Practice Management

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  • 1.  Tricare Denials for TC charge

    Posted 01-28-2019 10:24
    We are having a huge problem with our Tricare claims.  Tricare is paying the PC and denying the TC for "duplicate claims."  Is anyone else having this issue with Tricare paying for the split billing claims?

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    Brandi Henry
    Executive Director
    Valley Regional Imaging
    Fayetteville
    (910) 221-22500
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  • 2.  RE: Tricare Denials for TC charge

    Posted 01-28-2019 12:03

    Brandi,

     

    We are also seeing denials for some of our TC claims with "Duplicate" on the EOB.  I just discovered these and so far the ones I'm seeing this with are mammograms and dexa's.  I haven't contacted Tricare yet because this just came to my attention on Friday.  Have you contacted them?  I'm assuming you are also dealing with Tricare East.

     

    Billie T. English, CPC

    Director of Practice Management

    MCBS, LLC

    1125 Troupe St.

    Augusta, GA 30904

    706-667-7404 office

    706-737-1314 fax

    billie.english@mcbs.com

     

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    Original Message


  • 3.  RE: Tricare Denials for TC charge

    Posted 01-28-2019 12:11
    Yes this is Tricare East.  It is for all modalities for us and we have spoken to several people.  We have been told it is a known issue wherein the system sees the same code, no matter what modifier is present, and denies it as duplicate.  We have a large number of charges that have not been paid.  I guess the next step is to file a grievance.  Thank you for your reply.

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    Brandi Henry
    Executive Director
    Valley Regional Imaging
    Fayetteville
    (910) 221-22500
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    Original Message


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