Dr. Bhoyrul in San Diego AND Tricare

[Jess77 0]

I was hoping to find someone who has had the lap band procedure with Dr. Bhoyrul here in the San Diego area and that has Tricare insurance. I've been told that Dr. Bhoyrul doesn't have a contract with Tricare so his surgeon fees would not be covered but that all other fees (such as the use of the medical facility, anethesia, etc.) would be covered by Tricare since the procedure is done at Scripps medical clinic which is contracted by Tricare. Any input about this would be much appreciated.

I'm trying to decide between UCSD and Dr. Bhoyrul. Is there anyone out there that has been in this same situation who had to choose between these two?

[tztmama 0]

Im in San Diego and since my surgery my insurance has changed. I recently had port pain and called my original surgeon. They told me to find out which lab accepted my insurance and that my surgeon would send in a request for lab work to see whats going on. He is good about trying to save me money. I have Pacificare insurance and my dr is Dr. Owens.

[Ann Skipper 0]

i had dr b do my surgery at the surgical center, rather than have it done at UCSD. I am so glad I did. I love him and he has been nothing but supportive and warm.

[AliNSanDiego 1]

I'm no help with the insurance, but I can say that I really like Dr. Bhoyrul.

My friend had her surgery done at UCSD with Dr. Horgan. She also really liked him.

I went with Dr. Bhoyrul because he accepts my insurance.

They are both good doctors in my opinion...

[eazes 0]

Tricare didn't refer you to an approved surgeon? They try to find one within your commuiting area. Are you Tricare Prime, Standard, or Remote? That may change the way they are handling your case. I'm Tricare Prime and when my PCM referred me they set me up with an approved surgeon so everything is covered and I have no out of pocket fees.

[kellikb17 0]

Actually Dr. Bhoyrul does most of his surgeries at the La Jolla Orthopaedic Surgery Center. Sometimes he does them at Alvarado, too. I have Tricare but I used my Blue Shield since the surgeon Tricare wanted to set me up with I didn't like. Dr Bhoyrul is amazing. You're looking at $6500 for his fees for the surgery without insurance though, just to let you know. Office visits pre-op are extra I believe. I'd call his office and ask Beverly about the Tricare thing to see if any of the places he does surgeries takes Tricare. She does most of the communication with the surgery centers and insurance companies. Or you could always check with Tricare directly to see if any of the facilities have a contract with them. Good luck!!!

Btw, the surgery center in La Jolla has an amazing staff and they take such good care of their patients. I'd definitely recommend having your surgery there if you get the choice. The nurses were great, the anesthesiologist was great...they even called later that afternoon AND the next day to check on me to see how I was feeling.

Edited June 10, 2010 by kellikb17

[mlfsandiego 0]

I just had my surgery with Dr. B on May 18th. He is the best! Surgery center was excellent!

Sorry can't help with the insurance problem, but the above post was correct $6,500 surgeon fees that includes one year of fills I think.

I paid cash for the whole thing and the Surgery Center was $8,500.00.

Good Luck!

[Nelsondevon05 0]

Tricare didn't refer you to an approved surgeon? They try to find one within your commuiting area. Are you Tricare Prime, Standard, or Remote? That may change the way they are handling your case. I'm Tricare Prime and when my PCM referred me they set me up with an approved surgeon so everything is covered and I have no out of pocket fees.

I need some help ASAP i currently have Tri Care Prime and have meet with Dr.B and I am scheduled for surgery on the 14th of this month(and i am currently on the 10 day liver shrinking diet:eek:). Beverly from LWM submitted the authorization to Tricare and it was declined because they needed a consult to be submitted from my primary care doctor. I met with him yesterday and he submitted it but he told me the way it works was that he would submit the consult to Balboa Naval Hospital and that they would either accept the surgery or have it discharged and returned back to tricare and then it could go to a third party.Has anyone heard of this or is it BS?

I spoke with Balboa this morning and the accepted the consult. so does anyone have any advice on how to get Tricare to authorize it through La Jolla Weight Managment instead of Balboa because i have already done everything through Dr. B (i.e met with dietician and blood tests) and Balboa has a bunch of hoops they make you jump through befor they do anything. So I would prefer to do the surgery through him because he has great reviews and an awsome staff.

Any help is greatly appreciated,

Devon