Fix Coming for Major Problem Faced by TRICARE Appointment-Seekers

Fix Coming for Major Problem Faced by TRICARE Appointment-Seekers
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This article by Karen Jowers originally appeared on Military Times, the nation's largest independent newsroom dedicated to covering the military and veteran community.

  

Military Tricare beneficiaries seeking health care in the civilian community will see more accurate directories of medical providers in the future, said the director of the Defense Health Agency.

 

Those who are trying to find a provider in the Tricare directory of providers for their area, and for the needed specialty, are too often finding that the civilian provider isn’t available for a variety of reasons, such as no longer being in the networks.

 

It’s a big, issue, and officials are working on it, said Army Lt. Gen. Telita Crosland, director of the Defense Health Agency. “I got a lot of feedback that the network directories are terribly inadequate,” she said, during a family forum at the annual meeting of the Association of the U.S. Army Tuesday.

 

[FROM MOAA: GAO Report Highlights Problems With TRICARE Provider Directory]

 

In the next generation of Tricare contracts, which will tentatively kick off in 2025, depending on a pending protest, the contractors will check monthly on the adequacy in each of the areas. “There are penalties for not having a network that has capacity that actually leads to appointments to see individuals,” she said.

 

“But that’s not to say we’re not addressing it now” with contractors in the U.S. as well as overseas, she said, to get good data for patients to be able to make appointments and see providers.

 

Officials “got the wrong measure” in the current contracts for requirements for networks of medical providers, she said. “The contractor is doing exactly what we asked them to do, which is to sign people up. They do that in good faith.”

 

[UPDATED MONTHLY: MOAA's TRICARE Toolkit]

 

Because of the feedback she had been hearing about the provider directories, she did a small test, and had 10 team members call 10 numbers in the National Capital Region to get a Tricare behavioral health appointment. It resulted in three appointments.

 

“That’s dreadful,” she said.

 

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