tkee99516

You can add me - tkee99516. I've had RNY on 3-11-13, so slowly learning to eat again.

Would have like to taken a "mini" vacation, but only took 6 days off. I'm a certified coder & a medical biller, so having a desk job made returning to work pretty easy.

Add me to the March list - my surgery is tomorrow, 3-11-13. Excited & Nervous at the same time, even though I shouldn't be, as I've been through this before (Lap Band 8/2009, taken out on 3/20012, now going to a RNY). Keep me in your thoughts & prayers please, as prayers do work! Tammy

Just rec'd notice this morning from TriWest that I have been approved for RNY! The auth was put in yesterday from the MD's office & they approved it less than 24 hours later. Guess they don't move as slow as I thought they would. Actually, I thought they would deny it & I'd have to go through the appeal process like I had to do with the Lap Band back in 2009.

Here's what was faxed to me by TriWest: TriWest will cover only ONE bariatric surgery in a lifetime, except of there is a complication from the original covered surgery (slip of a band, etc.). Repeal/Revision of a covered bariatric surgical procedure, due to technical failure of the original procedure, is covered when ALL of the following criteria are met: 1) The patient has failed to achieve adequate weight loss, which is defined as failure to lose at least 50% of excess body weight or failure to achieve body weight to within 10% of ideal body weight, at least TWO years following the original surgery 2) the patient met ALL the screening criteria, including BMI requirements of the original procedure, AND HAS BEEN COMPLIANT WITH A PRESCRIBED NUTRITION AND EXERCISE PROGRAM FOLLOWING THE ORIGINAL SURGERY. 3) The requested procedure is a covered bariatric surgery. Hope this helps.

Do you have TriWest North? Did you have to "prove" to Tricare that you were following a supervised diet? I'm a little bit different than you as I had the band removed last year, and now I've put in for an RNY to be done in March 2013. My MD's office is submitting the paperwork today without the Nut as I don't have "6" months worth of visits. Your situation might be different due to the fact you don't have your band out yet.

I have Tricare. Had lap band put in on 8/2009. It slipped & I had it removed at the MTF 03/2012. I'm now in process trying to get a RNY approved with Tricare. Just had my first visit today with the off base surgeon, who will submit the auth to Tricare this Friday. If approved, will have the surgery on 3-11-13.