Tricare Denial..REVERSED!!

[KarinaM 0]

JWRN, I'm so sorry to hear about your hospital stay. Will you be able to keep your band with the allergy? Congrats. on losing the 20lbs, but such a hard way to do it. Keep taking the antibiotic so you will get to feeling better everyday. Good thoughts coming your way. Maggie:girl_hug:

Meggie, I would no wait for your surgeon to call TriWest. I'm still waiting and will be one month this friday.

I had a TriWest lady on the phone lst week and she started: "oh you called...." I interrupted her and told her not to count because I call at least twice a day everyday and I also check the web at least 10X. After she told me it was still pending I told her: Ok I will call again tomorrow morning. hehehe

They are probably hopping I get approved so they can get me to stop calling.

[JamieNP 20]

I can't believe you have not heard anything yet! I am feeling better everyday. I am forcing myself to eat so that I can heal. I am on my blackberry as I am at my parents house to recoup . Thank you all for your messages. FYI I have no regrets and it looks like I am loosing about a pound a day.

[Maggies 0]

Karina, I have called Triwest and they won't put me thru to the person handling mine. They said they will only talk to the doctor. This is getting very old and frustruating. Hopefully you will be hearing something soon. I don't know why it is taking so long for them to let you know.

JWRN, Kick back and enjoy Mom and Dad taking care of you. It probably makes them feel good to be able to do it. I know it does me. Sounds like you are doing better and at least you got to keep your band. I was kinda worried that you would not. A pound a day would be great, but it will slow down, and that is when you will want to start weighing yourself just once a week. Keep up the good work.

Maggie:shades_smile:

[Maggies 0]

Hi, how is everybody doing. My latest news is: An appeal was submitted yesterday by the surgeons office. I talked to them today and she said it sounds good. They talked to Tricare yesterday and they requested all the info being resubmitted to them. Apparently they did not have my sleep study which shows I have sleep apnea. Healther, at the surgeons office said she is calling them on Tuesday to check on it if she doesn't hear anything by then. So the wait continues:rolleyes2: Maggie

[JamieNP 20]

There is no reason why you should have been denied unless there was paper work missing. Goodluck and keep us informed.

[Maggies 0]

How are you feeling today? I keep thinking I would of been banded for over a week if it would have been approved. Oh well, no sence in looking back, just forward. Maggie:shades_smile:

[Maggies 0]

Restless Monkey hasn't posted in a while. Come out, come out wherever you are. How are you doing? Maggie:shades_smile:

[RestlessMonkey 7]

Maggies You are so funny! I was just thinking I should post. I have had a wild school semester, computer problems, you know: life as usual! LOL I am glad they are reviewing you. I bet you get approved this time! I'm so glad! And JWRN wow you have really shown dedication to get the band. I hope you drop weight like it's hot!

I got my first fill today...a whopping 1 1/2 cc's in a 14 cc band! Good grief! My surgeon, though, explained why he's going slow and what he wants me to do; he feels he is setting me up for long term success and you know, he's the pro. I have to trust him.

Maggies, this may be your last weekend in limbo! I HOPE so!

[Maggies 0]

Restless, good to see you posting. Its strange how we get used to people posting and then when we don't hear from them, it seems quite in forum land. How is your weight loss going? I am checking the Tricare site everyday to see if it has changed, but it hasn't yet.

Karina, any news on your appeal? Keeping my fingers crossed for you!!!!

JWRN, are you back to feeling like your normal self yet? You kinda made me think twice about banding, but of course I still want it. I can't seem to lose weight on my own and keep it off, so banding is for me.

Have a good day, Maggie:shades_smile:

[RestlessMonkey 7]

My weight loss stalled but honestly I expected it to while I was recovering. I gained on liquids (Water weight because of all that salt in the broth, the Soups, etc) I've had NO restriction, felt fine, and been hungry so it's almost been the old status quo for me. I now have 1 1/2 cc in a 14 cc band (LOL hold me back LOL) but doc said to QUIT snacking. When I go back in 5 weeks if I have managed to quit snacking he'll be more aggressive. But he told me that if he BOOM restricted me and I was struggling with that and getting BACK out of the snack habit I'd be miserable and that's not what he's after.

He said "you did the preop diet for almost 6 weeks. I think you can cut out snacks" and he's right of course. I was kind of just testing my limits if that makes sense. I'd pretty much discovered there weren't any (although I didn't ever try anything carbonated) and now I'm ready to get down to business.

I'm actually having a Protein shake for lunch (skipped Breakfast but I bet I don't tomorrow LOL!) and hope to have the gain vanish by next week.

AND Maggies I KNOW they are going to approve you. They have to.

[RestlessMonkey 7]

I wanted to say, too, that I love my Doc. I said "good grief 1 1/2 cc's is hardly worth the lidocaine you used!" and he said he truly would give me more restriction RIGHT THEN! if I wanted it. He said he thought he shouldn't and explained why but said "It's your health and your body; you know yourself best. I'll do it if you want". What a guy, huh? I told him no, I'd trusted him with my life, twice, I figured I could trust him on this too. Which is the truth.

[Maggies 0]

Good Monday Morning, I hope to hear good news this week, but as long as Karina's is taking I probably have over a month to go. Restless, how do they decide what size of band that they put in? The surgeon I am working with says he only uses two sizes, large and small. Oh well, I guess I will worry about that later. JWRN, how are you doing by now?

Maggie:shades_smile:

[JamieNP 20]

I am doing much better. I have finished all of the antibiotic and am feeling life a normal person. I have lost 25 lbs since the day of surgery.

[RestlessMonkey 7]

Restless, how do they decide what size of band that they put in? The surgeon I am working with says he only uses two sizes, large and small.

Maggie:shades_smile:

I think it depends on how large the stomach opening is, actually. The "small" is standard and holds 10 cc's, (unlike the 1st Lap Band by allergan/inamed that only held 4 cc's) and the Large holds 14 cc's so it's a bit wider inside. Allows for more adjustment etc and I guess that's why post op we allergan/inamed banders don't feel as much restriction as people did in the early days. My doc picked it of course, once he was "in".

If you get a realize band I think it only comes in one size. They both have pros and cons (both brands I mean)...

glad my doc picked for me! LOL

[HelloPenny 0]

WoW! I can't believe some people had issues with Tricare!

I was approved in less than 48 hours! But, I met the 200% of ideal body weight requirement. Maybe that is why I got an approval so quickly.