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Why Have Area Hospitals Stopped Accepting Tricare?

November 30, 2007

Dear Tico Times:

Several months ago, and without notice, ClínicaBíblicaHospital closed out medical services to the recipients of Medicare and Tricare. Then, just recently, and again without notice, CIMAHospital coordinated this action and discontinued services in the same manner. No circumstances were ever given and I request, most humbly, that The Tico Times conduct some research as to why these two hospitals have put us down.

James J. Seta

Retired, U.S. Army

San José

First of all, as far as we can tell, Medicare has never covered U.S. citizens abroad, except in some emergencies.

As for Tricare, we called CIMA and Clínica Bíblica hospitals to see what was the trouble and got the same answer from both places: Tricare has not been paying its bills on time, if it pays them at all.

That’s because the U.S. government program designed to offer health care to veterans has become cautious about paying claims from abroad after several high-profile fraud cases, said representatives from both hospitals.

That caution has meant long delays and incomplete payments, which indeed caused Clínica Bíblica to stop accepting Tricare altogether, said International Health-care Coordinator Rogelio García.

García said the hospital sent out notices in mid-2006 advising customers that it was no longer accepting Tricare.

CIMA, meanwhile, hasn’t stopped accepting Tricare. It has, however, started charging Tricare holders their deductibles and co-pays up front, said CEO Carole Veloso.

Veloso said it can “easily” take six to nine months for Tricare to pay CIMA’s claims, something that is not good for business.

“There are a lot of reasons why they are so cautious,” Veloso said. “But what it ends up being is we’re providing a service we don’t get paid for for a year.”

 

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