Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Tricare referral/need advice



Recommended Posts

Hi everybody, just started posting on here today and trying to find my way around. I have done all pre op tests required for gastric bypass but have decided on lapband instead. My doctor put my referral in yesterday and I was wondering how long it will take for Tricare to either approve it or not. My sleep study showed that I do have slight sleep apnea and they said losing weight would cure that. Any insight into the Tricare process would be helpful. I need to lose 110 pounds. Thanks in advance for your help. Maggie:rolleyes2:

Share this post


Link to post
Share on other sites

Once my surgeons office did send in the referral, it took about an hour to get the approval. You can check it on the Humana-Military.com web page. The doctor's office called me and said they found a problem with my approval code and it was resubmitted, then two hours later she called back and said the second one was approved with the right codes and my banding is schedules for August 12th. AS long as you meet the 100+ pounds with 2 comorbids, or 200% over ideals weight you should have no problems. If Tricare had approved the bypass, you shouldn't have any trouble getting the approval for the band since they both treat the same problem, just different methods. Good Luck,

Share this post


Link to post
Share on other sites

Sherry, Thanks for the info. I would have had the RNY at a military hospital but they do not do lapband. Just checked on line and it says approved with a referral number and a doctor to contact for appt. Is it possible that it was approved so fast? Hope to be joining you in August with the lapband. I am going to call the doctor tomorrow to make appt.

Maggie:thumbup:

Share this post


Link to post
Share on other sites

Congrats !!! Yes it means that it was approved that quickly. What took so long for mine was that the surgeons office didn't send in the paperwork until three weeks after my inital appointment. If Tri-care is going to approve or disapprove they usually do it as soon as they get the paperwork. I checked that web site everyday until I wal typing my password in my sleep. I only have to have an endo scope and a phsyc eval because that is what the surgeon requires. Let me know when you get a date.

Share this post


Link to post
Share on other sites

Sherry, Is the referral approval and ins. approval the same thing????? What will happen once I have my appt. with the surgeon? I know 2 many questions, I'm just very excited......Thanks for all your help. Maggie:thumbup:

Share this post


Link to post
Share on other sites

Hello everyone this is my first time on this site. I am planning on having lap band surgery August 5th. I am scared to death, hence the name. I'm afraid I'm going to miss food too much. As of right now the only medical problem I have is a very bad back and hopefully having surgery and losing weight will help.

Share this post


Link to post
Share on other sites

Hi Scared, I was going to gastric bypass and finally decided that was to drastic so am going to have the lapband. I'm not nervous yet, but maybe after I get my date. I'm tired of saying I will start my diet on Monday and it never comes so hopefully this is the answer. Good luck on your surgery and a fast recovery. Maggie:rolleyes2:

Share this post


Link to post
Share on other sites

Maggie,

The referral is asking the insurance (tri-care) for approval. When that little block on the right has an a (and the words approved pop up) that means that it was approved. So yes if the referral was approved by Tri-Care it means you have insurance approval. I am no expert but that has been my understanding of this whole process.

Share this post


Link to post
Share on other sites

Sherry, That is great. I am calling the doctor tomorrow and making an appointment. I have spent the last hour researching him and it is all good. Will let you know when I get my appt. Maggie:rolleyes2:

Share this post


Link to post
Share on other sites

Hmmm, when I got my referral and subsequent approval it was only for the visits to the Lap Band Surgeons Office for evaluation. Then they send in all the paperwork to Tricare. Now I wait for the surgery approval which is separate from the approval to go see the LB surgeon. They could still tell me no at this point, even though I've done all that is required by Tricare. Lets hope not!

Share this post


Link to post
Share on other sites

Hmmm, when I got my referral and subsequent approval it was only for the visits to the Lap Band Surgeons Office for evaluation. Then they send in all the paperwork to Tricare. Now I wait for the surgery approval which is separate from the approval to go see the LB surgeon. They could still tell me no at this point, even though I've done all that is required by Tricare. Lets hope not!

Same here. The initial referral approval was just for a consult/evaluation by a surgeon. Then you had to get separate approval for the actual procedure.

Share this post


Link to post
Share on other sites

That's what I thought that the referral approval was just for the consult. However, I can see how that is confusing for some since why would they even pay for a consult if you don't qualify. Gotta love tricare!

Share this post


Link to post
Share on other sites

That's what I thought that the referral approval was just for the consult. However, I can see how that is confusing for some since why would they even pay for a consult if you don't qualify. Gotta love tricare!

You know, that was my initial thought. And I showed up for my initial consult, weighed in and thought I was doomed for denial because I JUST missed the 100 pound cut off, but had a whole mound of co morbids. I wondered the entire time while waiting for them to submit if they deny me for the surgery, why did they approve me to see the surgeon in the first place.

Share this post


Link to post
Share on other sites

I was already approved to have the gastric bypass done at a Travis AFB Hospital but felt that it was to invasive. I also have had all pre op tests done at Travis. So, I wonder if that will make a difference. I am calling the doctors office at 8:00am this morning to see how soon I can get an appt. with them. Will let you know. Maggie:rolleyes2:

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Prdgrdma

      So I guess after gastric bypass surgery, I cant eat flock chips because they are fried???  They sell them on here so I thought I could have them. So high in protein and no carbs.  They don't bother me at all.  Help. 
      · 1 reply
      1. NickelChip

        It's possible for a very high fat meal to cause dumping in some (30% or so) gastric bypass patients, although it's more likely to be triggered by high sugar, or by the high fat/high sugar combo (think ice cream, donuts). Dietitians will tell you to never do anything that isn't 100% healthy ever again. Realistically, you should aim for a good balance of protein, carbs, and fat each day. Should you eat fried foods every day? No. Is it possible they will make you sick? Maybe. Is it okay to eat some to see what happens and have them for a treat every now and again? Yes.

    • NovelTee

      I'm not at all hungry on this liquid pre-op diet, but I miss the sensation of chewing. It's been about two weeks––surgery is in two days––and I can't imagine how I'll feel a couple of weeks post-op. Tonight, I randomly stumbled upon a mukbang channel on YouTube, and it was strangely soothing... is it just me, or is this a thing? 
      · 1 reply
      1. NickelChip

        I actually watched cooking shows during my pre-op, like Great British Baking Show. It was a little bizarre, but didn't make me hungry. I think it was also soothing in a way.

    • Clueless_girl

      How do you figure out what your ideal weight should be? I've had a figure in my head for years, but after 3 mths of recovery I'm already almost there. So maybe my goal should be lower?
      · 3 replies
      1. NickelChip

        Well, there is actually a formula for "Ideal Body Weight" and you can use a calculator to figure it out for you. This one also does an adjusted weight for a person who starts out overweight or obese. https://www.mdcalc.com/calc/68/ideal-body-weight-adjusted-body-weight

        I would use that as a starting point, and then just see how you feel as you lose. How you look and feel is more important than a number.

      2. Clueless_girl

        I did find different calculators but I couldn't find any that accounted for body frame. But you're right, it is just a number. It was just disheartening to see that although I lost 60% of my excess weight, it's still not in the "normal/healthy" range..

      3. NickelChip

        I think it's important to remember that the weight charts and BMI ranges were developed a very long time ago and only intended to be applied to people who have never been overweight or obese. Those numbers aren't for us. When you are larger, especially for a long time, your body develops extra bone to support the weight. Your organs get a little bigger to handle the extra mass. Your entire infrastructure increases so you can support and function with the extra weight. That doesn't all go away just because you burn off the excess fat. If you still had a pair of jeans from your skinniest point in life and then lost weight to get to the exact number on the scale you were when those jeans fit you, chances are they would be a little baggy now because you would actually be thinner than you were, even though the scale and the BMI chart disagree. When in doubt, listen to the jeans, not the scale!

    • Aunty Mamo

      Tomorrow marks two weeks since surgery day and while I'm feeling remarkably well and going about just about every normal activity, I did wind up with a surface abscess on on of my incision sights and was put on an antibiotic that made me so impacted that it took me more than two hours to eliminate yesterday and scared the hell out of me. Now there's Miralax in all my beverages that aren't Smooth Move tea. I cannot experience that again. I shouldn't have to take Ativan to go to the lady's. I really looking forward to my body getting with the program again. 
      I'm in day three of the "puree" stage of eating and despite the strange textures, all of the savory flavors seem decadent. 
      I timed this surgery so that I'd be recovering during my spring break. That was a good plan. Today is a state holiday and the final day of break. I feel really strong to return to school tomorrow. 
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Now that I'm in maintenance mode, I'm getting a into a routine for my meals. Every day, I start out with 8-16 ounces of water, and then a proffee, which I have come to look forward to even the night before. My proffees are simply a black coffee with a protein powder added. There are three products that I cycle through: Premier Vanilla, Orgain Vanilla, and Dymatize Vanilla.
      For second breakfast on workdays, I will have a low-fat yogurt with two tablespoons of PBFit and two teaspoons of no sugar added dried cherries. I will have ingested 35-45 grams of protein at this point between the two breakfasts, with 250-285 calories, and about 20 carbs.
      For second breakfast on non-workdays, I will prepare two servings of plain, instant oatmeal with a tablespoon of an olive oil-based spread. This means I will have had 34 grams of protein, 365 calories, and 38 carbs. Non-workdays are when I am being very active with training sessions, so I allow myself more carbohydrate fuel.
      Snacks on any day are always mixed nuts, even when I am travelling. I will have 0.2 cups of a blend that I make myself. It consists of dry roasted peanuts, cashews, pumpkin seeds, sunflower seeds, pistachios, and Brazil nuts. This is 5 grams of protein, 163 calories, and 7 carbs.
      Breakfast and snacks have been the easiest to nail down. Lunch and dinner have more variables, and I prepare enough for leftovers. I concentrate on protein first, and then add vegetables. Typically tempeh, tofu, or Field Roast products with roasted or sautéed vegetables. Today, I will be eating leftovers from last night. Two ounces of tempeh with four ounces of roasted vegetables that consist of red and yellow sweet peppers, sweet potatoes, small purple potatoes, zucchini, and carrots. I will add a tablespoon of olive oil-based spread, break up 3 walnuts to sprinkle of top, and garnish with two tablespoons of grated Parmesan cheese. This particular meal will be 19 grams of protein, 377 calories, and 28 grams of carbs. Bear in mind that I do eat more carbs when I am not working, and I focus on ingesting healthy carbs instead of breads/crackers/chips/crisps.
      It's a helluva journey and I'm thankful to be on it!
       
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×