Tri Care Prime with Dr. Lord

I switched to tricare standard to get around having to have a referral for the surgery. But I did have to pay for my nut and pysch eval. I also had to pay my 150.00 deductible and then right before my surgery I had to pay 200.00 for the surgery. Tri-care picked up everything else. I also had a different Dr.  Good luck with your surgery!!

I didnt pay one penny for my surgery. Tricare Prime picked up the tab for everything. As long as you have your refferal, you should be alright. Ask your dr to waive the Admin fee. Its not like he isnt going to make a fortune off your surgery anyways. Cant hurt to ask. I saw Dr. Robbins, and he didnt say anything about a Admin Program fee... Everything was included in the price of the surgery. Even the follow up appts. Id call Tricare and ask... cause everything should be included. What the heck is a Program fee anyways? Is it just me, or does it sound like a gimick??

I called tricare on that, and they said I have to pay it.
The Admin Program Fee Covers:

1. Pre-Surgery Educational Materials
2. Pre-Surgery group meetings (supprt group/nutrition orientation)
3. Letter of medical Necessity Requested by and sent to your insurance company.
4. Insurance Verification and correspondence nescessary for preauthorization
5. Review of previous medical records and diet history
6. Copy of Bariatric Book
7. Nursing Consults
8. Psychological Evaluation
9. Nutritional Evaluation
10. Remedy MD

The refferal was sent to him over a week ago from Tricare Prime. I went to the seminar and found out about this fee, and that there is a $150. charge everytime you go in for an adjustment. I am in the process of calling tricare again and maybe speak to someone that might know more.
This Dr. Is a Center of Excellence, no deaths, been doing this for years, did over 3000 in RNY and over 2000 in Lap Band.
I thought that Tricare covers all that. My PCM said I dont have to worry about a penny.
I will keep you informed.

Wow. Dr Robbins didnt charge me for one penny. I am glad I didnt have to pay all that. Good luck. I hope it works out.

Okay I spoke to a really nice guy at Tricare and he explained that tricare covers everything. He said for me to ask for the billing codes for the admin program fee. and call tricare back and tricare will go over every code with me to find out if i have to pay any of those are or not. So as it stands I dont pay for anything not even the adjustments.

So how are u doing with yours? I have been walking 20-30 mins a day now, and drinking more water. I hate water. But I am getting use to it. If it is cold great! If it is warm nope.
Thank You Again

YAY! I am so glad you finally spoke to someone who could help you. I was told at the beginning that I would have to pay out of pocket for my Phyc Eval. I just asked my PCM at Lyster for a refferal, and Tricare covered it. That was the only "potential" payment I would have owed. I am so glad you are checking into this now rather than when the bill comes. :o) Good luck.
About the water... I think its Crystal Light that makes a water bottle mix that is Green Tea and Rasberry. Its sweet and actually pretty good. I love water, so mixes are not usually my thing... but this was some good stuff.

How long after your tricare prime referral did you pay admin. fees,  take classes,  and have surgery?

I went back and forth with Tricare and Dr. Lord's office about the admin fee.

Tricare Prime will not pay for the admin fee. I ended having my LapBand with another surgeon in Pensacola after meeting with Dr. Lord for a conslt. I met with both of the well-known bariatric surgeons in Pensacola. I chose the other, and now after complications, and in my opinion lack of aftercare and concern, I am having to have a revision surgery, my lapband is having to be removed, and least to say my experience was not pleasant. . .

I didn't pay anything out of pocket except $50 for the nutritional consult. I didn't "click" with Dr. Lord personally. I loved my choice of surgeon until I started having complications with my Band. Once I became "needy" and questioning things, I felt my concerns were not being addressed, and I was being ignored because I didn't choose Gastric Bypass.

Well, looks like I was correct since I am having to have the band removed. 
I wish you the best of luck, I know a few other military wives here who adore Dr. Lord and his PA that does his fills.