I had to drive to the clinic today because I'm still sick with some sort of infection. So I stopped at the referral management office to see if they had an update on my request for the nerve burn.
It's never good when the worker at the computer types something and then looks confused at the screen then has to flag down another worker to helper her figure out what something means. They print out a paper and hand it to me, with a very sad look on their face, saying "Tricare has denied your request. You sh)ould receive a letter in the mail soon saying why. It will have steps to appeal the case." A letter in the mail? and you won't even tell me why?! I summoned all my dignity and in a reasonably level voice asked "can I please have my patient advocate? Like, right now?"
She handed me a post-it with his name and number. I went to a far corner of the waiting room where I cried and texted my husband to come see me. Then I called the advocate. He was in a meeting so I left a message. My husband came and met me. He called Tricare and demanded an explanation of why I was denied.
And here is what told to us: my case was reviewed by 2 boards of nurses. Both boards are of the opinion (opinion) that spinal nerve burns aren't proven to actually work. So they decided that I couldn't have my burn. Despite the fact I have had this procedure before, it was approved and it worked wonderfully. So my health was determined by a bunch of people that don't even know me and didn't even look at my history. They strictly looked at my MRI report and then at the request before them. We were both livid. And tricare was incredibly confused that I had even had the burn before, which makes me question their record keeping.
Tricare refuses to reverse decisions. They are forcing us to appeal. Bryan leaves in 2 weeks. I am screwed. And let me tell you, my hubby is not someone that gets mad easily but he pretty much exploded.
He is still on the phone as we speak. He has even managed to get ahold of the board of nurses.
Now what had us so very angry with this "not a proven practice" thing is last week our good friend saw my exact doctor and got the exact same burn. Paid for by Tricare. We have several friends in active duty that have gotten this burn paid for by Tricare. This all boils down to I am not active duty. I am a dependant. I am very close to setting something on fire.