process?

miissxangela · February 21, 2008

I had an appointment with my PCP today to get a referral to be banded. My Dr. said he would write one, but I am confused on what happens from here. I know I have to call in 2 days to activate my referral, but what happens after that?? Does anyone have tricare prime that knows what's up? I'm so anxious and can't wait to find out if I will be able to have the surgery

luigismama · February 21, 2008

You might want to call your insurance yourself. Even if someone else has tricare, their plan could be totally different from yours. I called my insurance and asked exactly what they covered including all the things they required for approval. This is your journey and your body, so learn as much as you can!

Elisabethsew · February 22, 2008

I agree. Call your insurance carrier and request in writing their requirements for weight loss surgery approval. Congratulations on taking the 1st step and welcome.

miissxangela · February 22, 2008

will do! thanks to you both

Emily'sDad · February 27, 2008

I have tricare prime and the policy regarding Lap-band is standard across the Tricare Prime system.

Once your PCM submits the referral, tricare will then evaluate it to make sure you meet their criteria. Your PCM should already know what the criteria is and will make sure you meet it. A couple of days after the referral is submitted Tricare will fax your referral to the approprite surgeon and most likely the surgeons office will call you to make an appointment. I was a little inpatient and called tricare to check the status to find out if i was approved, and I was. In my case both Tricare and the surgeons office called.

miissxangela · February 28, 2008

thanks! ... How long was it from the time you had your seminar until the date of your surgery??

kyplaybunny · February 28, 2008

i called tricare myself and got all of the info from them and they think it will take me around 7-14 days

miissxangela · February 28, 2008

wow! that is quick and awesome! i'm hoping i will be approved and having the surgery ASAP!

Emily'sDad · February 28, 2008

I actually didn't have a chance to attend a seminar. From the time I met with my PCM to the surgeon's office consult was about 7 days. As for the surgery I was told it would be about two weeks after I get the surgery approved. The approval "should" come in today or tomorrow.

miissxangela · February 28, 2008

I just got home from the seminar...and there is a 6month waiting list. I'm kind of upset. I think I am going to call tricare and see if there is anywhere else I can have the surgery