TriCare Approval...1st Time

[YngGram 73]

Hi All,

TriCare(Standard) offically started processing my request on the 21st., I just checked the web site and it has been approved as medically necessary:party:. However the date of service listed is 3/5/09, hope I really don't have to wait that long.

[RestlessMonkey 7]

I too am tricare standard and got approved in under 24 hours. I feel for the tricare prime people who have to struggle so much!

Call your surgeon for the surgery date; it's set by him, not tricare.

[help1977 0]

Why do you say Tricare Prime people have a struggle to get an approval. I am Tricare Prime and my doctors office is getting everything together now for me to get it turned into Tricare this coming week. Where do you go online to check on it?

[RestlessMonkey 7]

i don't know where to go online to check...I didn't do that. The hospital where my surgeon is head of bariatrics handled all the paperwork for me.

I've just read a LOT of people on here who were "borderline" (like just at a certain BMI, or 100 pounds overweight by one chart but not another, etc) having trouble. I didn't even need a referral; just had to go to a center of excellence.

[Mimilou2004 13]

Niterun, Tricare also set a date of service for me that was about 2 months after the approval date. The window was then open for about 9 months after that. It took me about all the 2 months to do all the preliminary work anyway. Best wishes, my total out of pocket was about $2100, hope you do better than that.

Mimi

[YngGram 73]

TriCare Standard doesn't require a referral for visits, so what is really needed is that the doctor will accept what TriCare pays for covered service. Prime does have this requirement, so I guess the docs submitt as a general rule of thumb for anyone who plans to use any type of insurance. I did call the office on Fri. just before (they said) they called me. I got the dummy date info, and that I will need to attend a nut. class next week (4 hours), then I can be put on the list to be scheduled for surgery. Joyce told me it takes about 2 weeks to get things scheduled and there will be more tests for me to take. So I am going with an estimate of early March, right around the dummy date . I checked online with mytricare.com, but an ID and password is needed.

[El Diablo 1]

I'm Tricare Prime, took ten days to get my approval but turns out it was because the docs office didn't submit everything the first time. But still, me too....Tricare approval, first time.:thumbdown:

[lisw55 0]

Hi All,

TriCare(Standard) offically started processing my request on the 21st., I just checked the web site and it has been approved as medically necessary:party:. However the date of service listed is 3/5/09, hope I really don't have to wait that long.

I would like to talk with you offline regarding Tricare Standard coverage. My email is lisw50@yahoo.com Thanks Leona

[YngGram 73]

:eek: Doc's letter came on Wed., I will roll on 3/9 as promised!

[dl2418 0]

Why do you say Tricare Prime people have a struggle to get an approval. I am Tricare Prime and my doctors office is getting everything together now for me to get it turned into Tricare this coming week. Where do you go online to check on it?

I am Tricare Prime and my biggest hurdle so far was getting the prior auth from my PCM to get my psych eval done. Once my surgeon got that, they submitted and I got a phone call a few days later stating that Tricare wanted more information. Either X-rays showing arthritis or a letter from my PCM or ortho that the joint pain was interfering with activities of daily living. I had an appt. yesterday with my PCM and he said he'd submit a letter because X-rays may not show any abnormalities. Hopefully it will be enough to get the approval as well as the GERD. We'll see.....I weighed 220 so I met the 100# overweight for my height.

[mellygirl 0]

I am Tricare Prime also and checked the website 4 days after it was submitted and the approval was ready and waiting. I had more trouble getting my medical records from my PCM than actually getting approved. Total out of pocket for Tricare Prime is $49 and you just can't beat that!