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Tricare Denial..REVERSED!!



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They don't care what brand, just as long as you have one come surgery time.

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I just got denied today. I don't know why. What did you have to do to get it reversed?

Start your appeal process and do whatever it takes to get it. I packed some "extra weight" hopefully will work this time. I hope I can resubmit next week. Don't give up.

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Sunnylilme...you need to find out WHY they denied you, then make that go away

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Sunnylilme...you need to find out WHY they denied you, then make that go away

The same happened to me and what they gave me was the guide lines (100lb over and one comorb or 200% over weight) and nothing else.

I am now over 100lb and I'm trying to get my PCM to prescrive me diabetes meds, but I'm not sure will work. Maybe you need to add some ponds, maybe will work. Get the 200% of your weight adn then you will not needa comorb.

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My BMI is 42, I'm 5'6 252, which is 100 lbs overweight. I have sleep apnea which is a comorbidity, I think...

I'm so upset, I'll just have to wait for the letter, I guess.

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Sunny - Definately appeal it! You have all of the qualifications, just fight them. So far, I havent seen anyone get denied on their appeal! Its just gonna take a little longer, but you'll be way more prepared. Go for it!!

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Look at it this way...whatever time you take, you are saving yourself 15k. That is a pretty high salary, IMHO! LOL It's worth it.

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Am I talking to you on 2 threads? :shades_smile: Yes Had to have all of the above.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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