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February 28, 2019 at 10:10 am #29649
APPT Administrator
KeymasterContracting to be a Tricare for Life provide
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Subscribe to topic01/10/2019 2:00 PM
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Message # 6993930
Vicki HoloubeckWas wondering if other LIMHP’s that are not LCSW’s are Tricare for Life providers. Years ago a provider relations
person from Tricare for life told me if I was not a medicare provider (which cant be because am not PHD or LCSW) that I can
not be a Tricare for Life provider. Others have told me that they have gotten paid. What is other peoples experience with
this?
01/11/2019 2:04 PMEdit Move Delete Quote
Reply # 6996012 on 6993930
Dr. Roger AveyardHi Vicki:
Not sure about Tricare for Life, but for your information a PHD is not the most important credential for getting
accepted by Tricare, Medicare or Medicaid. It is the License that matters. I have a PHD but I am paid as an LIMHP by
everyone. A lot of people look at reimbursement schedules and believe that they can get reimbursement as a PHD if they have
one, but only if they have a Clinical Psychologist license. A long time ago Social Workers and Clinical psychologists
lobbied Congress for reimbursement for all of these programs, to the exclusion of other professionals similarly trained but
not licensed as those professionals. Therefore a Bachelors Degree social worker with a social work license can become a
Medicare provider, but not a PHD in, for example, Educational Psychology, like me. I once applied to Medicare to become a
Medicare provider and was denied. I appealed that decision to an administrative judge, who told Medicare that it would have
to prove that I was not qualified to be a Medicare provider, based on my education and experience. I waited for the
approval, only to receive a letter from a different administrative judge who over-ruled the first judge, who apparently had
been dismissed. He said I was not qualified! Politics!!
01/25/2019 10:48 AMEdit Move Delete Quote
Reply # 7129050 on 6993930
Vicki HoloubeckThank you Roger. I know, it is always confusing. That is why I was asking. People have told me you can be a provider
for Medicare because are an LIMHP and that is not true, you have to have a masters in Social work. Mine is in Clinical
psychology and they wont blink at me. I have heard that Tricare for Life is different than Medicare rules, but I was under
the impression they followed the same as Medicare
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