Contracting to be a Tricare for Life provide

Contracting to be a Tricare for Life provide
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01/10/2019 2:00 PM

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Message # 6993930
Vicki Holoubeck

Was 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 PM

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Reply # 6996012 on 6993930
Dr. Roger Aveyard

Hi 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 AM

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Reply # 7129050 on 6993930
Vicki Holoubeck

Thank 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