), but don't know if I want TRICARE "helping" me.

 

I would appreciate any input.

 

Thanks

[mastergunner]

Well, I guess no one has used this TRICARE Program...guess I'll be the first!

 

I also don't know if this is the appropriate forum to post this in. I'm tempted to post this thread in the Medical Billing & Medical Collections forum.

 

No matter which forum it's in, I'll post updates as they happen.

 

I copied and pasted this from TRICARE/PGBA/HMHS website that I found in the post from Dragonflyer...thank you for posting it.

 

What I am concerned with is sentance that I highlighted in the passage below.

 

"TRICARE's Debt Collection Assistance Officer Program

Debt Collection Assistance Officers (DCAOs) are located at each TRICARE Regional Office and MTF to assist TRICARE beneficiaries in determining the validity of collection agent claims and/or negative credit reports received for debts incurred as a result of receiving health care* under the TRICARE program. DCAOs will take all measures necessary to resolve the issues presented.

 

Beneficiaries must bring or submit documentation associated with a collection action or adverse credit rating to the DCAO. This includes debt collection letters, TRICARE EOBs, and health care bills from providers. The more information the beneficiary provides, the less time it will take to determine the cause of the problem. The DCAO will research the beneficiary’s claim with the appropriate claims processor or other agency points of contact and provide the beneficiary with a written resolution to the collection problem. The collection agency will be notified by the DCAO that action is being taken to resolve the issue.

DCAOs cannot provide beneficiaries with legal advice or fix their credit rating, but DCAOs can help the beneficiary through the debt collection process by providing documentation for the collection or credit-reporting agency in explaining the circumstances relating to the debt.

 

The DCAO directory is available online.

*"Health care" includes medical and adjunctive dental care under TRICARE." "

[Moorlock21]

Well, I guess no one has used this TRICARE Program...guess I'll be the first!

 

I also don't know if this is the appropriate forum to post this in. I'm tempted to post this thread in the Medical Billing & Medical Collections forum.

 

No matter which forum it's in, I'll post updates as they happen.

 

I copied and pasted this from TRICARE/PGBA/HMHS website that I found in the post from Dragonflyer...thank you for posting it.

 

What I am concerned with is sentance that I highlighted in the passage below.

 

"TRICARE's Debt Collection Assistance Officer Program

Debt Collection Assistance Officers (DCAOs) are located at each TRICARE Regional Office and MTF(Are you pretty close to the regional office for Texas or a military treatment facility? to assist TRICARE beneficiaries in determining the validity of collection agent claims and/or negative credit reports received for debts incurred as a result of receiving health care* under the TRICARE program. DCAOs will take all measures necessary to resolve the issues presented.

 

Beneficiaries must bring or submit documentation associated with a collection action or adverse credit rating to the DCAO. This includes debt collection letters, TRICARE EOBs, and health care bills from providers. The more information the beneficiary provides, the less time it will take to determine the cause of the problem(Seems to say bring in your paperwork and we'll look at it for you). The DCAO will research the beneficiary’s claim with the appropriate claims processor or other agency points of contact and provide the beneficiary with a written resolution to the collection problem. The collection agency will be notified by the DCAO that action is being taken to resolve the issue.Do you think that the CA cares if it is wrong?

DCAOs cannot provide beneficiaries with legal advice or fix their credit rating, but DCAOs can help the beneficiary through the debt collection process by providing documentation for the collection or credit-reporting agency in explaining the circumstances relating to the debt Like what? that despite the fact that it should have been covered that they didn't cover it?.

 

The DCAO directory is available online.

*"Health care" includes medical and adjunctive dental care under TRICARE." "

 

Unfortunately I have some experience with Tricare and what I have found is that they don't care! If it was truly Tricare's fault and not the doctor's or hospitals for coding it wrong( that's a possibility also that you might want to check up on) then it'll show up on the Explanation of Benefits and you can go from there(i.e. you'll know what to argue about anyway). I will spare you the long and ultimately unsatisfying experience that I had attempting to get them to pay for something that plainly stated it was covered in the big manual that they send out. I swear to god that it seems like there is some special top secret language that insurance companies use.

 

Good Luck,

 

Joe

Edited February 22, 2010 by Moorlock21

[breeze]

I handled my Mom's TFL stuff, and I can say that those folks didn't care. The people who cared were the one's I threatened to sue - the provider and the collection agency. Same situation - improperly coded procedure. Get a litigation mindset - that doesn't mean you will sue, it must means you're going to think like it.

 

Do you have all your proof and paperwork, plenty of evidence that you've tried to resolve this through channels? Who's trying to collect, the provider or a collection agency?

[mastergunner]

Hey Joe, I like your wit.

 

Are you pretty close to the regional office for Texas or a military treatment facility?

I will be using main Humana Military Health Services/TRICARE/PGBA DCAO via fax/email. I am close (relatively) to a few here in Texas, but I’m a lot closer to a fax and computer.

 

 

Seems to say bring in your paperwork and we'll look at it for you

Yeah, though I have the same paperwork TRICARE does.

 

Do you think that the CA cares if it is wrong?

What? NCO and the rest don’t have hearts and will do the right thing?

 

 

Like what? That despite the fact that it should have been covered that they didn't cover it?

Something like Oops, we made a mistake. Do y’all take explanations as payment?

 

 

I swear to god that it seems like there is some special top secret language that insurance companies use.

Yeah, they learned it from lawyers and salamanders!!! (No offense to any lawyers or salamanders intended)

 

To Breeze:

 

Get a litigation mindset - that doesn't mean you will sue, it must means you're going to think like it.

That should not be a problem. As I like to say, “Let the BIG cat jump!â€

 

Do you have all your proof and paperwork, plenty of evidence that you've tried to resolve this through channels? Who's trying to collect, the provider or a collection agency?

As stated earlier, I have the same paperwork TRICARE has…neither one of us has EOBs or claims from the Providers other than what’s listed below.

 

I have EOB for date of service (DOS) 4/30/05 showing Emergency Room Service only and not for physician services. Statement from provider showed payment due for emergency room service and physician services.

 

No EOB for DOS 10/06/05. TRICARE doesn’t have a claim either. I phoned the providers business office and spoke to someone who stated “We filed and the Insurance company paid $37.64. We adjusted the bill and you need to pay the rest.â€

 

NCO-Medclear (placed for collection 03/2006) and CMRE Financial (placed for collection 08/2005) are TL’s showing up for the DOS 4/30/05. (Different CA Acct #s; same amounts). NCO updates monthly and CMRE last updated 10/2005. No collection attempts from anyone. The Provider sent me a statement when I asked them to (shows bad debt adjustment; sold to MEDCLEAR), but no other contact. Both of these will drop 03/2012.

 

Medical Data Systems (placed for collection 06/2006) is TL showing up for 10/06/05. Updates monthly. No collection attempts from anyone.This one drops 09/2012.

 

Still digesting info from here concerning Medical Collections before I attempt anything.

The providers seem to be willing to provide me with necessary info, and are local (well, Texas local anyway, if you know what I mean) so I need to get their stuff from there.

 

I’ll give TRICARE beneficiary team a try to see if they can resolve this before I go to TRICARE DCAO. Don’t know if I want DCAO dabbling in my Credit business.

 

I’ll update as it happens. I still don’t like the idea of “Riding Pointâ€.

[breeze]

I still don’t like the idea of “Riding Pointâ€.

 

Somebody's gotta do it.

[mastergunner]

Update:

 

Today, I spoke with 5 different Debt Collection Assistance Officers at Humana DCAO Office. 4 couldn’t find the claims or EOB’s I was attempting to gather information on nor could they satisfactorily answer my questions. The 5th DCAO found them and reconciled the amounts listed. I now feel comfortable about paying my cost share.

 

DCAO’s wanted me to fax over my credit reports so they could gather addresses to send letters to the OC, or HCP explaining the situation to them. Based on the first paragraph, I told them I would not require that service, but thank you for asking.

 

Now over to WhyChats threads/posts to take care of these.

 

In the mean time, I disputed the CMRE Financial Svcs off TU, as they hadn’t reported since 10/2005. CMRE TL deleted.

I also disputed NCO Medclear off EX as it was listed as an installment loan. Medclear TL deleted.

 

Thanks to all who responded.

[breeze]

Nice job!

[mastergunner]

Well, what do you know?!?

 

NCO-Medclear dropped off of all 3 CRA's. I didn't even have to contact the other 2...Medclear must have pulled them. WoW!

 

Have 1 medical left...

[vetswife]

sweet success!....I wish this applied in my own medical but I had a tricare/medicaid overlap