tricare standard... no referral needed was told?

[heidsz 0]

Hi, I was checking my status on "Mytricare.com" and this morning there was no pending authorizations in my account. So I thought, "Oh no it was denied" but I thought it should at least show it there. I called Tricare (north) and the lady told me that I didn't need an authorization. Then I explained to her that this was for lapband and there were requirements that tricare has, and she said I met the requirements and a letter would be sent, but that I didn't need an authorization. I know for all my other care like specialist I don't need authorizations that is the great thing about standard but I thought for this I would get one. Any thoughts? I haven't been able to get ahold of my doctor yet this morning. Wondering how long now till my surgery. I am scared but excited at the same time.

Heidi

[AirForce.Wife 0]

Tricare can be tricky.. I really worry about some of the people who work there, lol! That being said, I'd call them back and talk to someone different to make sure. If you get the same thing from two people then you should be good to go. I know with Tricare Prime you have to have all kinds of approvals and stuff. Good luck!

[brat7169 0]

I am on Tricare Standard (North) also. Yes you do need an authorization. My experience is that Tricare North is a little slow compared to the other regions. Also if it doesn't show pending then the doctor hasn't submitted the authorization. If you are still have problems verify your doctor actually submitted (because mine lied and told me it was submitted and it wasn't). My overall process from submission to approval was 2 weeks.

Good Luck!

[wisconsin jen 0]

Hello Ladies...

I am tricare north too... I did get an authorization, however, the letter to the doc stated that no authorization was required so the doc took a deposit, just in case.

Tricare states that you do not need an authorization, however, you MUST meet the criteria... now I did everything for a preauthorization and they did go through those motions, showed me approved on tricareonline.com. They also requested three tests prior to getting me that approval, negative h-pylori, negative TSH, lung and heart eval.

After getting those to tricare they gave ME and authorization letter... but they gave a letter to my doc that no authorization is needed (and that is the truth)... however, going through the preauth process pretty much ensures that you will know whether or not they will pay for it...

My auth did not take long.. less than 10 business days.. and then two days after they got the test results....

Hang in there.. meet the standards and you should HOPEFULLY be fine...

Jen

[maximr 0]

Hi, I was checking my status on "Mytricare.com" and this morning there was no pending authorizations in my account. So I thought, "Oh no it was denied" but I thought it should at least show it there. I called Tricare (north) and the lady told me that I didn't need an authorization. Then I explained to her that this was for lapband and there were requirements that tricare has, and she said I met the requirements and a letter would be sent, but that I didn't need an authorization. I know for all my other care like specialist I don't need authorizations that is the great thing about standard but I thought for this I would get one. Any thoughts? I haven't been able to get ahold of my doctor yet this morning. Wondering how long now till my surgery. I am scared but excited at the same time.

Heidi

I was banded on Jan 25, 2010 and have Tricare Standard (South). I had to have pre authorization for the surgery. It took a letter from my PCP and the LapBand Dr. I was told so many different things by TRICARE. I was told that the authorization would not show up on the website - wrong it did. I was told that I needed a consult prior to approval - wrong, when the LapBand Dr's office sent in the results of the consult Tricare wanted to know why they were sending it, when the Surgery was approved. Bottom line don't take anything for granted...get the Approval/Authorization Number and then you know every thing will be paid for. I got a different answer everytime I called. The important call is the one where they give you the Approval/Authorization Number.