Tricare Approval or Denial??

[cobrien78 0]

Well, I meet the weight requirement and was already weighed in at my consult. The problem I have is with "documented" co-morbids. I have them I'm just not being treated for them and that is why I'm going to PCM for meds for these conditions. I just hope she doesn't give me the run-around about how it would be best if I just lost weight and didn't take meds! I'm not leaving without meds!

[Divamom 1]

My surgeon just weighed me but this was just a suggestion for someone who may be at the end of their rope and desperate.

Hope everyone is doing well on the band journey.

[Mommie_of_4 0]

I have comorbids, back pain and joint pain. Only med I'm taking is a steroid (which I use every once in a while). I didn't have anything else documented with my PCM but I got the approval.

Cobrien ~ I think the problem may lay with the surgeon you have chosen if they don't write a strong enough reason for the surgery you will get denied.

[JamieNP 20]

I am so excited! My surgeon's office finally submitted everything, and I am "PENDING" right now...could be any time now before that changes!!

[Maggies 0]

JWRN, Hope you get your approval soon. I have my first appt. with the surgeon on the 21st. Hopefully he will get the paperwork in to Tricare and I will here something by the end of August. Let us know when you get your APPROVAL and date. Maggie:cool2:

[KarinaM 0]

I had my papaerwork submited on friday but they needed a referal form filled out and the Dr.'s office faxed late friday. Yesterday was showing pending online and today I was told they needed more "clinical information" from my Dr. I called the surgeon coord and she told me she had NO TIME and she would send it to Tricare WHEN SHE HAD TIME. In the mean while I'm ready to have a stroke, I check the Tricare online every 5 min, I can do or think about anything else. I wonder if the fact they need more info it is a good or bad thing....

[JamieNP 20]

I am still pending. I called Tricare today and they said that it has not been reviewed yet. Argh!! Waiting is the hardest part!!

[SusieC 0]

I too have Tri Care and I go to my PCM on Thursday of next week to get a refural or a surgeon.. I then have a class on Tuesday the 26th.. I hope tri care is fast:unsure:...

[KarinaM 0]

Called Tricare again and they told me the Dr's office did not fax the info they need YET. I called the lady and after 10min waiting they told me to leave her a message. If she does not called me with in 3 hous I will be going over there and ask to fax my self. Is this to extreme??????

[JamieNP 20]

Go for it Karen! What do you have to lose? (well, they could send you in for another Psy exam, :tongue_smilie:

I am still "Pending" on the Tricare site. So I called Tricare to see what was going on. Apparently they have sent it to the post hospital (which I have never had anything to do with, and my surgeon is not there) and they have to refuse it first and then it is sent out to a local surgeon. She said that usually that means I am approved. I should find out something officially tomorrow. So, I am thinking..does that mean I am approved?!?!?! The soonest that my surgeon can get me in is Sept 23. I guess I am a control freak...the waiting is KILLING me!!

[KarinaM 0]

I know, I think you were approved by what they told you. I'm also a control freak and I think I am getting everyone insane at Tricare and also at the Dr's office. Can you imagine my family? I just want an anwer and NEED to be the A letter. Let me know as soon as they approve you. I think my surgery in case I get approved will not be until end September because my Dr. is very busy. As long as I get this before October, I'm happy. GOOD LUCK.

Go for it Karen! What do you have to lose? (well, they could send you in for another Psy exam, :tongue_smilie:

I am still "Pending" on the Tricare site. So I called Tricare to see what was going on. Apparently they have sent it to the post hospital (which I have never had anything to do with, and my surgeon is not there) and they have to refuse it first and then it is sent out to a local surgeon. She said that usually that means I am approved. I should find out something officially tomorrow. So, I am thinking..does that mean I am approved?!?!?! The soonest that my surgeon can get me in is Sept 23. I guess I am a control freak...the waiting is KILLING me!!

[cobrien78 0]

Well I was told I should hear something tomorrow or Monday. However, I'm not getting my hopes up even the nurse at my surgeon's office said it might not be likely that I will get approved. So I don't know what to do now. However, if I am approved the surgery won't be until NOVEMBER!! UGH!

[SusieC 0]

Well I was told I should hear something tomorrow or Monday. However, I'm not getting my hopes up even the nurse at my surgeon's office said it might not be likely that I will get approved. So I don't know what to do now. However, if I am approved the surgery won't be until NOVEMBER!! UGH!

why all the way untill Nov?

[cobrien78 0]

This is the only city in the state of Montana that does lapband and there are only 3 surgeons here so, it's busy. My dr. is the most popular out of the 3. If I get approved I could be moved up though. But like I said before I really don't think that will happen since the dr.s at the base are being assholes about this.

[KarinaM 0]

Well I was told I should hear something tomorrow or Monday. However, I'm not getting my hopes up even the nurse at my surgeon's office said it might not be likely that I will get approved. So I don't know what to do now. However, if I am approved the surgery won't be until NOVEMBER!! UGH!

Why is she telling you you are not gettin approved? Are you way under weight??? They should not tell you that.