TRICARE PRIME PATIENTS

[blackmajyk 7]

I started the journey in Jan 2011, surgery July 6th, tricare has specific requirements, as long as u have a pcm that will work with ya for all the consults then everything should be great. Nutritionist and Psy was done within the first month..but then my dr gave me the run around..march had EGD done...then finally in May changed drs because found out so much wrong with the one I had..unfortunately have to go 2 1/2 hrs away for surgery but thats ok with me..the new dr is great..all i had to do was cardio and thats because of family history..once they turned in all the paperwork to tricare I was approved within 24hrs. So I would say average is about 4-6months depending on what your sirgeon requires.

Ann

Hi Everyone, I have Tricare prime and just curious about how long of a battle I have here with TriCare if anyone can give me a rough estimate. I am so anxious and impatient and want some kind of guess or comparison how long the process takes. My PCM sent in my referral on May 9th and I received the approval from Tricare on the 16th in the mail, they picked my surgeon so I called and attended the Seminar on June 9th and attended my consultation yesterday(June 29th). I have a 47 BMI and high blood pressure. Just curious what kind of hoops they make you jump through and about how long it takes if anyone can give me their own similar process. Thanks!

[melzie_99 22]

All of my process (meeting with PCM, meeting surgeon, and Tricare approval) was done in less than 10 days. I think my starting BMI was around 44, however, and I had already been diagnosed with HBP and sleep apnea, as well as having a documented history in my medical records of trying to lose weight. I was not required to have a true psych eval; I met with a social worker for about 5 minutes. Nutrition class was for about 3-4 hours and then I had my counsult. I actually could've had surgery the following week but decided to wait until the following month to mentally prepare. I have Triwest, and honestly, you never know about Tricare; it took me 3 years and 4 doctors to get my last surgery approved even though I superceded all their requirements yet this was approved in less than 48 hours. Make sure you give your PCM as much info as possible so they can submit a good referral; a lot rides on what they send into Tricare...

ETA: Just for clarification, my surgeon is a Center of Excellence, so even though the process was fast he's not sketchy in the least.

[rachelmiller1978 3]

Thanks Ladies....I go to my PCM tomorrow for the psych referral and have to get a documentation from her stating I have HBP even though I have been diagnosed and am on medication for it. LOL. The surgery center says as soon as I fax in those 2 things that it should take 24-48 hours for the approval from Tricare then I can schedule for 2 weeks later. So let's hope this moves along very smoothly and quickly.

[JLynn288 0]

I am in tricare region South. I hope that it helps. I think it helps if your doctor basically builds a case for you. I am hopeful that I can get surgery during the schools spring break so I wont be out too long. One step at a time and it seems to be coming together nicely. Have faith you will get it.

Thanks for the information. I too am in the South Region. I have been doing everything for my doctor. and on the 15th I will have done everything he requires. I will start my pre-op diet on the 11th. To be ready to have surgery in August. NO DATE YET But I was already told that TriCare is one of the easiest insurance companies. If you get a referral to see a surgeon your pretty much approved. After all we all know we had to jump through a lot of hoops just to get the refferal.

[Tracy_1day 0]

I just got my lap band last week through tri-care. They were pretty easy for me. I had to do a psych eval, meet with the nutritionist, pap & mamogram, attend a seminar and get an ekg along with the standard blood work. I started my journey in April and had surgery June 30th. Good luck, hope it's as easy for you

[LVGirl 4]

Hi Everyone, I have Tricare prime and just curious about how long of a battle I have here with TriCare if anyone can give me a rough estimate. I am so anxious and impatient and want some kind of guess or comparison how long the process takes. My PCM sent in my referral on May 9th and I received the approval from Tricare on the 16th in the mail, they picked my surgeon so I called and attended the Seminar on June 9th and attended my consultation yesterday(June 29th). I have a 47 BMI and high blood pressure. Just curious what kind of hoops they make you jump through and about how long it takes if anyone can give me their own similar process. Thanks!

Mine went very fast. Got my referral in March and had surgery in May. Longest wait was for my appt with my PCM to get all the referrals for lab, x-ray and ekg. I was approved within 2 days of them submitting everything to Tricare.