Tricare Approval?

[swmr2006 5]

So my surgeon's office just sent my information out today for tricare to approve (Even though I have had everything turned in for over a week.) After reading all these denials given for not having a six month diet, I am sort of concerned. My office told me tricare north literally just changed the requirements last month saying you just need to have documentation of a diet in a doctor's note and there is no time limit. Sooo i got that information for the doctor, printed out my nutrisystem and weight watchers receipts from the past 2 years but all I had were my personal weigh in logs, and i had an actual 8 month nutritionist diet and weigh in (from like 6 years ago) printed out and sent to my doctor. My doctor just typed that all up in a note. But I'm still hearing about people getting denied.

Anyone have any similar circumstances? How long should it take for me to hear from the tricare if I have been approved or denied?

Ugh waiting is always the hardest part! Hope everyone else is flying through their insurance approvals!

[marinewife78 33]

We have tricare I had to have 6 nutrient appointments within the year and they did pull some dr notes to use for it. Other then that I did all mr pre op work before the requested approval. I was approved within 2 weeks for all 3 types of the surgery!! Good luck!

[goddessblaze 98]

I am having the same problem. They want more documentation of weight mang. Support groups... I just moved here all my stuff is in Arizona I'm really hoping a letter from my pcp will be enough.

[swmr2006 5]

YAY! I have been approved! They only took one of my doctors notes and sent it (that summarized all my diets and weigh ins even though they weren't "official") and it was obviously enough.

I am a little confused about the mytricare site. It was obviously approved but I am a bit confused on the beginning of service (BOS) and end of service (EOS) date thing. How it is worded, I feel like those are the dates I have to have surgery and my hospital stay by but I was literally approved yesterday morning and my dates on the BOS and EOS were yesterday and today. Hmmmm. I'm sure the hospital will figure it out.

[sharoncarrie 49]

Congratulations on your approval!! I know first hand how hard it is to going through the approval process. Luckily it didn't take long to get your approval!!

[swmr2006 5]

Thanks so much! I know my approval was probably faster than many others but it felt like an eternity. I'm just happy to know everything is a go!

[goddessblaze 98]

Congrats!!!!

[cbrks2012 23]

That's great news I'm also waiting to see if I have been approved by tri care west, I'm just so nervous. I've been dieting and exercising for 8 months now and have been stuck at the same weight now for 3 months. I hope by Monday I get the email or call that says I'm approved and have my surgery next month. Can't wait to hear everyone's success story's good luck too everyone!!

[swmr2006 5]

Good luck! I am crossing my fingers for you! I know how hard on the nerves waiting can be.

[cbrks2012 23]

Thank you do much I just can't stop thinking about it.

[roxyraquel 77]

Ok so I have tri care south and I'm getting all of my stuff ready like blood work ect what kinda doc. Do I need I have gotten so far my copys of medical charts which say my weight since jan 2011 and I got my gym member ship dates form since 2011 till now and I'm just nervous its not enough? What did your doc write out for you did you need doc of diets or what? What if it was from a book or store bought pill does that count? I'm sorry I'm asking so many questions I'm just nervous they won't approve me!

[cbrks2012 23]

@roxy if you have done everything your doctor has said and you still have not been successful in losing weight then you should be fine with getting approved, I just got approved last week and go for my consultation on the 8th. If you have done a 6 month evaluated diet with your doctor then you should get approved, but when your doctor puts a referral in make sure to call tri care everyday and see if they have it so you can start your new journey. Good luck with everything

[swmr2006 5]

Ok so I have tri care south and I'm getting all of my stuff ready like blood work ect what kinda doc. Do I need I have gotten so far my copys of medical charts which say my weight since jan 2011 and I got my gym member ship dates form since 2011 till now and I'm just nervous its not enough? What did your doc write out for you did you need doc of diets or what? What if it was from a book or store bought pill does that count? I'm sorry I'm asking so many questions I'm just nervous they won't approve me!

I literally went to my PCP and told her that I was getting the surgery and gave her a list of diets that I had tried with my approximate weight at the beginning and end over the passed 6 years. If I knew how much I lost each month (like with Weight Watchers or Nutrisystem), I gave those weights to her as well. She ended up taking my weight for that day and typed up ONE note with the exact information that I gave her. Book diets are OK (south beach, Atkins, 17 day diet, etc) but pills don't count because they want a diet and exercise program. I don't know if Tricare North doesn't require the 6 month diet like they had previously or if my doctor's note just seemed like 6 months of medically supervised weight loss programs condensed into one note (which it sort of was since my mother is a doctor and she was advising me and recording my progress for my personal use... my PCP didn't know that however). Either way, my PCP's last sentence was "After full evaluation and several failed attempts up to today's weigh in, I am referring this patient to a local bariatric surgeon for a consult for Lap-band or gastric bypass." That sentence in itself sounds like she had been supervising me all along. Also, she didn't really refer me... my first visit with my surgeon was the day after she typed up the note and I had already set up an appt with him. Anyway, Good Luck and keep us posted.

(PS: Sorry if something in here doesn't make sense. It is really late here and I am super tired. If you need clarification on anything, just let me know.)

[Ha! 12]

Glad that worked out so fast for you! I had to do an additional three month weight loss/ nutritionist trial. While I hated to do more it was so that Tricare had no reason not to approve me and it made it all ok.

I will have my surgery on August 6, 2012. And am so thankful for my approval : )

Looks like we are in the same area : ) Maybe we can get together sometime : )

Best to you on this wonderful journey

[cbrks2012 23]

@deege where do you live at maybe one day we can meet each other and share our personal story's with weight lose.