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New mission act & Community Care/Tri West???


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Anyone   having problems with the community care act  to be approved by  tri west insurance?

I have been approved by the Community Care people at the VA   They had me to find a Dr and I was approved for the care..I found a Dr  the Dr sent me to a OT Therapist  or Physical therapist (they do both) anyway the girls at the private physical care center  in my home town calls us and tells my spouse they can't get a confirmation on the Approval from Tri West..they said they need the approval from Tri west because Tri West is how they get paid...I have check with my VA PCP and she said I was approved for the care....the girls at the physical therapist center  (clerks)says they can't see me until they get a confirmation approval from Tr West...They are waiting on Tri West to call them back with a confirmation Approval.

.its been a month now I been waiting  and I need this seen about  my medical problem soon  or the only other thing is surgery as to which I am trying to Avoid.

Anyone had problems with Tri West not getting back to the private care Docs?

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Buck have you tried calling Tri West to see if they can send the approval physical care center, you shouldn't have to but it might speed things up. Here is their number in case you don't have it 1-855-722-2838. I got their number from http://www.triwest.com/en/contact/.

Hopefully they will help you.

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I dont know about Tri West, but VA is slow, as usual, to pay for providers in my community.  

Hopefully there is someone in your VA that you know who can speed it up.  I have a gal in my VA that "fixes anything" for Vets, and know her well.  

If you dont have someone like that, then get someone like that.  I think maybe I will get her flowers for thanksgiving.  She needs to be someone who has been around VA a long time and knows all the ropes and knows everyone else who works there.  

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Broncovet  its not the VA   THE VA has approved me for the private care  its Tri West Insurance  who VA uses to outsource veterans when they can't get to the veteran in 30 days for the healthcare.

The Approvel has been approved by the VA Community Care people...the private Dr Has been set up to do the care  but they need a confirmation approval from Tri West  before they start the care...the girl at the Private care has called and called Tri West Insurance  and they will not return her phone calls,    she has called them 4 times and still not a word from Tri West.

We have called Tri West and they tell us we are approved  to go get the treatment care  but the private Dr will not do it until they hear back from Tri West..I don't blame them for that I 'd want to make sure I got paid too.  but in the mean time I suffer.  eh!!!

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Yes Paul my wife has called them and ask them to call the private Dr office and let them know its ok to do the treatment...well this is what the private Dr is waiting on   their waiting on Tri West to call them and give then a confirmation approval for the care and they will send them a check after the care is completed.  Tre West will not call them? and this is what I need them to do.

the VA COMMUNITY CARE PEOPLE REQUEST THE PRIVATE CARE Dr  CALL TRI WEST....when they do call  Tri west  they can't get them to say its ok go ahead with the treatment...the private Dr has tried and tried..and I am afraid they may tell me to seek treatment ele where...this place is very busy  they are that good  people come form mile and miles to this healthcare physical therapy center...this is why I chose them to do my health care.  and its in my home town  so I don't have to drive across the big city's of Dallas & Ft Worth 3 times a week for physical therapy on my Hand,  other wise  the Dr said he will have to slice my hand into and scrape out the matter  that is giving my hand  problems.

They can do microscopic heat rub therapy on my hand for 6 weeks  3 times a  week  and that should desolve the matter inside my hand  so I can use that hand and my fingers will straighten back out.

its called something else I can't remember what they call it ? but its new and it works  and pain free.  other wise the Dr said he will have to do surgery on my hand and its not a pretty sight.

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Well, Tri West says the problem is with VA, and VA says the problem is with Tri West.  My guess?   The VA never sent them the authorization.  Call VA and ask them to send it again, that it apparently got lost.  Get fax numbers of tri west, and ask VA to fax it.  It shouldnt take a month, tho I have had delays with that, too.  

Edited by broncovet
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