KarinaM

Hi I am going to get my gastric Bypass with Sanchez. I think I will get my surgery at Mills since he only operates at El Camino once a month. I just got approved after 4 months of appeal with my insurance company and on monday I will schedulle my surgery. I've seing Sanchez a couple times and really liked him.

Hi I have GERD very bad and I also heard about the band and people with reflux. I am getting a gastric bypass instead because I always wanted. I finaly got approved after 2 appeals (since Aug). I should have surgery in 2009 maybe January????

Thank you so much. I got my letter from Tricare today and now I realy believe it will happen. Can't wait for monday to schedule the surgery. I ALWAYS wanted to get the Gastric Bypass but I was going to Mexico to pay for a LapBand if I as not approved. I was very tired of fighting with Tricare...

Can't wait fo rmonday to find out about my surgery date. I wonder how long I will have to diet. Good like on yours.

Hi guys after a long fight with Triwest I finaly got my APPROVAL. I sent my last chance appeal to TMA on Nov 26th and today I was told by the Appeal person at Tricare that my case was reversed and it was APPROVED. Now all I need to do is wait to Triwest issue my authorization and schedule my surgery. Thank you soo much for all the support.:laugh:

Who was your Doctor in Mexico and how much did you pay?I gave up on my insurance after an appeal denied again.I guess I will come up with the money and get my ass there.

Where did you get your surgery?

You guys are so kind with me thank you so much for all your support. I'm very discoraged but I will try Travis AFB, lets see what happens. Meggie, do you have Mrs Frasier phone number? What should I tell her? I went to my PCM and they told me they would get a letter ready for Travis AFB Surgeon's General and this was on tuesday so maybe tomorrow I will call to see if it was faxed the Travis.Who knows.... I'm very happy JWRN, Meggie and TOmatoegirl are doing OK. Can't wait to see you guys pictures later. Keep us posted.

:biggrin: Thank you Meggie. I'm so glad you and Tomatoegirl got the surgery over with and you guys are home and feeling OK. Keep us posted with the progress. :thumbup:

I have no questions it will be the same, they think it is cosmetic, not a medical necessity and since I do not have a comorbidity they gave me a big NO.

Tomatogirl and Meggie, GOOD LUCK TOMORROW. Let us know as soon as you guys can how you are feeling. So happy for you guys. I should be getting my letter tomorrow, but I already knew it would be a NO since Meggie and JWRN got their approval so fast. Well I went to my PCM and gave her a letter asking her to give me a letter of referral and pretty much telling her what I need her to say. I was trying to fax all the paperwork to Travis but my fax did not work, I don't know why. I did write a letter (almost the same I wrote to Tricare) but I don't know if it will help me since my main problem is not have any comorbidity (diabetes or high blood preassure). I do have the family history and a very bad acid reflux desease getting worse with the weight gain. Since I have a rod and six screws in my leg I am trying to play the joint pain card. Do you guys think this will work???? DO they only take the BMI? If they go thru Tricare I don't think I should go thru the trouble. Well, GOOD LUCK again Meggie and Tomatogirl.

NOT APPROVED. I checked this morning and it was still showing pending but this afternoon it was showing NOT APPROVED. Well at least I got an answer. I will try to see my chances on Travis , but I'm not sure if it will work or not.Do you know if they go thru Tricare?

I'm so sorry you had to start over. I also had the same problem to get approved. My doctor's office took 2 weeks to fax extra info to TriWest so while the authorization process should not take more then 5 days it took 12days. (MY LUCK)

Are you guys ready to hear my wining??? Here I go: Yesterday I wrote an email to the appeal people asking them to take me out of my misery and how stupid I think this wait is etc. This is what I got from them: Dear KARINA, Thank you for your recent web mail inquiry. According to the notes on your file, the appeal process will be completed by 11/8/08. You will receDear KARINA MANG, Thank you for your recent web mail inquiry. According to the notes on your file, the appeal process will be completed by 11/8/08. You will receive the determination via mail. We do not have any way of "speeding" up the process, these guidelines are set forth by the DoD, Peer Review and the Medical Director. If you require additional assistance with this issue, please call TriWest toll free at (874-9378). When I made my midday call this morning guess WHO answer the call the same IDIOT who answer my email. Of course we got in to it and he try to tell me my appeal is a FACTUAL not a MEDICAL NECESSITY appeal (he pretty much is telling me I just WANT the surgery, I do not need it). I just can't take these people anymore. I wish I could complaint to someone higher then a CUstomer Service Rep.:smile:

Congrats, HelloPenny!!! Happy for you. Let us know how you are feeling when you can.

Meggie and Tomatogirl you guys gave HOPE again. I called Travis AFB and they told me all I need is a letter form my PCM. I called my PCM and she is off today but I asked her to call me tomorrow. They told me it takes abt a week to be added to the sytem and then they will call me for an appt. By this time it will be Nov 8th(last day for Triwest to give me an answer). I will take ALL my paperwork and hopefully will work, lets see. I really don't care WHERE I wil get the surgery, of course I would love to get it with my gorgeous doctor Sanchez in Burlingame, but as long as I get it done. My first choice was the band because I was going to get it with Dr. Ortiz in TJ, but since money was very short and I realized I had a chance to get approved I decided to try. Meggie, Mountain View is between Palo Alto and San Jose, it is in the Sylicon Valley (Google HQ is located here). It's abt 30mi from San Francisco. My husband is works at the USCG San Francisco Air Station (SF airport). Thank you one more time Tomatogirl and Meggie. Of course I can NEVER thank my friend JWRN enought. If I get approved by TriWest will be totally her fault. hehehehe

Meggie, I'm trying to get the gastric bypass, I want to go EXTREME. Do you think I could go to Travis? I have Tricare Prome Remote, so I think I'm not allowed to go to a military facility. Do you think they would be easier there? Do you think if I get denied now for the gastric can I ask the doctors office to resubmit as a LapBand (would this be a new authorization or they would take my old one?

Meggie, you made me:lol:. You are funny. I'm so happy for you guys. HelloPenny is probably done by now,I guess. Are you ready for your surgery? How about you Tomatogirl? Are you both on the LapBand? I'm hoping they approve me for my gastric Bypass. Nothing yet but if I'm sure if I think hard I will realize they are just taking their time to tell me NO!!!!!. Oh well....

Great question. I have no idea, I think after this THAT'S it, nothenig else. I will have to deal with it.It really sucks they are taking so long they could just say NO so I can sleep again. The only day of the week I can relax it's saturday because I know they wil not be making any decision. From mon-fri I stress and call them all the time. On sunday I'm alreday waiting for their decision maybe on monday.

THAT'S WONDERFUL, Meggie. So happy for you. I wish I could get mine also before Dec 22nd when my parents come from Brasil,but I don't now if it will work. TriWest told me they now have a note saying they will conclude my appela by Nov 8th (it will be 60 days). hehehehe I guess we all know it will be a denial.Well.....

YEP, the phone call t was almost funny, because I dumped on the poor lady how TriWest was to blame for my depression.hehehe. Well, I just can't take it anymore.

I'M SO HAPPY FOR YOU!!!! :tt2: I called Triwest yesterday and I got a very nice lady on the phone and she felt sorry for me and told me she was going to have someone calling me to give me a better update. This morning I got a phone call from Triwest and I was so happy thanking the person on the phone for getting back to me. Well, this lady felt really bad because she was calling me to tell me about my options about depression(she is from menthal health). Of course I told her ALL my depression is TRIWEST's fault and unless I get approved there is NOTHING they can do for my. She felt REALLY bad and so far NOBODY called me. They tell me I will get an answer by Nov 8th. :w00t:

I'm SO HAPPY for you and Meggie!!!! Congrats. I'm still waiting on my appeal.:smile:

Are you serious I think he is the hole WORLD JOKE and it's very embaracing for us to have him as a president.He is stupid, imcopentent and I'm very surprised the american people kept him there until now. Did anyone heard about impeachment?

If I get my surgery approved by my insurance(I'm currently on appeal), I will have it done with Peninsula Surgical Medical (with Dr. Sanchez). I heard very good things about them.