scentedgal

I have Tricare Prime and Im in the west region. I just called them to find out what providers are qualified and they had nothing. I was transfered to another person they couldn't find a a Dr. either. Im in Ft. Leavenworth, KS anyone had this problem?

I just wanted to do research on the Dr.'s in this area that Tricare covers so when I see my PCM I will have a say in who I go to. Suggestions?

I started backwards. I actually searched the name of the Dr. I wanted thru the Triwest services website.

But if you are Triwest like me, you can copy and paste this link on your browser and search for providers in your area

http://triwest.com/unauth/apps/OnlineProviderDirectory/default.aspx

I'd recommend you register and activate an account if you are a beneficiary, as you can view your referral's etc.. faster than just be waiting on the mail to bring you the letters...

Hope this helps! Good Luck!

Thanks "Navywif99" ! I'll definetly need all of that ! )

About the referrals.. you'll definetly need it for your consultations, etc.. but not for the seminar. But make sure before you see the surgeon (at the consultation) you bring your referral from the PCM other wise.. Tricare wont pay for it.. It took me like 3-4 days to get it, without counting the days I had to wait to see the PCM ) hehehe

Good luck ! and hope all works out for you too!

Thanks "Navywif99" ! Still working on it !

I dont think you need a referral for the seminar. But you'll definetly need one from your PCM for your 1st consultation with the surgeon otherwise the insurance wont pay for it. After that, you'll probably need to see the psychiatrist for a pre-op evaluation (you'll need a referral from your PCM too), and after the psychiatrist submits your evaluation to the surgeon, the surgeon will submit all the packet (PCMto Triwest and see if they'll approve your surgery. At least that's how it went with me.. it might be diff. .. dont know..

But good luck with the journey !! )

I have Tri-West too and Im just begining the process. I am scheduled for a seminar for April 23 but that is as far as I have gotten. Do you know if I need referrals from my PCM to see the surgeon?

I hope your apeal goes through. Good luck!

Can someone help out on ideas on what to put on my appeal ?

I am frustrated, as my LAP-Band procedure was denied by Tri-west today!

I did the "scavanger hunt" (PCM referral for consultation and seminar, attended the seminar, met with my surgeon, met with the psychiatrist, etc.. everyone approved for me to get my lap band surgery - except TRIWEST).

I sort of know that you either are 200% over your ideal weight, or weigh over 100 lbs plus have 1 morbid disease.. (HBP, Diabetes, etc.) to be approved for the procedure.

I am 100+lbs overweight, and with no co-morbid diseases.. However, I had Gestational Diabetes back in 2009 and had my gallbladder removed back in 2005. Have a family history of HBP, Heart attack, diabetes (granparents), and my dad actually has type 2 Diabetes. I've had anxiety attacks in the past, but other than that.. .. that's it.

Any suggestions on what to submit on my appeal ??? Referrals?? etc.. ?? I'd really apprecciate it..! Am frustrated and heartbroken! :S 2 months of doing all this .. to get a no..