Is there a quicker way to get an appointment when dealing with Tri-West Healthcare?

SPC Diana D. — Fri, 06 Oct 2017 17:10:27 -0400

It seems to take them forever to get you an appointment. I had to have a Myelogram and a Hip Arthrogram done and it took them 5 months to get them all approved and scheduled. Surely there is a better way to schedule appointments. I realize there are a lot of individuals dealing with Tri-West but I would have been better off waiting on the VA. The worst part is that if you have elected to go through Tri-West you can not transfer back to the VA for the procedure or appointment.

Response by LTC Kevin B. made Oct 6 at 2017 5:16 PM

LTC Kevin B. — Fri, 06 Oct 2017 17:16:02 -0400

You should ask more specific questions. If you get right to the point you want addressed, you'll get more specific responses.

Response by LTC Jason Strickland made Oct 6 at 2017 6:02 PM

LTC Jason Strickland — Fri, 06 Oct 2017 18:02:32 -0400

SPC Diana D., another option is to chat with the Veterans Choice Program (VCP) operators. Go to this website: https://www.va.gov/opa/choiceact/for_veterans.asp, and you should be able to chat with an operator who may be able to assist.

Veterans Access, Choice and Accountability Act | For Veterans

Veterans Choice Program

Response by 1SG Frank Boynton made Oct 6 at 2017 9:19 PM

1SG Frank Boynton — Fri, 06 Oct 2017 21:19:58 -0400

Diana. That’s not true. At anytime you can opt out and return to the VAMC that you are enrolled in. However if the authorization is a Choice 1st authorization that means your VAMC does not offer that service and your only option is to go to a civilian provider. A Choice 30 means the VAMC cannot schedule you within 30 days. A Choice 40 means you live 40 miles or more from your VAMC or CBOC. I’m a contact center manager at TriWest. I am responsible for 4 VAMC. I am intimately aware of the appointing process. At no time does it that long to secure an appointment. However depending on how far out the civilian provider is scheduling out it can be months, but when that is the case we reach out to get your approval before we book an appointment beyond 30 days.

Response by PO3 Phyllis Maynard made Oct 6 at 2017 9:53 PM

PO3 Phyllis Maynard — Fri, 06 Oct 2017 21:53:00 -0400

From reading what is on the website, it seems like they are a community based outpatient clinic (CBOC). Here on the east coast Veterans Integrated Service Network 6 (VISN6) we have CBOCs. This facility sounds similar. Read through the website and then ask your primary care provider questions. It is better to work within the facility to prevent going all the way back to the beginning with a new providing situation. http://www.triwest.com
If you are not familiar with navigating Veterans Choice you may end up with Bill because proper authorizations were not in place. I hope you make headway with your needs.

TriWest Healthcare Alliance

TriWest Healthcare Alliance is On a Mission to Serve our nation’s Veterans and military community in partnership with the Department of Veterans Affairs (VA) in administering the Veterans Choice Program (VCP) and Veterans Affairs Patient-Centered Community Care (PC3) program. It is our privilege to work alongside VA as we provide Veterans with access to high-quality health care through our network of community providers.

Response by MSG Laura Washington made Oct 8 at 2017 9:45 PM

MSG Laura Washington — Sun, 08 Oct 2017 21:45:30 -0400

SPC Diana D. You have received some good advice with options using the VA and the option of the VA Choice Program. My question is as a Vet do you have TRICARE Standard or TRICARE Prime. With standard you have some choices, you can check the website for a TRICARE authorized provider and what you cost shares or copayment, and make the appointment. If you have prime, you your Primary Care Provider has to make a referral for you. You should be able to create a mytricare account and view information like your explanation of benefits, Eligibility, Authorizations & Claim Status. If you decide to use VA Services, there is a patient advocate to assist you with appointments and referrals. Not sure how long you have been waiting, it may be due to the upcoming changes that go into effect 1 Jan. I hope this info is helpful.
http://www.mytricare.com

myTRICARE.com

The Military Health System (MHS) is modernizing TRICARE to better serve you and respond to changes in law and policy. Most provisions will go into effect on January 1, 2018, with full implementation occurring on January 1, 2019. Learn about the upcoming changes to the TRICARE Program.