Tricare Insurance Evaluation
Ages 2.5 to 59 - testing must fit our areas of expertise
Intake, 1 to 2 testing Tricare testing sessions, Feedback, and Tricare Report with diagnosis and recommendations
Health insurance lets us “answer the question asked.” These evaluations are more brief and limited by what insurance deems medically necessary. For example, we CAN answer the question “Does my child have anxiety?” or “Does my child have autism?” Tricare Evaluations are more in line with a brief Psychological Evaluation. Any strengths and weaknesses noted through the testing deemed necessary to answer the specific question will be noted; testing used to assess the full range of strengths and weaknesses will not be performed in most cases.
NO INSURANCE COVERS EDUCATIONAL EVALUATIONS FOR LEARNING DISABILITIES - Tricare clients may discuss adding an Educational Addendum that is not billed to Tricare and includes a separate testing session to their report with an out-of-pocket fee. On Tricare Humana Website: “TRICARE doesn’t cover psychological testing for academic placement.”
OSE tries to book six Tricare cases a month. If we have availability, we will move Tricare clients forward if times are not needed for private pay clients. If there is a cancellation, we will work to move clients forward. This is a difficult process, with each evaluation being at least three appointments, and this doesn’t happen very often.
Tricare clients must provide complete and accurate Tricare Humana information prior to the intake. Failure to do so will result in the client being responsible for paying for the cost of the evaluation. Oceanside Evaluations sends you an email with a link to the Tricare forms that need to be completed when you set up your appointments. Please make sure to complete those at least three business days before your intake. Tricare allows you to upload the ID card necessary to our secure portal.
Some of our Tricare clients have deductibles or copays. Oceanside Evaluations processes the claims through Tricare and will invoice the client for the amount Tricare says they owe. Typically, if there is a copay, there will be three total copays due for the process of intake, 1 testing session, and feedback.If a Tricare client wishes to be a Private Pay client, please let us know before testing takes place. Scheduling for Private Pay cases is done differently, and we want you to get the full value of what you are paying for. No superbills can be submitted to Tricare since Oceanside Evaluations is in-network with Tricare.
What Happens During a Tricare Evaluation?
A Tricare evaluation is broken up into four parts:
Intake – this initial session allows us to get to know you better. Usually, if the client is a child, only the parent(s) attend intake. We’ll answer questions, ask questions, review the health and psychological history, and talk about who will complete the rating scales. It is possible to do this session virtually if the person attending is in Virginia.
Testing sessions – one to two in-office sessions will take place where an individualized testing battery is administered to gain an understanding of the person’s skills and abilities as well as a deeper understanding of areas where they are struggling. A Tricare Evaluation is individualized to answer the questions of concern such as possibly:
Anxiety
Depression
ADHD
Trauma
ASD
Feedback – Usually, if the client is a child, only the parent(s) attend feedback. During this session, your psychologist reviews the results of evaluations, asks any follow-up questions to get the information they need before writing their report, answers any questions you have, and discusses possible support resources. We consider the feedback session part of the evaluation process. It is possible to do this session virtually if the person attending is in Virginia.
Report – after your assessment is completed, a thorough report of findings will be provided for your information. This will arrive as a PDF around 15 business days after the feedback session through the messaging portal. You can download and share the report as you see fit. Oceanside Evaluations does not automatically send the report to the doctor or referral source. It can be used as documentation for your therapist, physician, school, and others who offer support and resources.
How Do I Get Started?
Whatever reason you have for considering psychological assessment, the Oceanside Evaluations team looks forward to hearing from you. Getting started with one of our knowledgeable psychologists is quick and easy. You can email our office at office@oceansideevals.com or call 757-771-0269. Our team looks forward to speaking with you soon.
