Tricare Does Not Require An Overnight Stay?

[Ineedalapband 0]

So after reading here that Tricare required an overnight stay I asked my Dr. office to look into it. She just wrote me back and said that Tricare did not require an overnight stay. I have Tricare Prime (Humana South). Just want to be absolutely sure this is correct. I certainly cannot afford to pay for this surgery because someone made a mistake.

So, overnight stay required or not?

[thatDEgirl 1]

I was told by both my local Tricare office and my surgeon that Tricare required an overnight stay. If I was you, I would call Tricare directly and ask them.

[JamieNP 20]

I have Tricare North and as of a month ago, they required the overnight stay. Take it if you can get it.

[asimmons 1]

I have Tricare Standard South and they had to authorize the overnight stay - otherwise it would have been straight outpatient. My doctor required an overnight stay because of severe sleep apnes.

Anne

[Mommie_of_4 0]

I have tricare south. My approval states Outpatient surgery. I called Tricare and they stated that if the hospital is less than 50 miles away then an overnight stay is not necessary. If more that 50 the overnight is required.

Hope this helps...

[Ineedalapband 0]

So I called Tricare today and they said that the Dr. had put it in as a inpatient procedure. I called the Dr. office again and they said they put it in that way so they can get an approval number. She said if they put it in as outpatient they won't get this number. So, although I'm put in for an overnight stay, I won't be staying the night unless there is complications. (Please Lord, help that not to happen).

Just as long as they can't say they won't pay because I didn't spend the night I'll be happy. I don't care about staying overnight but it would make things easier.

[thatDEgirl 1]

I'd be really worried about this, because how they submit it is what they must follow or Tricare can refuse not to pay.

[tomatogirl 0]

I have tricare south. My approval states Outpatient surgery. I called Tricare and they stated that if the hospital is less than 50 miles away then an overnight stay is not necessary. If more that 50 the overnight is required.

Hope this helps...

I hope this is right- I'm going to call tmw and ask about TriCare North. I really don't want to have to stay overnight at a hospital that is 20 miles from my house, tops.

[Ineedalapband 0]

I'd be really worried about this, because how they submit it is what they must follow or Tricare can refuse not to pay.

I know what you mean. I asked the lady at the surgeons office at least 3 times if that was the case. She told me "You aren't my first Tricare Prime patient. I've never had a single person call me after surgery and tell me that they had to pay more, or pay anything because you were authorized to stay overnight and were discharged". She assured me it would be fine.

Wonder if I should call tricare again and ask if they can deny payment because of this?

[pmcfarm 0]

I am Tricare South and I called them last week on this issue and was told all forms of wls are considered surgery and require an overnight hospitalization. I will follow that guideline rather risk non-payment of surgical costs,

[Ineedalapband 0]

Ok, I just called AGAIN. She said that the surgeons office would have to call on the day I am discharged and change my surgery from inpatient to outpatient. I sent the surgeons office an email stating this fact. I also CC'd myself so I'd have proof that I told them. I also kept a record of who I spoke to at tricare and at what time - she told me they record all of the calls.

Hopefully, that will do it. Now, I just hope I can remember in my drug induced haze after surgery to ask if they did it!

[Ineedalapband 0]

I just got an email from the surgeons office in response to my email. It simply said "Its the hospitials responsibility to call Tricare and let them know you were discharged early".

[tomatogirl 0]

I just got an email from the surgeons office in response to my email. It simply said "Its the hospitials responsibility to call Tricare and let them know you were discharged early".

That's the jist of the response I got, too.

[Ineedalapband 0]

That's the jist of the response I got, too.

Thanks tomatogirl. That makes me feel better.

I head to my preop, class and to meet the surgeon tomorrow!