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Tricare

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I just found out last night I'm approved. Once the paperwork was all submitted correctly it only took about 2 days to see my A. So, even with the referral needing to be resubmitted, etc. It took one month, almost to the day.

from the time my dr's office sent everything out until i got the call from tricare...about 4 days. the whole process itself took....about a month and a half. it went by very quickly.

Hi Everybody, I have Tricare/west and have my approval to see the surgeon. After I see him and he takes me as a patient and submits to Tricare for the actual surgery. How long is that process? I thought once you received the approval to see the surgeon, that was also the approval for the surgery. I have done all the tests required for the RNY (gastric bypass) but have changed my mind and decided on the band. I was going to have the RNY at a military hospital and they do not do the band. So as you can see I have been working on this for almost a year. Any insight into the Tricare approval would be appreciated. Thanks Maggie:mellow:

Maggies - in my case a referral and approval to see the surgeon is certainly not an approval for the surgery. They are two differnt things. You go see the surgeon, they tell you what to do as far as paperwork is concerned, you do it, they submit to Tricare and then you wait for approval for the surgery. Two very different approvals.

Go to your surgeons appt and they will point you in the right direction.

Good Luck!

Ineedalapband, How long did it take you for the approval once you see the surgeon? I wish I would have decided on Lapband from the beginning of this process, but oh well all in good time. Thanks for the info. Maggie:shades_smile:

did you guys go through your pcp or the place that you want to have it done. i go for the seminar on 08-05-08 i went to my pcp and gave her the names of the docs and facility i have tricare south and will have the surgery in nashville im glad to hear positive things about tricare

Hello, I live in Roy too. I am going to see Dr.Richards. I have had a terrible time with Tri- Care. I have been fighting with them since April. It is a long story, but I truly hope you have better luck. I feel so disappointed. I am still pending my appeal.

Hilbean - Were actually in the same city?! lol I'm so sorry to hear about your troubles, I would love to know the whole story. Esp since were seeing the same surgeons office. How do you like Dr Richards? I went with Dr Cottam b/c Richards was out on some medical thing when I started this process. I really like him, and have never met her, but have heard great things. Any insight you have with Tricare, like appeals, etc would be wonderful. Let me know how it goes.

Lisa,If you have Tricare you have to have your PCM refer you to the surgeon. After your appointment, he will order the necessary tests. Then they will submit it to tricare. Today is my last step (I am getting my EGD today). Once everything is in, my surgeon will submit it to Tricare. He works with Tricare quite a bit, and used to be an Army Surgeon. I live in Clarksville, but I work in Nashville, and I chose Dr. Steely for his reputation and because he knows the ins and outs of Tricare. He didn't seem to think there would be any problem with getting me approved for surgery, and I am on the border line of the requirements.

Good luck!

hi, thanks for writing back. i am going through centennial center for the ,yes. obesity. they have two doctors that were affiliated with the army at one time i am going for the semminar tomorrow night . i hope that my doctor sent the referal today. i saw her friday. her office can be a bit slow. i wil have to call her wednesday and check. is there a way that we can check on referals on line? good luck to you to. by the way i live in pulaski, an hour south of nashville. where does your doctor work lisa

My doc is in Clarksville at Gateway. You can go to the Tricare site and it will show you when the authorization goes through.

https://mim.mytricare.com/Login.auth

Maggies - I went to my PCP and got the referral to the Dr. After I got the referral from Tricare to go to the surgeron I made the appt and they told me what to do. I went back to my PCP and did everything I needed and got the preop letter, etc. Then they sent all that info to Tricare/surgeons office. Within 2 days of everything being submitted (correctly) I was approved by Tricare. Total about 30 days from first date of Surgeons visit. 1 1/2 months from first appt with PCP (since I had to wait for appts). HTH!

My surgery is scheduled for the 20th! I start my 2 week diet on Wed!

Ineedalapband -- Congrats!! As you know my husband still has issues with the band so I am not there yet. Best of luck and please keep us informed of your progress.

Fdiljn I was going to send you an email today and let you know! Good to see you saw it here. After I got approved I mentioned it to my DH and he still wasn't thrilled. He told me to go ahead though. I kind of feel like he felt like after jumping through all of the insurance hoops I left him no choice.

Anyway, now that I have a surgery date and it has all sunk in for a day or two he seems to be doing better. He wants to go to the preop with me (hopefully that will help him deal with his fears) and he's even starting the preop diet with me tomorrow. He's going to do it the entire 2 weeks to help me out. Now, thats love!

I hope your husband comes around too. Keep in touch.

Hi everyone! I just found out today that I am approved!! Yay! I was getting really worried because it kept saying "pending" and then Tricare needed more info, so my docs office faxed it in and the lady from Triwest actually called me today to tell me it had been approved!! She was so nice and said that I would have to stay overnite ( I'm also having a hernia repaired ) and that they would call me to check after surgery! So, from the time the doc's office submitted to Tricare, its been 10 days. Since I started this whole process, about 2 1/2 months.

Yeah!!! Hopefully I am next to find out. Everything should be submitted to Tricare this week or next.

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