Tricare Approval or Denial??

[rucsac1971 0]

It was a month ago today that I went to my first seminar, and my paperwork is being submitted to Tricare today for approval. Now the fun part begins of constantly checking Tricare website to see if there and approved or not.....

[babygirlsmom29 0]

I have been doing that all week I think I check way too many times and call about the status. Mine was submitted on monday so online it is still pending it has been a long stressful week this week...But hang in there and I hope and pray that all goes well for you..

[Rsilversea 2]

I've been informed my appeal was denied. Back to Weight Watchers until Tricare changes their policy.

[babygirlsmom29 0]

Keep appealing dont give up!!!!!

[nursesandy 0]

I have Tri-Care South and my surgery was approved 2 days after the doctor submitted it. My height is 5'8" and I weigh 269. My co-morbidities are Severe OSA and joint pain. I have also been started on medication because my blood pressure has just now started to creep up there. For me it was alot easier than I thought it would be. I'm sorry that some of you are having difficulty. I hope it works out for you.

Sandy

[Rsilversea 2]

Unfortunately, I have no co-morbidities. My triglycerides are high but I don't need to be on medication--yet. I've been told by other Tricare professionals that whoever is reviewing my case is reading their policy wrong but that doesn't help me. I'm going to try one more time but I'm starting Weight Watchers today. I've pretty much lost hope.

[babygirlsmom29 0]

Unfortunately I was denied b/c tricare stated I am not 200% and that my asthma will continue to be unchanged....I have no ideal of where to begin or what to do. I guess I can start weight wather and go on from there.

[Felisha 0]

Every time I think of quitting smoking i have a panic attack and have to rush to have a smoke.

[Felisha 0]

I'M MAD. I guess I had an approval sitting there for a MONTH before I got the letter!!

So hopefully I get approved for surgery

[KatieMT 0]

I just got my letter in today that I've been approved for the surgery. I saw my PCM for a referral to my surgeon on April 22nd and the surgeon consult was approved on March 14th. Surgeon's office called me and said they were going ahead and submitting the surgery paperwork so that I'm already approved and don't waste my time with all the preliminary stuff if they don't approve me. I got the letter in the mail today that surgery was approved March 19th!

I'm barely in the 100lbs over weight range, and my PCM listed severe joint pain and sleep apnea as comorbs.

My PCM said that sleep apnea is a major key to getting the surgery with Tricare, so I'd recommend anyone have one if they can.

[sara31 2]

My paperwork was submitted yesterday to Tricare. I am having a problem though - I registered online yesterday to watch the claim status and they have to MAIL you a code to check on it. The phone system shows nothing and the lady on the other end of the line said that they needed a date of service (I told her the drs office submitted it yesterday?) but other than that she cant give me any information. The crazy part is that my Doctors office said that I would find out online before they would, but how can I if I can't get access? Argh! Any of you have this problem and if so, how did you get around it?

[Rsilversea 2]

It didn't take long to get the letter in the mail but I kept (well, actually my husband) kept after the Tricare rep. That's how I found out if I was approved or not.

[jenn2481 0]

I found out I was approved for my surgery today. I have Tricare Prime Overseas (Germany). The surgeon submitted my claim on Tuesday and I got a phone call from the Tricare office today telling me I was approved. The only co-morbidity I have is joint pain in my ankles and feet.

[copeland6353 5]

My heart dropped when I saw that TriWest had not approved my surgery. I'm 5'4" 241lbs. What I don't understand is why they would approve me to see a LAP-BAND® Specialist, approve my Psychological evaluation. I have my surgery scheduled for the NOV 16 2010. I don't know what to do. I'm so desperate that I will pay for this surgery to better my health. I did appeal, and it has been 3 days and it is in Pending review status. Do you think that is a good thing? I have been checking the status every 2 hours. My heart beats fast when I load the TriWest page. I'm going to be so heart broken if its not approved. I did write an appeal letter stating why I should have this surgery. The one thing I told them was that I am Boarder line diabetic. Do I have to wait another year to roll around for me to have full blown diabetes? Because if I do TriWest will be paying for my diabetic medication and constant doctor visits for the rest of my life. I want to prevent this before this happens. Hope that TriWest will understand my dire need to have this surgery.

[jesikka06 0]

im actually waiting to hear from TRICARE STANDARD as we speak ... they got everything by fax last thursday ... ive been so worried sick about whether ill be approved or not. im actually going for the gastric bypass. im 22, weigh 380 ibs, i have high blood pressure, border line diabetic, hyper cholesterol and i retain Fluid ... all of these are pretty serious for a 22 year old ... i hope they approve me ... my scheduled date (unless denied) is november 19th ... :thumbup: plus ive also had problems with my joints swelling bc of my obesity

Edited November 2, 2010 by jesikka06