WEST REGION — TriWest Healthcare Alliance president and CEO David McIntyre Jr. apologized in a publicly posted letter to TRICARE beneficiaries in the West region for coverage problems linked to errors in patient portals. The portals incorrectly indicated some beneficiaries had other health insurance, resulting in denied claims.

McIntyre wrote: "I want to personally take this opportunity to apologize to those of you who have experienced challenges with Other Health Insurance on our watch, and to assure you of my and my whole team's commitment to your beneficiary experience. I understand that some beneficiaries' claims incorrectly reflected that they had OHI, which resulted in the claims initially being denied — as well as delay and frustration. What's more, the encounters for some with our customer service operation were not efficient or effective. This is not acceptable, and our team has been working diligently to fix this issue."

TriWest administers the military's healthcare benefits to more than 4 million people and processes more than 2 million claims per month. The company is one of the contractors that administers TRICARE, the military's healthcare program for active service members, veterans and their families, which is overseen by the Defense Health Agency, a part of the Defense Department. TRICARE coverage is divided into East and West regions, and in 2025 TriWest took over the West region, replacing Health Net Federal Services.

A spokesperson said the denial rate for Other Health Insurance errors was 2.3% a little over a year ago. The letter stated that rate is now down to 1.3%. TriWest representatives have been in touch with some beneficiaries since early May, working to resolve coverage claims.

Guy Shoemaker, 64, of Fort Worth, Texas, a retired Army sergeant first class diagnosed with Stage 2 throat cancer in 2021, had tens of thousands of dollars in previously approved claims overturned and money paid to providers clawed back due to coverage errors. His portal indicated the denials stemmed from an Other Health Insurance error, though he had only a vision plan. Shoemaker stopped speech-language pathology appointments needed after chemotherapy and radiation when denials began last year. When he returned in January, his speech-language pathologist told him his health had deteriorated so much due to delays in care that he should consider a feeding tube. After TriWest was contacted about his case, a customer service representative reached out and the company began correctly processing his claims.

"What they've done is acknowledged the fact that they have an issue," Shoemaker said.