Laugh or Cry?

[DaniKLargo 0]

If anyone has a story like this (Catch-22), I'd love to hear it.

So I was referred for a sleep study by my PCP a month ago. I never received the referral, so I called, and they said I didn't need a referral for a sleep study. So I said OK, where do I go, what do I do to schedule this thing? And she said "It will be on your referral paperwork." So I said, "oh, I'm getting referral paperwork?" And she said, "No - I just told you you don't need a referral."

OK - after going around like this for a while, she finally says, "You don't need a referral for the study, but you need a referral for a doctor to read the study." So I said, "OK - so how do I get that?" She said to ask my ENT doctor. So I said, "I don't have an ENT doctor - how do I do this?" And she said - yes you guessed it ..."you need a referral to see an ENT dr."

Although this is Tricare, I'm sure there are some other doozies out there. I'd love to hear some stories so I know I'm not alone in some crazy alternate universe.

[Randi 0]

Dani,

Has the sleep study issue been resolved? If not, the way that it has worked for me in the past is that the PCM submits the referral, but the referral is not required to go through Tricare for approval. Instead, it goes to your local CAMO office, which is usually the same office you call to set up your appointment with your military doctor. However, before the sleeps study can be approved for a sleep study lab in your local area, the CAMO office must determine whether the MTF can handle the request (This should definitely be done by now).

In short, contact your CAMO office. I believe you'll find the request has already been approved. You can wait, but what usually happens is that they will eventually send you a letter with a list of authorized sleep study labs from which to choose. Then you still have to choose the lab you want to go to, set up your own appointment, and pay a co-pay to the lab (I think the copay is $12).

Usually, the sleep study lab has a doctor who will interpret the results. So, before you book the appointment check to verify how the results will be interpreted and when you can expect to get them. Make sure they mail you a personal copy for your records.

Now, if the results of the sleep study show that you have sleep apnea, you will then need a referral to ENT because that's the office that can write the prescription you'll need to get your CPAP machine.

[DaniKLargo 0]

It's finally resolved, but I had to have the PCP talk to the Tricare office to get it all right. There's onlty one doctor in the area who does the sleep study, so from the time I first requested it, through all this mess, to my appt it will be over 2 months. AAaaarrgghhh!!!

Thanks for your help Randi. :confused: