Tricare Approval or Denial??

[KarinaM 0]

That is so awesome !!! I start my 2 week pre-op diet on the 26th coming up soon !!!

Can't wait fo rmonday to find out about my surgery date. I wonder how long I will have to diet. Good like on yours.

[Jewlo 0]

KarinaM

I am soooooo happy for you !!! I know how hard it is to get denied !!! I am also getting Gastric Bypass.:laugh:

[KarinaM 0]

KarinaM

I am soooooo happy for you !!! I know how hard it is to get denied !!! I am also getting Gastric Bypass.:tongue_smilie:

Thank you so much. I got my letter from Tricare today and now I realy believe it will happen. Can't wait for monday to schedule the surgery. I ALWAYS wanted to get the Gastric Bypass but I was going to Mexico to pay for a LapBand if I as not approved. I was very tired of fighting with Tricare...

[munger 0]

I am so happy for you - I hope you can not detect the raging jealousy!!!! I know how much you want this and I am truly happy for you. I got a letter form Tricare also on the 19th - but mine was to say that basicly they needed me to resubmit EVERYTHING!! So off to the clinic - agian, wieght, height, bone structure....... faxxed it to her - again!! Of course she said it will be a few weeks before I hear anything - I am sure that they will take more than a few weeks and then they will need something else!

Enjoy your Christmas. Have one last piece of fudge or fruit cake which ever is your passion!

Don't forget to shop all the winter sales for severl size smaller - so you will have new clothes for cheep! 75% of an expensive size 10 sweater, or coat. My friend Lisa says she is always cold now - less insulation!

What will you new years resolution be?

Again, I am sooooo happy for you ( and SOOOOO jealous!)

[KarinaM 0]

I am so happy for you - I hope you can not detect the raging jealousy!!!! I know how much you want this and I am truly happy for you. I got a letter form Tricare also on the 19th - but mine was to say that basicly they needed me to resubmit EVERYTHING!! So off to the clinic - agian, wieght, height, bone structure....... faxxed it to her - again!! Of course she said it will be a few weeks before I hear anything - I am sure that they will take more than a few weeks and then they will need something else!

Enjoy your Christmas. Have one last piece of fudge or fruit cake which ever is your passion!

Don't forget to shop all the winter sales for severl size smaller - so you will have new clothes for cheep! 75% of an expensive size 10 sweater, or coat. My friend Lisa says she is always cold now - less insulation!

What will you new years resolution be?

Again, I am sooooo happy for you ( and SOOOOO jealous!)

THANK YOU!!!!! You are so sweet and please don~t worry about the jealousy because I understand. I~m sure things will work out for you just DO NOT GIVE UP and do WHATEVER it takes to get approved, I did. Please keep me updated and GOOD LUCK.

[munger 0]

THANK YOU!!!!! You are so sweet and please don~t worry about the jealousy because I understand. I~m sure things will work out for you just DO NOT GIVE UP and do WHATEVER it takes to get approved, I did. Please keep me updated and GOOD LUCK.

I am "supposed" to hear something within two weeks - I am sure it will be closer to 3-4 weeks. I am going to start another diet on the first - I am going to do a pre-op protien diet. If it doesn't work out I plan on starting Weight Watchers - I believe it is the only diet I have not tried.

Good luck - I hope you will be happy with your new life style and body!

[Ready4a2ndChance 0]

So I've talked to tricare and my paperwork has been received but still pending............hopefully i'll know something by Wednesday, they told me to call back at 7am..............I totally forgot Monday was a holiday.:ohmy:

[munger 0]

All I can say is stay on it call back - call back and oh call back. make sure they know you are there and don't let them forget about you!

[Ready4a2ndChance 0]

Well, the doctors office called me back and discussed a little about my thyroid and lipid panel. I already know I have hypothyroid, but I haven't been very good at taking my thyroid pill in the last 2 or 3 months. We've been getting ready for a move then home for christmas for 3weeks then actually moved and have been remodeling for approx 4wks. So needless to say I've done badly. My thyroid is off the charts apparently......or "really really really bad" is what the nurse on the phone said.........and my cholesterol is 278. I already have an appt. on Wednesday.....she said that my doctor would discuss things in more detail then but for now i should buy some fish oil. She said that I should loose some weight, WELL DUH!!! I went in for a lapband consult, no shit, I know I need to loose weight. I'm sure the lady on the phone didn't know that though............I just keep thinking this is a bad sign and they are going to tell me that they are going to stop the referral process or that I need to wait 6months to have the surgery......I can't wait........hubby is going to Afghanistan in May........and no one else is able to help me take care of our kids while I have the surgery. Geeez I hope she doesn't tell me that..............

[Ready4a2ndChance 0]

OK, so I called tricare north this morning to check on my referral........and they said my referral was approved for up to 5 visits with another doctor. I don't understand. I thought that my pcm put in the referral for the lap band surgery. I'm so confused.

[KarinaM 0]

OK, so I called tricare north this morning to check on my referral........and they said my referral was approved for up to 5 visits with another doctor. I don't understand. I thought that my pcm put in the referral for the lap band surgery. I'm so confused.

Hi, this is what will happened. You go to your PCM and she will request a referal for you to see a surgeon. When you see your surgeon (usually they gove you 5 visits) he will request a few things like pscy eval, nutricionist, sleep study and blood test. After this is all done the SURGEONS office will submt your paperwork to Tricare to have the pre authorization for your surgery approved.

Let me know if you have more questions because I went thru this whole thing and had to fight Tricare for 6 months for approval. KEEP GOING and Good Luck.:mad2:

[Ready4a2ndChance 0]

Well I found out what happened.........tricare approved me for a surgeon that DOES NOT do the surgery. Go figure right? I talked to my PCM and she said that not many people around here do it, and thats it's still relatively new around here and NO ONE in jacksonville, NC does it at all. I have to go to Wilmingon or Greenville.........and I think greenville is in SC if i'm not mistaken but there may be a greenville nc. Anyway, she is having the referral specialist fix it today and they will give me a call. She thinks I'm a perfect candidate for the surgery.........BTW they checked my thyroid (since I haven't taken mine in a couple months, big mess anyway) and my thyroid was 30........30!!! so any of you that know anything about TSH levels know that's HORRIBLE.........hopefully i wont feel so drained after I start my new dose today How is everyone coming along that has been banded recently?????? Anyone having problems??? I hope all is well, and FYI they have some cute icons on photobucket for lapbanders!!!!:eek:

[lisw55 0]

Can't wait fo rmonday to find out about my surgery date. I wonder how long I will have to diet. Good like on yours.

Hi Karina,

I am just wondering what you think about my situation. I have Tricare standard and am wondering if you think they may approve a BMI of 37.4 with sleep apnea, hypertension, high cholesterol, and hypothyroidism?

[Ready4a2ndChance 0]

I would definately think so...............are you 100lbs over weight

[lisw55 0]

Hi Karina,

I am just wondering what you think about my situation. I have Tricare standard and am wondering if you think they may approve a BMI of 37.4 with sleep apnea, hypertension, high cholesterol, and hypothyroidism?

I wonder what scale/chart that Tricare uses to determine if you are 100 pounds over weight?