dl2418

I'm hoping to be banded in March as well!

I talked to my surgeon's office and the two tests are not required by them, nor by Tricare. However it may be required by the psychologist. So I will call there and ask again tomorrow when I get there. No need paying big bucks for things that my surgeon and insurance don't want/need. I also asked them if losing weight now by trying to live a healthier lifestyle would affect my approval/denial and was told to go ahead as they would be submitting my weight at the initial consult. GERD and borderline hypertension are the only co-morbidities I have, with a BMI of 40.9. I hope that is enough to get Tricare to approve me.

So finally, after months of trying to get my prior auth from my PCM, I got it and my appointment with the psychologist is tomorrow. According to the psychologist's office I will be taking an MPMD, and MMPI II in addition to the one hour interview. However, I think Tricare Prime is only covering the interview. So I have a call into my surgeon's office to see if the other testing is required by them, or just other insurances. Regardless, if it's a requirement of the surgeon's office, then I will suck it up and pay out of pocket. Also I've had my initial consult with the surgeon and once they receive my psych eval, everything will be submitted to Triwest for approval. How harmful would it be to try to start losing weight now, on my own? Just making healthier choices similar to what I'll have to do after the band and working out more? Or do I need to stay fat until the day of surgery?

Weighed in at 220, BMI is 40.9. Doc will dictate a letter for Tricare. Once I get my psych eval done, all will be submitted and according to the nurse, approval/denial turnaround time has been about 72 hours. So here's hoping I can get my psych done at the beginning of the new year and and start this new life.

Well the doctor I was supposed to meet, was apparently pregnant and delivered last night. So my appointment has been rescheduled AGAIN. So now I don't go until December 15th. So here's to some chowin' down at Turkey time.... Still worried I'll be denied. But at least I can say I gave it a shot. And if so, I'll figure something out. I will be a hotter version of me before my husband comes back from the sandbox, one way or another!

I am even more worried now that I won't be approved because I don't think I'll make the 100lb overweight mark now. Sad thing is I've been trying to maintain my weight, if not gain about 5 pounds. However I lost a couple after I started my current job since I'm on the go constantly (nurse). Then somehow in the last week I managed to lose 6 more pounds! What the heck?? Had I been trying to lose, certainly I would have gained. Cross your fingers that between now and Monday I can get those 6 pounds back.

My surgeon requires that the psychiatrist perform an MMPI. They have particular paperwork they request be completed by the psychiatrist performing the evaluation. And we all know Tricare only requires what the surgeon requires. This is a requirement for my surgeon.

Kudos to you! Definitely sounds like one heck of an adventure. Thank you for sharing your story. I talked to my out of state friend today and it sounds like she will be able to be here to help me out. I am so thankful!

I am currently seeing someone who is a Tricare covered psychologist, but they will not do the test I need for surgery because they said Tricare won't pay for it. Yet Tricare is paying for my weekly talks that I self referred to. Go figure.

Have your PCM send a referral for prior authorization to the person you found that is able to do it. He should be able to specify that you need an MMPI (or at least that's what my surgeon requires) and this is the only person in the area that performs the test needed for surgical clearance. Good luck. I will be attempting the same thing. If that doesn't work then I will just pay out of pocket to get it done.

Thanks for being so candid, terilynn. I really appreciate it.

Thanks for sharing your story. I have an almost 2 year old and a 7 year old. They would only spend the night with a neighbor if I have to stay overnight at the hospital due to not having anyone to drive me. Just curious, how did you manage the no lifting anything heavier than a gallon of milk if one of your twins was totally dependent on you? Did you have any complications from doing so much so fast?

I am assuming if I do have to go it alone, that I will have to stay overnight before I'd be allowed to drive the 1 hour home. If that is the case, my next door neighbor would likely keep the kids for me or I could have the neighbor across the street pick them up from next door and stay here with them. I tolerate surgeries fairly well. My laparoscopies I've recovered quickly and only after the first did I receive morphine. The others I left with just Motrin. After an emergency C-section with DS, I was up and walking after 3 hours. The only reason it wasn't sooner is because the day shift nurse wouldn't let me. He was born Monday, we were discharged Wednesday, I had my staples out on Friday morning and by Friday afternoon we were on our way to Indiana from Oklahoma. Once there we celebrated Christmas Eve and Christmas with our families and the day after was spent walking around the outlet mall. I'll be sure to ask my surgeon for something non-drowsy for pain relief, such as tramadol. Thanks for sharing your experience.

I am in the same situation. DH is over in the sandbox and the closest family I have is a 12+ hour drive. I also have no real friends here. The closest I've got is my next door neighbor, who is our child care provider. I have a friend in Colorado who said she would try to be here for it, but she just started a new job and I'm not sure she'll be able to come. So I'm just making a "Plan B" in case I do have to go it alone.

I am just curious if any of you have gone through the banding process without a key support person? It is very likely that I will have to do this all on my own. There is no one here to drive me to the hospital or home. I am planning surgery for midweek so that the baby can go to daycare next door and my oldest will be in school. This will give me a couple days to recoop before having them both all day over the weekend. My main concern is how long I will have to stay post surgery before I can drive home. I've had 3 other laparoscopic surgeries for other issues and could get by the day after surgery with Motrin. However, after going through the Emmi presentation, I realize Motrin may be a thing of the past for me. I live about 1 hour from where surgery will be taking place. So if anyone has BTDT, I'd love to hear from you on how you worked it out. Thanks.

If he is a Tricare Prime contracted provider, then he has agreed to accept the payment from Tricare. Did you have your referral to him through your PCM? I'd be calling Tricare and letting them know he is still trying to bill you after accepting payment from them for services. If he does then it is fraud. Also you should have recieved your beneficiary statements from your visits that will show what your provider billed, what tricare paid and any amount owed by you. If that amount is $0.00 then he is being shady......

The seminar is a requirement of the surgeon I will be seeing, not Tricare. I will recieve the paperwork at the seminar, once that is complete, I can schedule my consult and go from there.

That is the same logic I used when I was taking phentermine (under a doctor's supervision). I knew I wasn't getting much calorie-wise and wanted to make sure what I did eat was giving me the nutrients I needed. I am hoping that I will carry that same mentality with the band.

I'll do my best to keep everyone updated.

Well, I had recieved the prior authorization to see the surgeon, but I'm not sure that means that I've actually been approved for the surgery. I'm sure I'll learn more next weekend at the seminar. I'll recieve my paperwork then as well so that I can schedule an actual appointment with the surgeon.

Has anyone who has been banded through Tricare (Triwest) been approved for the surgery without hypertension or diabetes as comorbidities? I am 100lbs overweight with a BMI just over 40%. But I do not have high blood pressure, diabetes, or high cholesterol (as far as I know...waiting on lab results). My TSH/T-4 levels are also WNL. The only health issues I can really relate to being a fatty are depression, shortness of breath with moderate exertion (stairs kill me), and some acid reflux. But only the depression is documented. The other stuff I just deal with and/or treat with over the counter medications. I recieved the referral to see a bariatric surgeon and I am attending the required seminar next weekend. I am just so worried about being denied because I don't have HTN, DMI or II, hypthyroid, or hyperlipidemia. I've tried weight watchers, thedailyplate.com, increased exercise with portion control, and phentermine. The only one I've had any success with is phentermine but it caused my blood pressure to increase and chest pain, which was no longer a healthy way to lose weight. There's also been lipovoxx, avakar, and alli that have also failed. I can only seem to lose 10 pounds before hitting a plateau I can't get around and then gaining it back. So....just wondering if anyone else had been approved without the "traditional" comorbidities.