Tricare Approval or Denial??

[Dave_NW 92]

My surgeon submitted my surgery request to Tricare Prime on Friday, Oct 15, 2010. I received a phone call on the following Wednesday, Oct 20, 2010, just three workdays later. I was asked a few questions over the phone, and then I was approved. Pretty easy.

Dave

[jesikka06 0]

My surgeon submitted my surgery request to Tricare Prime on Friday, Oct 15, 2010. I received a phone call on the following Wednesday, Oct 20, 2010, just three workdays later. I was asked a few questions over the phone, and then I was approved. Pretty easy.

Dave

i called to check on mine today and they said it wasnt even in the system yet, that the surgeon needed to call and talk to them about it since its gastric bypass ... then i call the bariatric center back and told the insurance lady and she said that wasnt normal procedure. shes calling them and then hopefully some good news will come my way ..

[AZteacher 0]

I don't know if this is the right place to ask, but I was wondering if anyone has had any out-of-pocket costs with Triwest. A friend of a friend is having the lap-band surgery in a couple of weeks with a different insurance company and she says she has $1200 in fees she has to cover. She made it sound as if it was the doc that charged the fees, but I would like to think insurance would cover it. Does TriWest cover 100% if they approve the surgery?

Thanks!

[airsangel 0]

AZteacher - it all depends on the surgeon. I have Triwest also & even though they pay 100% for the surgery, they do not cover the dietician or the psych evaluation. The surgeon I'm using has a one time fee of $450 that covers 3 visits with a dietician & 1 with the psychiatrist. It also is supposed to cover things like, support group, the seminar, etc...

I have not been approved by Triwest yet but I have to pay the $450 in advance & it is non-refundable.

The good thing about Triwest is that when you are approved, they do pay for 12 fills!!