Re: Anyone seeing Ponseti doctors with TRICARE?

[Guest guest]

,

We have at least one other mom here (Faith) who is with Tricare but

she had to switch to the other plan (can't remember what it's called,

not prime though...) to get Dr. P. covered. I think... I'm sure

she'll pipe up soon with info for you. And, for whatever it's

worth, that one child Dr. P is having problems with is only one of a

very, very few. I only know of one other that has a foot that just

isn't staying corrected either (Kai - Angel is mama). Like was said,

the foot corrects easily but doesn't stay that way. If anyone can

correct atypical though, it's Dr. P. There was also some information

recently that came from the Nov. symposium in Iowa from Dr. Deitz

(Dr. P's colleague). He had information he presented that alluded to

atypical not being present at birth, but very possibly being caused

by casting improperly. Now take that with a grain of salt because

it's new information and not a for sure at all but we do know that

one kind of atypical, plantaris doesn't show up till after the

tenotomy. Whether it's there beforehand or not, not known just yet

but they're working on figuring all that out. The one thing that is

interesting to me with this theory is that they've never had an

atypical case come out of Iowa's CF clinic. Yet they're showing up

all over the world after attempts to correct all the

time. Interesting to say the least...

If Faith doesn't chime in soon I will email her privately. I know

she's been mega busy lately and isn't checking the website as much as

she used to but email should get her attention. She knows how to

work this tricare thing pretty well by now lol...

Kori

At 09:18 PM 12/26/2005, you wrote:

>Hello. Dr. Ponseti has expressed an interest in seeing our daughter,

>but right now, it doesn't look like the visits would be covered for us

>by our insurance. He is considered a " non-network provider. " I thought

>that all we needed to do was get a referral from our PCM, but I was

>told by Tri-Care that non-network is only when there are no other

>orthopaedic surgeons in the area. I have even tried looking up

>intrastate Ponseti doctors on the Tricare provider list, but none of

>them are listed. We have TriCare Prime in Florida... I have explained

>that their providers want to do unnecessary surgery, and that this

>would be more cost effective, but so far, it doesn't look good. There

>has to be a way around it! Anyone else had experience with this?

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[Guest guest]

Hello again! I asked Dr. Ponseti's office if they accepted Tricare-

they said yes. Our PCM put our referral in as a second opinion and

we got it. I believe I was told once that if you go and see a non-

network provider, they will still pay some (maybe 80% ?) but you

have to pay the rest- this was from a friend, not Tricare. Are you

talking to your local tricare office (at the base) or the 888

number? The people at the 888 number usually don't know what they're

talking about. It's better to talk to the local people. Also, have

you contacted your pcm? You should put in a telephone consult to

them and make sure they know what's going on. Ours got together with

the local Tricare office here to figure out how to put in our

referral since he was out of state.

Hope some of this works!

Jenn

>

> Hello. Dr. Ponseti has expressed an interest in seeing our

daughter,

> but right now, it doesn't look like the visits would be covered

for us

> by our insurance. He is considered a " non-network provider. " I

thought

> that all we needed to do was get a referral from our PCM, but I

was

> told by Tri-Care that non-network is only when there are no other

> orthopaedic surgeons in the area. I have even tried looking up

> intrastate Ponseti doctors on the Tricare provider list, but none

of

> them are listed. We have TriCare Prime in Florida... I have

explained

> that their providers want to do unnecessary surgery, and that this

> would be more cost effective, but so far, it doesn't look good.

There

> has to be a way around it! Anyone else had experience with this?

> -

>