Beware of Local “Emergency Centers” Not Authorized by TRICARE

Posted by Jason Van Steenwyk

tricareTRICARE beneficiaries may have noticed new kinds of “Emergency Centers” popping up in their area. It may seem like a tempting health care option but, free-standing emergency rooms (ER) that are not affiliated with a hospital may not be TRICARE-authorized. If a provider, such as a free-standing ER, is not authorized then TRICARE is prohibited from paying it “facility fees.” That can leave a beneficiary stuck with a big bill.

Beneficiaries need to “know before you go.” Check a free-standing ER’s TRICARE status – before emergency care is needed. Beneficiaries can check if a provider is TRICARE-authorized by calling their regional contractor. Contact information for regional contractors is available at www.tricare.mil/contactus.  All TRICARE network providers are also searchable at www.tricare.mil/findaprovider

TRICARE defines an emergency department as an organized, hospital-based facility available 24 hours a day providing emergency services to patients who need immediate medical attention. Emergency departments affiliated with a hospital are most likely TRICARE-authorized providers. Beneficiaries who seek care at a free-standing ER need to ask if the facility is affiliated with a hospital-based emergency department. If it isn’t, the beneficiary will need to make a decision about getting care elsewhere or being responsible for the facility charges.

Learn more about emergency care under TRICARE at www.tricare.mil/emergency.

Source material here.

 

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