LVMAC Tidbit: Did You Know Your TRICARE PRIME Primary Care Manager May Have Changed?

The Department of Defense has announced there are now only two TRICARE Regions as of 1 January 2018. The North and South Regions have combined to form the new TRICARE East Region, while the West Region remains mostly the same.  Humana Military is the new regional contractor for TRICARE East, and Health Net Federal Services, LLC, is managing TRICARE West.  Originally, Health Net Federal Services managed our area.

Why are we mentioning this?  While some of you using TRICARE Prime may have been notified already – and Humana has stated that during the transition you will be able to see your new or previously assigned Primary Care Manager (PCM) – the transition period is not stated upfront, and a change of PCM may have already been made for you.  That should be worth your finding out now, according to one of Healthcare in Our Community Co-Chairs, Alexander Alex.

He was “clicking” his way through the Humana Military web page getting familiar with it and decided to log in to his personal account. There, he found information that changed which needed correcting.  Some of it could be dealt online, but other parts required calling the toll-free line (800.444.5445).  However, what was most alarming to him was the discovery that Humana had already changed his PCM without notifying him.  Normally, you make your own changes from a limited, area list of primary care physicians provided to you.

We are not saying this is happening in all instances, but we do advise you to verify your own situation because of the implications on patient billing.  If a TRICARE PRIME enrolled patient goes to their old PCM believing he/she is still their assigned doctor, there is the potential of a later surprise in the form of a bill for the entire cost of the visit.  Naturally, we would expect the front desk to properly notify you of this problem when you sign in when they verify your insurances, but there is not guarantee of this.  Therefore, you should want to avoid the possibility of any problems yourself.  It is not that hard to do: the log-in site and number to call are provided above.

###

As of 22 January 2018

Comments are closed.

%d bloggers like this: