My son has 2 health insurances, one from the state because he has autism,(medicaid) and the other we pay for through the guard (tricare) for the whole family.
He goes to an organization for therapy and he has a psychiatrist there too, and that psychiatrist recently moved away. Their new psychiatrist isn't yet contracted with tricare, so she cannot see my son. He has been 6 months without a psychiatrist and we're about to run out of refills for his medication. They just keep telling us they expect it to come through soon. Why can't the new psychiatrist just bill the secondary insurance only, since for all his other therapies the primary just denies anyway before secondary then pays. Are we not allowed to see any provider that's in network with either of his insurances? Because finding someone that takes both was very difficult.
Primary vs secondary… help!
byu/Life-Wolverine2968 inInsurance
Posted by Life-Wolverine2968
1 Comment
To put it bluntly, you just can’t “choose” to not bill to the primary insurance, that would just lead to industry-wide inconsistency. You’re right that you *should* be able to see a provider that takes Medicaid but not Tricare and have them bill Tricare and then bill Medicaid for their normal reimbursement. Medicaid is already weird with their rules like not allowing providers to accept cash payments, I’m sure Tricare has their own weird rules as a government funded entity.
I would contact Tricare and your Medicaid administrator tomorrow to get actual confirmation of billing rules and get help navigating this.