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Insurance Discuss insurance topics for the gastric bypass and Lap BandŽ operations.

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Old 03-11-2008, 06:23 AM   #1 (permalink)
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Default Question About Tricare

Hello Everyone,

Those who have or who have had tricare, how long does it take to get a response back from them, whether it be positive or negative? I'm about to submit all my paperwork to my surgeon tomorrow and was just wondering how long it would be before I heard anything?

Thanks,
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Old 03-11-2008, 11:20 AM   #2 (permalink)
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Quote:
Originally Posted by Soon2BeThin33 View Post
Hello Everyone,

Those who have or who have had tricare, how long does it take to get a response back from them, whether it be positive or negative? I'm about to submit all my paperwork to my surgeon tomorrow and was just wondering how long it would be before I heard anything?

Thanks,
They usually can take up to 4 days.
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Old 03-19-2008, 09:03 PM   #3 (permalink)
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Unhappy

I have the strangest feeling they are going to deny me because I don't have any co-morbids.

This will kill me if I have to live the rest of my life like this
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Old 03-19-2008, 09:34 PM   #4 (permalink)
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Don't give up on them! If you get denied the first time, and your surgeon is willing to fight the fight, you should get it covered. I didn't qualify and was denied - I am over 100 lbs overweight, and have co-morbids, but not the ones Tricare is looking for. My PCM wasn't willing to fight for me - he felt that if I could get surgery, great, but he wasn't going to do anything to help - he doesn't believe in surgery..... I finally got a referral into the military system and have a great surgeon - I will finish up my pre-op stuff by mid April and am shooting for a May surgery date!
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Old 03-20-2008, 10:39 AM   #5 (permalink)
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so i called today and of course they denied me. said that i need 3 more months nutritional counseling even though i've had 4 visits.....when i talked to tricare previously they said that they didnt have a set number of times i needed to go, now they're changing it once again.....and then in 3 months it'll be something else.....i don't think i'm ever gonna get this surgery.......i feel like crawling under a large rock right now and never coming out again....this is so depressing to me.

the thought of having to seclude myself in my home for another summer is too much for me to bear right now....i swear nothing ever seems to go my way
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Old 03-20-2008, 10:42 AM   #6 (permalink)
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Keep fighting it and I would suggest getting and reading a copy of your policy so you can be prepared when they start to change the rules. My doctors office gave a typed list of the exact criteria needing to be met for approval. This helped me tremendously. Good luck and I will keep my fingers crossed for you.

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Old 03-20-2008, 10:44 AM   #7 (permalink)
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appeal. Will your surgeon fight for you? There is NOTHING in Tricare's guidelines that say you need those appointments.....
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