KarinaM

NOT APPROVED. I checked this morning and it was still showing pending but this afternoon it was showing NOT APPROVED. Well at least I got an answer. I will try to see my chances on Travis , but I'm not sure if it will work or not.Do you know if they go thru Tricare?

I'm so sorry you had to start over. I also had the same problem to get approved. My doctor's office took 2 weeks to fax extra info to TriWest so while the authorization process should not take more then 5 days it took 12days. (MY LUCK)

Are you guys ready to hear my wining??? Here I go: Yesterday I wrote an email to the appeal people asking them to take me out of my misery and how stupid I think this wait is etc. This is what I got from them: Dear KARINA, Thank you for your recent web mail inquiry. According to the notes on your file, the appeal process will be completed by 11/8/08. You will receDear KARINA MANG, Thank you for your recent web mail inquiry. According to the notes on your file, the appeal process will be completed by 11/8/08. You will receive the determination via mail. We do not have any way of "speeding" up the process, these guidelines are set forth by the DoD, Peer Review and the Medical Director. If you require additional assistance with this issue, please call TriWest toll free at (874-9378). When I made my midday call this morning guess WHO answer the call the same IDIOT who answer my email. Of course we got in to it and he try to tell me my appeal is a FACTUAL not a MEDICAL NECESSITY appeal (he pretty much is telling me I just WANT the surgery, I do not need it). I just can't take these people anymore. I wish I could complaint to someone higher then a CUstomer Service Rep.:smile:

Congrats, HelloPenny!!! Happy for you. Let us know how you are feeling when you can.

Meggie and Tomatogirl you guys gave HOPE again. I called Travis AFB and they told me all I need is a letter form my PCM. I called my PCM and she is off today but I asked her to call me tomorrow. They told me it takes abt a week to be added to the sytem and then they will call me for an appt. By this time it will be Nov 8th(last day for Triwest to give me an answer). I will take ALL my paperwork and hopefully will work, lets see. I really don't care WHERE I wil get the surgery, of course I would love to get it with my gorgeous doctor Sanchez in Burlingame, but as long as I get it done. My first choice was the band because I was going to get it with Dr. Ortiz in TJ, but since money was very short and I realized I had a chance to get approved I decided to try. Meggie, Mountain View is between Palo Alto and San Jose, it is in the Sylicon Valley (Google HQ is located here). It's abt 30mi from San Francisco. My husband is works at the USCG San Francisco Air Station (SF airport). Thank you one more time Tomatogirl and Meggie. Of course I can NEVER thank my friend JWRN enought. If I get approved by TriWest will be totally her fault. hehehehe

Meggie, I'm trying to get the gastric bypass, I want to go EXTREME. Do you think I could go to Travis? I have Tricare Prome Remote, so I think I'm not allowed to go to a military facility. Do you think they would be easier there? Do you think if I get denied now for the gastric can I ask the doctors office to resubmit as a LapBand (would this be a new authorization or they would take my old one?

Meggie, you made me:lol:. You are funny. I'm so happy for you guys. HelloPenny is probably done by now,I guess. Are you ready for your surgery? How about you Tomatogirl? Are you both on the LapBand? I'm hoping they approve me for my gastric Bypass. Nothing yet but if I'm sure if I think hard I will realize they are just taking their time to tell me NO!!!!!. Oh well....

Great question. I have no idea, I think after this THAT'S it, nothenig else. I will have to deal with it.It really sucks they are taking so long they could just say NO so I can sleep again. The only day of the week I can relax it's saturday because I know they wil not be making any decision. From mon-fri I stress and call them all the time. On sunday I'm alreday waiting for their decision maybe on monday.

THAT'S WONDERFUL, Meggie. So happy for you. I wish I could get mine also before Dec 22nd when my parents come from Brasil,but I don't now if it will work. TriWest told me they now have a note saying they will conclude my appela by Nov 8th (it will be 60 days). hehehehe I guess we all know it will be a denial.Well.....

YEP, the phone call t was almost funny, because I dumped on the poor lady how TriWest was to blame for my depression.hehehe. Well, I just can't take it anymore.

I'M SO HAPPY FOR YOU!!!! :tt2: I called Triwest yesterday and I got a very nice lady on the phone and she felt sorry for me and told me she was going to have someone calling me to give me a better update. This morning I got a phone call from Triwest and I was so happy thanking the person on the phone for getting back to me. Well, this lady felt really bad because she was calling me to tell me about my options about depression(she is from menthal health). Of course I told her ALL my depression is TRIWEST's fault and unless I get approved there is NOTHING they can do for my. She felt REALLY bad and so far NOBODY called me. They tell me I will get an answer by Nov 8th. :w00t:

I'm SO HAPPY for you and Meggie!!!! Congrats. I'm still waiting on my appeal.:smile:

Are you serious I think he is the hole WORLD JOKE and it's very embaracing for us to have him as a president.He is stupid, imcopentent and I'm very surprised the american people kept him there until now. Did anyone heard about impeachment?

If I get my surgery approved by my insurance(I'm currently on appeal), I will have it done with Peninsula Surgical Medical (with Dr. Sanchez). I heard very good things about them.

I'm sure she will have NO problems on getting approved as long as she gets all her tests done (pscy eval, nutricionist, PCM letter and sleep study). Besides the nutricionist eval she should be getting all paid by Tricare.

I have High cholesterol(not comorb) and a very bad accid reflux desease(not considered eather) and high blood sugar but I'm not diabetic. My chances are almost 0, I guess.

Hi, I had to pay for my nutricionist because TriWest will NOT pay for it. I agree that TriWest its harder to get proved.

Any news, Meggie?

Yes and no they only sent me a letter saying I did not meet the criteria (the 100lb over with one comorbidity or 200%). I "gained" 20lb more and sent my appeal. I'm sure it will be a denial because it's taking more then 30 days.If it was an approval I think they would done it faster, What do you think?

Meggie, I would no wait for your surgeon to call TriWest. I'm still waiting and will be one month this friday. I had a TriWest lady on the phone lst week and she started: "oh you called...." I interrupted her and told her not to count because I call at least twice a day everyday and I also check the web at least 10X. After she told me it was still pending I told her: Ok I will call again tomorrow morning. hehehe They are probably hopping I get approved so they can get me to stop calling.

OMG. I'm so sorry for all this trouble you are going thru now. I'm sure this will be all gone very soon and you will be able to enjoy the band.Just remember you will get great results. Will Tricare cover the antibiotic????

YOU GOT IT!!!! I'm so happy for you. Hope you feel better soon. Just remember it's worth the pain. hehehehe:thumbs_up:

Meggie, I think you have Triwest. 1888-triwest

Meggie, I agree. How can you wait until the next day??? YOu have to drive them crazy. Keep calling. I call at least twice a day. I'm sure doesn't make much difference in my case, but I'm on top of whats going on. You know they don't care about us. Call your doctor, call Tricare.Did you get your letter yet? Who will be doing your appeal, the doctor's office or yourself???Ask the Dr's office what's the procedure and we go from there.

Nothing yet Meggie. Let us know if the doctor called Tricare. :thumbup: