Can anyone recommend a Tri Care approved...

SilentBob · March 10, 2008

Can anybody here recommend or know of a Surgeon that accepts Tricare Prime in North Florida. My PCM will give me a referral but I have to find one for him to refer me to, preferably in the Gainesville or Jacksonville area. I've tried teh search function to find one on this site or at least a lead on one. Tricare website breaks it down by general surgeons not bariatric. Plus, I would love to hear about the experience with the doc if anyone has any.

To be free · March 10, 2008

I live in North Florida and are assigned to a pcm at NAS Jax Naval Hospital. My pcm didn't want to refer me (didn't even know it was a covered benefit) but did to the bariatric clinic at the hospital, they don't do the lap band so the bariatric clinic referred me out. Now Tricare did refer me to a Dr. Jawad who is out of Ocala who is in the network, I called and advised that them that it is too far, they said he has a office on St. Augustine Road (but with a ocala number) and therefore I had to go to him. Well I called and they do not do consults there or the surgery for that you have to go to Ocala the St. Augustine road is only for aftercare. I called again today because the referral I got in the mail said that you can only receive care at the address listed...all they did was change the address to the Ocala one. If I want to go out of network here in Jax my pcm would have to write a letter stating that it is too far to travel and that they would consider one in Jax.

I had originally started out as self pay and had gone to a seminar and nutritionist appointment (paid 500.00) to Dr. Chappano at St. Vincents..they are ones that advised me that Tricare now covers it. I would prefer to go to Dr. Chappano and are going to my pcm Wed. Even if they approved it I was told that they wouldn't pay the entire thing.

I have an appointment with at Dr. Jawad's in Ocala on March 21st... He has a great record and he and the center are "centers of excellence" so it is not that the care would be inadequate it is just the distance....but getting it paid for vice paying out of pocket as self pay.....well that is were I am at.

If I had a choice it would be Dr. Chappano or Dr. herrera in Jax but the only par doctor that takes Tricare Prime is Dr. Jawad. I hope this helps......

SilentBob · March 10, 2008

TobeFree, thanks for the info... I did see that Dr. Cywes in J-ville is on the TriCare lists but he appears to be a pediatric surgeon. I have seen his name on these forums before but I'm pretty confused at this point.

I live eqi-distance to J-ville and Ocala so the distance doesn't bother me, I just prefer to go to Jacksonville or Gainesville. THanks for the reply again...

To be free · March 10, 2008

You are right I have seen Dr. Cywes mentioned here, that was the problem with Dr. Chappano, Tricare has him listed as a General Surgeon, they told me that he would have to be listed as a Bariatric Surgeon to be considered....now of course I hear if you hang up and call back you'd get another response so who knows......What I do know is that you are on the right track and congradulations for taking the first step!!!! Keep us posted!

chickzero1 · March 11, 2008

Hi there..I am going through the same thing. I had someone tell me that in Las Vegas where I lived there was only 1 clinic that accepted Tri-care...well I called Tri-care and they gave me 41 surgeons that accepted Tri-care. Well, they did not give me all 41 names but gave me a bunch and said there was 41. I was shocked how many different places actually would take Tri-care. Most were not in those clinic places that do only lapband. If you call them they should be able to give you a list of different surgeons who will take you on. Good luck.

SilentBob · March 11, 2008

Hi there..I am going through the same thing. I had someone tell me that in Las Vegas where I lived there was only 1 clinic that accepted Tri-care...well I called Tri-care and they gave me 41 surgeons that accepted Tri-care. Well, they did not give me all 41 names but gave me a bunch and said there was 41. I was shocked how many different places actually would take Tri-care. Most were not in those clinic places that do only lapband. If you call them they should be able to give you a list of different surgeons who will take you on. Good luck.

Thanks! I will call Tricare!

To be free · March 12, 2008

Thanks! I will call Tricare!

Let us know what Tricare said, I am curious what providers they gave you.

Thanks!

SilentBob · March 12, 2008

Let us know what Tricare said, I am curious what providers they gave you.
Thanks!

Well, They were about as helpful as I expected...Not very.

They mentioned Dr. Cywes but also mentioned to me that they have him as a pediatric surgeon. I called his office, asked about Tricare, and they accept it. I have a consult next week! I will make sure at this appointment that they do indeed take tricare and I'll find out exactly what is going on before I commit to anything.

Oh, the other providers mentioned were Dr. Jawad in Ocala and some other guy in St. Augustine ( don't remember his name off top of my head because I called and he didn't do lap bands yet just GB...)

To be free · March 14, 2008

Thank you for the update, glad to hear that you were able to get in with Dr. Cywes....you got in fast!! I see his name mentioned alot on this site. They would only refer me to Dr. Jawad in Ocala.....see I guess it depends on who you speak with. The original surgeon I went to as self pay are the ones that told me about Tricare covering the band and that they take Tricare, however as you see that is not who I can go to. You seem to have a very helpful pcp, mine will get me the tests I need but that is about it, I can't even get a letter, wrote me a referral though.....

Good luck next week, keep me posted! I have my consult the 21st.

SilentBob · March 14, 2008

They would only refer me to Dr. Jawad in Ocala.....see I guess it depends on who you speak with. The original surgeon I went to as self pay are the ones that told me about Tricare covering the band and that they take Tricare, however as you see that is not who I can go to. You seem to have a very helpful pcp, mine will get me the tests I need but that is about it, I can't even get a letter, wrote me a referral though.....

Are you near a Military facility? I think because I am Prime and live outside a Base/Station/Post service area ( I live in Palatka...:angry_smile:) I get a lil bit more freedom in my choices of who to see...

My doc sent in the referral but TriCare hasn't authorized it yet..or at least I don't see it on the online approvals thing...

To be free · March 15, 2008

You may be right, I am in Middleburg out near Camp Blanding but my pcp is at the Naval Hospital. My referral showed on line in three days. At this point I just want to get banded, now that I have made up my mind I don't have any patience. I wish you luck..keep us posted.