I am not getting excited anymore until its done!

Tammy22 · January 17, 2005

Okay so I have said tricare approved my approval- Well I am still being told by Dr. Smiths office (AFTER tricare called them personaly and told them its covered) that tricare won't pay for the lap band but they will cover the bypass. Makes no dam* sence to me at all.. I told them and told them they will but they wont believe for or them and they say in a stuck up way "well we can send them the paper work but don't be disappointed when a letter comes in the mail saying it wasnt approved!" I am only having the stuck up attitude form Tammy the insurance cord. for Dr. Smiths office.. I want to pull my hair out.. I called the tricare referral line again to double check my referral to see if i was hearing it wrong or something and heres what it says.. It said they got a refferal for me on Jan 11th for specialty care with Dr. Smith. and has been approved. 4 visits have been authorized to be completed by July 10th 2005.. Am I losing it or is that just for visits only? I can't talk to anyone today because they are closed. I am only able to listen to the referral.. Sigh.... losing hope.

Jammin & Losin · January 18, 2005

hang in there and don't back down call and call again till you get someone who knows for sure and can give it to you in writing. Good luck!

leatha_g · January 18, 2005

Speak with Charlie Collings and see if he or his wife will send you a note stating she was banded under Tricare insurance, by what Dr and on what date. It never hurts to start gathering ammo for your fight.

Good luck!

Tammy22 · January 18, 2005

I have been talking to Charlie through email. He has been great help.. I had told the Drs office that I knew someone with Tricare (Charlies wife) who got the LAP band and they say reason why TRICARE wont pay for the lap band but they will pay for the bypass is because they switched to humana.. Even still humana pays for it because I have seen it.. I am calling tomorrow to ask TRICARe and so is Charlie so hopefully I will know for sure or not.. It's just frustrating to know that I did all that calling and finally was told it would be covered and now I am having the problem again.. I know I know.. Dont give up.. I wont- Its just a complicated deal but I know in the long run it will be well worth it..

New Hope · January 18, 2005

Tammy, please get a clarification from your health insurance company in writing, exactly what they are authorizing for you. It sounds like they are approving 4 visits to the specialist, Dr. Smith.

Have you already gone through all the pretests and had the dr. submit(to your health insurance) for your band surgery approval? Please don't get discouraged!

These things take time and I know you are ready to move now. But you do want to know that everything is done properly so your insurance won't deny payment.

In the meantime, start getting in the habit of regular exercise (walking, treadmill, biking, etc.) and drinking lots of Water (but not w/meals). This will just get you ready and help you adapt easier after banding.