Tricare Approval or Denial??

[JamieNP 20]

I know I bugged tricare to death. I called everyday until I found out.

[tomatogirl 0]

I've been a total cow to them. I call every day, sometimes twice a day. My surgeons office marked the surgery as urgent, but when I talked to them today, they said that it doesn't fit the criteria for urgent, so basically, they'll get me an answer when they get me an answer.

[JamieNP 20]

Maybe you will find out today. When did your doc send the paperwork in? They may hear before you. In fact, I called the office and they ended up calling Tricare and got more info than I did.

[tomatogirl 0]

I hope so. I called this morning already. They sent the paperwork in last Monday (I think, may have been Tuesday) and the paperwork hasn't even been accepted yet. Ugh. I might call the surgeon and get the insurance lady to talk to them.

[JamieNP 20]

Did anyone here actually have tricare call them. I had read in earlier threads that someone from Tricare called to let them know they were approved and asked if there was anything they need to call them. They never once called me.

[JamieNP 20]

I hope so. I called this morning already. They sent the paperwork in last Monday (I think, may have been Tuesday) and the paperwork hasn't even been accepted yet. Ugh. I might call the surgeon and get the insurance lady to talk to them.

That is a long time. Usually Tricare is a little faster than that. What does it say at the website...is it even listed there? Does it say "pending"?

[tomatogirl 0]

Not even listed. I thought I was looking in the wrong place, but nope, it's just not listed.

[mljalways 1]

Does Tricare require a Psych evaluation? I have heard that some dont have to have one.

[JamieNP 20]

When you talked with them had they received the paperwork? Sounds like you need to give your Docs office a swift kick in the rear. Mine had it listed as pending for awhile, as soon as they got the paperwork.

[tomatogirl 0]

Nope, their only requirements are what the surgeon requires.

[JamieNP 20]

Does Tricare require a Psych evaluation? I have heard that some dont have to have one.

Tricare prime did..the slight hold up I had was because they did not have the psy eval...they had "misplaced it"

[tomatogirl 0]

When you talked with them had they received the paperwork? Sounds like you need to give your Docs office a swift kick in the rear. Mine had it listed as pending for awhile, as soon as they got the paperwork.

yep, they told me they had all of it- all 12 pages. They said it will be up as pending soon as they get it all in the system or whatever. :smile:

[JamieNP 20]

Ah..the waiting sucks, doesn't it?

As far as the Psy exam: I have heard conflicting requirements, but my surgeon's office and the tricare people I talked with said that they needed one. You can self refer and should be able to find one that is in "network". It isn't that big of a deal, if you can get in. My advice is to do a lot of the leg work yourself, like the psy exam, the support group, nutrition class, etc. It kills time while waiting for other stuff.

[KarinaM 0]

I've been a total cow to them. I call every day, sometimes twice a day. My surgeons office marked the surgery as urgent, but when I talked to them today, they said that it doesn't fit the criteria for urgent, so basically, they'll get me an answer when they get me an answer.

I spend ALL my day checking online and I call at least 3 times a day. I guess I'm the most hated at Triwest. They never give any diferent info. They always tell me they are "working on my appeal". hehehGood luck.

[KarinaM 0]

DOes anyone know for sure if the wesite is 24 hours behind or not? I got diferent ansfers from Tricare people like always.