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Tricare Denial..REVERSED!!

JamieNP

By JamieNP, in Insurance & Financing

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RestlessMonkey    7

RestlessMonkey
Posted

I didn't have to do one. But you need the appeal letter. You need to find out exactly EXACTLY why you were denied (you might need to call them) and then depending on what is missing, resubmit it. Tricare will be able to tell you their appeals process. You'll have to work a little but again, it's worth it if you want the band!

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JamieNP    20

JamieNP
Posted

Maggie, wait until your surgeon's office talks with Tricare. I had my appeal letter together and didn't need it. My office talked with Tricare and found out the details.

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RestlessMonkey    7

RestlessMonkey
Posted

I'm glad JWRN chimed in since she's one who appealed successfully! So....what SHE said! LOL :thumbup:

Good luck. You can get this if you want it!

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JamieNP    20

JamieNP
Posted

If it comes down to it, let me know and I can send you some ideas for an appeal letter. Your denial letter should come this week also, and it will say exactly why you were denied (at least mine did). I almost gave up and I sulked for a few days. But then I figured it was worth the fight. And now I am getting banded in 3 days!

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Maggies    0

Maggies
Posted

JWRN, What number at Tricare do you call? I'm going to call them tomorrow. Good luck on your banding and let us know how it goes. Maggie:shades_smile:

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JamieNP    20

JamieNP
Posted

It is 1-877-TRICARE

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Maggies    0

Maggies
Posted

JWRN, Will be thinking of you tomorrow as you enter bandland. Let us know how it goes as soon as you feel well enough. Mine would have been the day after yours if Tricare would have approved it. Again good luck.

Karina, any news on the appeal?

I called Tricare today, and they would not talk to me but said the doctor can call them. I hope he calls them tomorrow but I'm not counting on it.

Maggie:shades_smile:

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KarinaM    0

KarinaM
Posted

JWRN, Will be thinking of you tomorrow as you enter bandland. Let us know how it goes as soon as you feel well enough. Mine would have been the day after yours if Tricare would have approved it. Again good luck.

Karina, any news on the appeal?

I called Tricare today, and they would not talk to me but said the doctor can call them. I hope he calls them tomorrow but I'm not counting on it.

Maggie:shades_smile:

Nothing yet Meggie. Let us know if the doctor called Tricare. :thumbup:

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Maggies    0

Maggies
Posted

Hi everybody, I didn't hear from the doctors office today sooooo.:smile2: Any help you all can give me in appealling this would be appreciated. :( I guess you could say I am desperate and still just running in circles. Therefore nothing is getting done.

JWRN, where are you, we are anxious to here from you......

Karina, Hope you hear something soon:thumbup:

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RestlessMonkey    7

RestlessMonkey
Posted

Maggie...keep calling TRICARE. For gosh sake YOU are the insured. MAKE them talk to you. DEMAND a supervisor! AND call the doc's office. The squeaky wheel gets the grease. You are being passive and they are ignoring you. Go get 'em!

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Maggies    0

Maggies
Posted

Hey Restless, you made me smile when I read that. You are correct, That is one of my big problems. Someone tells me no, and I take it. I will be on the phone tomorrow and make them sick of me. Thanks for the kick in the butt, I needed it. :( Maggie

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RestlessMonkey    7

RestlessMonkey
Posted

Go Maggie GO GO GO! :(

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JamieNP    20

JamieNP
Posted

Well, I am home. Surgery went well. I have 6 incisions and the port site is bruised and swollen. I am hurting...gonna sleep in the lazyboy tonight. I am forcing myself to eat Popsicles and sipping on Water.< /p>

I still cant believe I am here!!

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Go To Topic Listing Insurance & Financing

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
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    • Alisa_S

      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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      1. summerseeker

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        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

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