Tricare: Question about criteria

[Allformyson 0]

So my PCP did my referral and I was approved to see the specialist. The specialist won't see me until I have all the requirements met and sent me a list...a few on there were one's I didn't know about. If I need to make an appt to see my PCP again, which I think I will, I would like to try to take care of everything at once.

1. What is cardiac clearance? I don't remember my PCP mentioning it.

Well I guess that was it...it says I need my PCP to provide a written medical history but I don't know if she did that so I will probably have to make an appt. I need to re-do my nutrition appt too because they person didn't take written notes and I now know I need that.

Thanks.

[rodriguezequal 3]

1. What is cardiac clearance? I don't remember my PCP mentioning it.

Well I guess that was it...it says I need my PCP to provide a written medical history but I don't know if she did that so I will probably have to make an appt. I need to re-do my nutrition appt too because they person didn't take written notes and I now know I need that.

Thanks.

Cardiac clearance usually means they will need an EKG. They need to make sure that your heart is able to withstand surgery...

[RestlessMonkey 7]

I am SO GLAD I have tricare standard and didn't have to go through all that! But I'd ask the specialist what exactly he wants. No reason to get an ecg if you don't have to. I got one as part of my preop testing and since it was "normal sinus rhythm" I didn't have to see a cardiologist.

[rodriguezequal 3]

It wont hurt to have one done though so the insuarance may just be trying to cover all bases

[YngGram 73]

I am Tricare Standard (north) and my life is a little easier but..each surgeron seems to want something different. I have been to three seminars and the first two got ditched because they required a 6 month structured weight loss program (which had to be paid for out of pocket) as well as a program fee also out of pocket. The thrid one does not and that is the one I have chosen. Below is what is listed as required by the first two:

1. a 6 month structured weight loss program

2. Lab results from: Hpylori, TSH level

3. Pulmonary clearance

4. Cardiac clearance

5. Psychological evaluation

6. Nutritional evaluation

I followed up with Tricare and found that only 2, 3, & 4 are what insurance requires. 2 is blood work, not sure for what, 3 and 4 are to make sure the lungs and heart are in good shape. Chest X-ray and an EKG should show this.

This office only required that I fill out a packet from the seminar(health history) and I had my first consult. Once I have my test 2-6 done, my file will be sent to insurance for approval; nutrional eval on 30th. My BMI is over 40 and I have high blood pressure.

Edited December 16, 2008 by niterun
forgotten info

[annjones 3]

The blood tests are to make sure you aren't running any kind of infections. All precautionary stuff for before surgery. I have Tricare Standard and getting cleared seemed to be a very easy (thank goodness).

Being Tricare I thought it would be harder than it was.

[kmcoolone 0]

hi all

I just went to a nother surgeon yesterday that is 2 hours away from me because the first surgeon I saw decided Tricare didn't pay enough. The new surgeon says I am only 98 pounds overweight and with tricare you have to be 100 pounds overweight. Anyway, now i'm not sure if tricare will approve me. I 'd like to know if anyone else was under and got approved.