Tricare Approval

[Jesusislove 26]

Minpinmom, have you lost more weight? When you checked your referral online did it say pending at first, and then approved? How long did it take for you to see approved.

[minpinmom 2]

I have lost a total of 13-14lbs (keeps bouncing back and forth). I was on liquids last week after my first fill - and I don't loose weight when I am on liquids - so that sucked, but I am starting to loose again now, and have continued to loose inches everywhere! I am wearing lots of clothes that have been too tight. :-)

On the referral, as soon as Tricare gets the paperwork and starts putting it in the system, it will show up as (P)Pending. Mine was pending for about 45 minutes (I was a bit fanatic in the beginning and refreshed my screen every 2 minutes in hope of seeing it go through) Then, it changed to A (Approved) One of the happiest days of my life.

[To be free 1]

I went for my appointment with the Surgeons office on Friday the 21st, I checked today on line just for the heck of it and there it was a big A!!!!! The surgeons office has not called me yet ( so I don't know if I am reading it wrong) and I don't have an surgery date but I think the hardest part is over. So far Tricare has been great! Hoping to be banded in April!

[KatsenD 0]

YEAH!!!! I got approval from Tricare for the surgery. Waiting for doc office to call me now, to set up required seminar with hospital, on what to eat. So I still wait. Good thing I know what it means, to hurry up and wait. HA HA HA...

[agm1 0]

I am so happy for you guys .My dr. submitted mine on Thur. or so they said and I can't find anything for me except and old approval from 2 years ago. Maybe sooooon!

[Long2BFree 12]

I'm Tricare Standard and was told that they will cover the fills 100%. My doc was apprehensive about taking Tricare but the office manager agreed to let it go through. I'm wondering how much they are losing by taking it? I was kind of shocked because the doctor was in the Navy Reserves so I was having a hard time understanding why he was apprehensive.

[VegasJen 0]

My Tricare aproval came in like 2 days - once they submitted (doc) Tricare was really fast. I got the claim sheet in the mail today and it said I had been approved for RNY/Bypass - not lapband! Has this mixup happened to anyone else? I have an appt with the surgeon tomorrow to sign consents/finalize surgery... but now I am nervous that they got approval for the wrong surgery?!?! I am also a little panicky that the statement says I am responsible for 50% of the cost of surgery?? Huh??

So now I am all worked up and scared that I have come this far and now it might not happen.... wish me luck tomorrow!!:biggrin:

[JenniLeen 0]

well i went to see my PCP and he sent in the referall quickly...thanks to Minipinmoms great Tricare sheet! But the next day Tricare notified him that they needed more clinical info. So I had to go have xrays done and had to have a glucose test done. I don't understand what this means. I am 265 and 5'3, so I fall in under the 200% over my ideal weight so I am totally lost why they are asking for all this clinical information. Maybe I should just call Tricare tomorrow?? Any suggestions? Thanks!

[KatsenD 0]

CALL TRICARE!!!!! My docs office is wanting me to prepay $600 for 6 followup appointments: fills. They are using an old code that Tricare wont pay on. So I called claims and talked to them. CALL THEM... get your questions answered.

[Sissy907 1]

Just for those of you who dont know.. Some bases offer this surgery, the key is are you within a "2 hour" travel window...

Last year this time Tricare south didnt not offer to pay for lapbands as they were concidered experiemental, and no base within the area would do the surgery.. but finally, Eglin AFB in florida is offering the surgery...

I dont know if Tricare has changed their mind as well, but it is deffinatly available on base now. Hope this helps some of you.. If you need the current number to the surgery clinic at Eglin I would be happy to get it for you...

Alli

[Long2BFree 12]

Just for those of you who dont know.. Some bases offer this surgery, the key is are you within a "2 hour" travel window...

Last year this time Tricare south didnt not offer to pay for lapbands as they were concidered experiemental, and no base within the area would do the surgery.. but finally, Eglin AFB in florida is offering the surgery...

I dont know if Tricare has changed their mind as well, but it is deffinatly available on base now. Hope this helps some of you.. If you need the current number to the surgery clinic at Eglin I would be happy to get it for you...

Alli

Alli,

Tricare came out the end of January 08 and said they would start covering Lapband surgery. In fact, it retroactive back to February 07 that they will cover it and anyone who paid out-of-pocket can submit paperwork to get reimbursed.

[hotchocolate 0]

I want LapBand procedure but I am not sure of the how the process works. Yesterday, I went to see my GI surgeon for another reason and I asked him if I could be a candidate for either procedure. He told me that gastric-bypass was definitely out, but he would send a message to the GI's that perform the surgeries and see if they would accept me as a LapBand candidate.

Now, again I am unsure who would I need to go to actually get the ball rolling so that I can get the procedure. I am at Ft. Lewis so I would have the procedure done either at a MTF or somewhere in Seattle.

Anyone have any ideas?

[Sissy907 1]

Thingirl-

Since I am a military wife I will tell you how I had to do it..

I first saw my family doc and asked him to send a referal to the surgeons office. Then I saw the surgeons and they said I had to get a buncha tests to see if I qualified because its not just about your weight when your sitting at the cut off. I had to go back to my family doctor to get these tests (I dont really know why they couldnt make the requests but whatever. Just ask your family doc to requests these tests in advance so it will cover all the bases before you see the surgeons) I had to be tested for diabetes, sleep apnea, my thyroid. Some require you to see a nutritionist, get a pshych eval, and go to a kind of seminar with info about the band (some do all of these last few things in one sitting- generally not the guys on base though) So if you can manage to get all those in before you see the surgeon you will be ahead of the game.

Then you will speak to the surgeon and decide if this is the thing for you and he will tell you to go home and wait they will contact you with a surgery date.. Thats the hardest part, waiting. It shouldnt be to long though maybe a month tops -if you go thru the military - civilian docs may differ timewise.

-Now I was trying to get the lapband this time last year and it wasnt aproved thru tricare and they didnt do them at this base at the time. I did see a civillian doc as well, but of course the procedure wasnt approved at the time. I did end up deciding to have a hernia fixed in the meantime waiting for the band to appear at this base (one of the docs said maybe by the end of the year) My heartburn was so terrible it was causing my esophugus to change and the doc was kinda scared to wait any longer...

I have not had the band surgery as of yet, but I have had a hiatal hernia repair and the surgery is very similar with exception that I have no band. I can speak to the recovery tho.

They did the surgery laproscopicly as they will with the band.. not to bad really I have tiny scars from it and they really didnt hurt to much the one to the far left gave me a little issue longer than the others, I think because it was close to the bottom of my ribs and I manage to poke it more than the others. I was sore, but not terribly. I didnt feel much like drinking any of the fluids they gave me, they were really begging me and upping my iv fluids. I had to explain that I was just queasy and didnt wanna take the chance on throwing up. A major no-no for any stomach surgery. They gave me a bit more nausea meds and I was good to go. I had done enough research on the band that I knew to only sip sip sip- the swelling was the same as I have my stomach wrapped around itself to act as a sort of natural band- there is actually quite a diffenece in the way I eat now than before the surgery. So I was fine after that. The pain meds they gave me kept me quite comfortable, almost more than I needed. They gave me liquid pain meds to take home, because there are no pills or anything solid for 6 weeks. I rested for a day in the hospital and then one day at home or so and only got up and walked around the house a bit.. by day three I started pushing myself a little more and walked the kids to the bus stop (its only at the end of my street), It wasnt to bad but I had to nap when I got home. after that recovery was a breeze. I just made myself walk a little farther than I did the last time until I was back to normal. I had the gas in my shoulders (and collarbone and chest) as many talk about mine felt like rice crispies under my skin, if you push it pops and feels nasty (those gasX strips REALLY help).. they doctor said not to push because it would cause bruising but, I just had to occationally! it was so yuck! lol but it really wasnt to bad of an experience over all... Hopefully my "natural band" will help me loose weight in the same way as the band (tho it is not adjustable) I have lost 30 lbs since oct just by changing my diet-because I HAD to to adjust to my new stomach and trying to be a bit more active. I only started back to the gym a few weeks ago as time has finally allowed it. We will see. if I dont start seeing some decent results I am going to go in and see about the band again I am having a 10 year renewal of vows with my husband (we didnt have a wedding the first time) next summer and there is NO WAY I am gonna be in a dress and be this heavy...

Good luck to you I would be happy to answer any more of your questions (I know I gave you more than you asked for here). I am stationed at Eglin AFB, FL... (my hubby just left ft lewis yesterday for iraq- small world huh?)

Take care and all the best,

Alli

Edited March 28, 2008 by Sissy907

[hotchocolate 0]

thank you so much for your response. Interesting that my GI surgeon already put in the request for me to have a sleep study done, because I told him that my husband complains about me snoring even though I am on my stomach. Around Sept or Oct '07 my PCM sent me to have my thyroid tested and my glucose levels all came back normal.

[agm1 0]

I"m Approved !

Waiting on Dr. Office to call back with date.

Whoo Hoo!! Happy Dance!!

It has taken $ months but

May 20 9:45 I enter BandLand!! :glare: