Tricare prime

[Cherie Murphy 22]

Need help figuring this out' date=' ive been lurking on this site since I decided I wanted lap band surgery and I love how supportive you all are. I've been trying to get my lap band approved through Tricare prime since January. I finally made it through all the hoops with my civilian doctor and fulfilled all their requirements and got Tricare to approved me, but since I am in an area with a military treatment facility, Tricare said they had to give them first right of refusal. The MTF decided they would do the surgery. I am really frustrated because when I called there, the bariatric nurse wasn't there but the person that I talked to said I might have to redo several of the steps using the MTFs requirements. For instance, they said they require a 6 month diet vs. the 3 month diet my civilian doctor required. They said I also might be required to attend their seminar and see their psychiatrist, along with a few other things.

Does this make sense to you? I am so frustrated![/quote']

Yes and No! I knew about the right of first refusal because I had colon cancer and had to have my colonoscopy done off base but they told me if something was found I would have to wait until BAMC said they couldn't fit me in for my civilian Dr to take care of the tumor. Thank God there was nothing there but I was informed that they did have the right of first refusal. What confuses me is that of my three friends that had procedures at an MTF NONE had to do a diet at all! Two at Ft Carson and one at Norfolk Naval Station. All three friends waited two months between first appointment to surgery whereas since I'm not by a MTF I had to go through TriCare and yes I had to do six months! I did talk to them and they all three said they mentioned the diet in the first meeting but then never followed through stating they would believe them when they said they have tried to diet before and failed? I have found there is no standard when it comes to WLS among MTF's and TriCare.

[candtwalker 46]

Need help figuring this out' date=' ive been lurking on this site since I decided I wanted lap band surgery and I love how supportive you all are. I've been trying to get my lap band approved through Tricare prime since January. I finally made it through all the hoops with my civilian doctor and fulfilled all their requirements and got Tricare to approved me, but since I am in an area with a military treatment facility, Tricare said they had to give them first right of refusal. The MTF decided they would do the surgery. I am really frustrated because when I called there, the bariatric nurse wasn't there but the person that I talked to said I might have to redo several of the steps using the MTFs requirements. For instance, they said they require a 6 month diet vs. the 3 month diet my civilian doctor required. They said I also might be required to attend their seminar and see their psychiatrist, along with a few other things.

Does this make sense to you? I am so frustrated![/quote']

All I can say is gather as many records/reports from all the doctors you have seen and take them with you when you go to the MTF. Maybe they can review the records and determine if you really need to go through it all again. Good luck!

[RitzysWeightLoss 3]

Well, I contacted the MTF and they basically said they wouldn't even talk to me until I attended their introduction class. Luckily they had one that day so I signed up for it. During the class there were about 4 of us going thru the same thing, Although I was further along then most. Anyway, after the class we talked and they told me it wasn't really up to them, they were just doing what the were told, but they would take any paperwork from my civilian doctor and use whatever they could. I still have to redo my labs on Monday and they booked me for their July 11 four hour education class. Hopefully everything else will fly. I also contacted my civilian doctor and they are giving me everything tomorrow so I guess it won't be too bad. At least I'm already approved for the surgery, so it should be ok.

[ADJL 685]

Well, I contacted the MTF and they basically said they wouldn't even talk to me until I attended their introduction class. Luckily they had one that day so I signed up for it. During the class there were about 4 of us going thru the same thing, Although I was further along then most. Anyway, after the class we talked and they told me it wasn't really up to them, they were just doing what the were told, but they would take any paperwork from my civilian doctor and use whatever they could. I still have to redo my labs on Monday and they booked me for their July 11 four hour education class. Hopefully everything else will fly. I also contacted my civilian doctor and they are giving me everything tomorrow so I guess it won't be too bad. At least I'm already approved for the surgery, so it should be ok.

I had mine done at BACH in Fort Campbell...the process is super quick...no diet for me either...I guess they figure if your PCP refers you that they've tried everything else?

Anywho...hopefully all your paperwork will transfer. It might be a matter of having it resubmitted to your doc at the MTF by each provider.

[RitzysWeightLoss 3]

I had mine done at BACH in Fort Campbell...the process is super quick...no diet for me either...I guess they figure if your PCP refers you that they've tried everything else?

Anywho...hopefully all your paperwork will transfer. It might be a matter of having it resubmitted to your doc at the MTF by each provider.

Oh, that's where I'm having mine. I met with Dr. Lehman when I was denied by Tricare the first time and he is the one who suggested the sleep study. I'm glad to hear yours went so quick.

[ADJL 685]

I used Lehman! Are you local? We should connect. He is an awesome doc...good surgeon.

[RitzysWeightLoss 3]

I used Lehman! Are you local? We should connect. He is an awesome doc...good surgeon.

Yes. I live in Hopkinsville and would love to be Lapband buddies. When and where do you go for support groups. Maybe we can go together.

[RitzysWeightLoss 3]

I used Lehman! Are you local? We should connect. He is an awesome doc...good surgeon.

Yes. I live in Hopkinsville. Where do you go for your support groups. Maybe we can meet there.

[ADJL 685]

Yes. I live in Hopkinsville. Where do you go for your support groups. Maybe we can meet there.

I haven't gone yet. They just started them up again at Ft. Campbell. First Monday of each month at noon. We can try the August one.

[RitzysWeightLoss 3]

I haven't gone yet. They just started them up again at Ft. Campbell. First Monday of each month at noon. We can try the August one.

Ok. Let's do that. Where do you live.

[ADJL 685]

I live on post.

[kimmyk2011 0]

It was a breeze. My doctor is fantastic and the only one of the three bariatric surgeons at Ft. Campbell that is authorized to do lapband. I wonder if the process is different here. I never even heard a word about tricare authorization at all. They essentially told us in our first seminar that because we'd been referred by our PCM and met the "requirements" that we were set. The only thing that could have stopped it was the psych eval.

Anyhow...I had a rough first few weeks after surgery because of the Vitamins. My body went on strike against them...basically dryheaving for hours/day. It took some figuring out, but once we got it pinpointed to the Vitamins and I stopped taking them I haven't had a single problem since.

I'm at about 6 weeks post op now and have dropped 25 pounds...just had my first fill on the 7th which also went great. So far I'm really glad I did this. I'm feeling optimistic about my "skinny" future.

Yours is coming right up Royalrags! Good luck!

Hi. I've been reading some of these posts and had a couple of questions. I'm nervous to start the process for getting the Lap Band. We are stationed at Ft Campbell and I don't really know where to begin. Can u tell me who ur PCM is and who did ur surgery? How did u feel about the surgeon? What happens if ur PCM doesn't feel like u ”need” the surgery?

[Cherie Murphy 22]

Hi. I've been reading some of these posts and had a couple of questions. I'm nervous to start the process for getting the Lap Band. We are stationed at Ft Campbell and I don't really know where to begin. Can u tell me who ur PCM is and who did ur surgery? How did u feel about the surgeon? What happens if ur PCM doesn't feel like u need the surgery?

Tricare's requirement is 35 BMI with two co-morbidities or BMI greater than 40 will get you a referral.

[ADJL 685]

Hi. I've been reading some of these posts and had a couple of questions. I'm nervous to start the process for getting the Lap Band. We are stationed at Ft Campbell and I don't really know where to begin. Can u tell me who ur PCM is and who did ur surgery? How did u feel about the surgeon? What happens if ur PCM doesn't feel like u ”need” the surgery?

I just sent you a PM...lets talk offline and I'll give you all that info and lay out the process.