So TAC Said No...AGAIN

Some important info I thought everyone should know when it comes to dealing with TAC, Treatment Authorization Centre's.

In 2010 I was approved by TAC for reimbursement for a medical test as it was required due to my pensioned condition. Well I "assumed" that when I submitted a receipt for the medical test reimbursement would be easy-peasy. Well you know what they say about "assume" you make an "ass" out of "u" and "me".

I should have known something was amiss when I submitted the receipt in July but heard nothing until December. That's right the TAC employee seemed to have a problem reading my file to discover that less then a year ago I had been approved for reimbursement. I'm giving the TAC employee the benefit of the doubt on not being able to find the decision in my file. I am going to "assume" that the employee did not even look at my file. Why should I be the only "ass" in this situation?

So I called the NCCN and told them to look for the decision from Sept. 2010. The NCCN employee found the document in a snap! So she called the TAC Manager and explained the situation to him/her. Apparently a TAC Manager does not have the power to overturn a denial. Why? Well seeing as a denial letter went out to the client it has to run it's course. Sort of makes me wonder why the title Manager applies to the TAC employee when he/she cannot make a decision when a wrong is pointed out to them? Well let's not dwell on that subject, we will save it for another day shall we.

Seeing as the NCCN employee and I had a good laugh over the situation, hey why yell at the NCCN employee they are just the messenger and probably get yelled at enough. I called the Office of the Veterans Ombudsman to inform them that this is probably a systemic problem and they can add it to the list. A list that is probably a kilometer long by now.

The OVO had some good advice for me when it comes to submitting a receipt for reimbursement. Leave a trail of bread crumbs for TAC when you submit your already approved receipt. Inform them to look for the positive decision for reimbursement by telling them the month and year the positive decision was made.

That's right we, the veteran community, have to do TAC's work for them! So sadly as veterans we need to keep our own records, sorry a file like VAC has on each of us, so we can submit receipts without having to go thru the headache of appealing a negative decision that we had already appealed and got a positive decision.

Hey one good thing about doing this is we will help VAC and TAC to reduce their turn around times for claims. Remember the receipt I submitted was stamped by TAC with the date 25 July 2011 as recieved and I was notified on 8 December 2011 of the denial.