Revsion and Tricare?

SuzinDallas
on 3/31/14 5:54 am

Anyone have any recent experience with Tricare?

 

I'm on Reserve Select, my first surgery was paid for by a different company long before I started using Tricare.  

 

My Dr just submitted everything into insurance and I'm waiting on pins and needles for approval. I was wondering if anyone here had dealt with them recently for a revision and how long approval took. I did a search but couldn't find anything newer than 2012 and I know they've recently made some changes.

 

Any words would be helpful right now, the wait is killing me!!!

Whit
on 4/1/14 2:59 pm
Revision on 12/10/12

I had revision surgery RNY to DS in 2012. Tricare Standard is my secondary insurance. My surgery was deemed medically necessary by my primary coverage so Tricare covered automatically. 

Good luck.

Whitney

Revision from RNY to DS 12/10/12 Dr. Ara Kesishian BMI: 19

Created by MyFitnessPal - Nutrition Facts For Foods

 

 

 

          

SuzinDallas
on 4/3/14 6:03 am

I just got my phone call with the approval!!

Apparently it came in yesterday but it was super busy and they didn't get a chance to call me. Either way I'm glad they called today, I'm at home and I broke down weeping when I got off the phone. 

 

My surgery, well I guess my new life, is scheduled for May 2nd.  Could have got it earlier-but needed to accomendate a few people so I can have some help with my two year old.

 

Yay!!!

Kennerknecht
on 4/5/14 2:11 pm

I am so happy for you! im trying to revise from band to RNY through tricare prime. my dr said he doesnt think it will be an issue but he will fight to make sure i get it :) 

Starting Weight - 350             Goal Number One 299
Surgery Weight-  335             Goal Number Two 249
Current Weight-  325             Goal Number Three 199
Goal Weight -      150             Goal Number Four 150
     

    
SuzinDallas
on 4/6/14 3:11 am

Thanks!  Good luck with yours!

 

My Dr's office-the person who does the insurance stuff said this was her first revision with Tricare but that she didn't think it would be an issue either given the other problems I was having.  They had me bring my records from my surgery as well as all all fills.  She did say that this year they changed one thing with covering the surgery and that was that they need/want 3 months of monitored weight loss efforts.  But that fill records as well as programs like Weigh****chers (she also said Medifast and Jenny Craig since they require you to go into the office and weigh in frequently) will count.  I actually had read that so I started Weigh****chers just in case (figured it wouldn't make things worse anyways) in Januaray so I nearly had 3 months right there.  I gave them my weight tracker to copy but I don't know what they ended up submitting.

They had all the things they needed, an upper GI showing the problems with my band and stomach, my evaluation with the nutritionist and all my records by late afternoon on the 27th, they told me they'd submit it right away.  I got the call that it had been approved on the 2nd, but they said it came in via email on the 1st. So that's really not too long of a wait. I hope yours goes just as quickly!  When did your Dr's office submit everything to Tricare?

Kennerknecht
on 4/22/14 1:20 pm

2 weeks ago, then they requested more clincal papers, im praying for approval soon. im so stressed out waiting to find out if this is going to happen im scared to death they will deny me! im so nervous lol they sent in the rest of the papers they requested today so heres to hoping

Starting Weight - 350             Goal Number One 299
Surgery Weight-  335             Goal Number Two 249
Current Weight-  325             Goal Number Three 199
Goal Weight -      150             Goal Number Four 150
     

    
pineview01
on 4/24/14 11:47 am - Davison, MI

Glad to hear yours went OK!

BAND REMOVED 9-4-12-fought insurance to get sleeve and won! Sleeved 1/22/13! Five years out and trying to get that last 15 pounds back off.

Most Active
Recent Topics
×