Newbie with a question Re: tricare approval on site

Newbie with a question Hi Everyone, I'm a newbie to the boards. I've read a lot and posted a few replies here and there, however I haven't introduced myself or posted any of my own threads. I woke up this morning and tricare had updated status for 2 of my referrals (the only 2 listed so far) and I am just curious what exactly the approval is for. I plan to call the Dr's office on Monday but you know how impatient and rushed/curious we all are when it comes to going through the approval's process. I will be cross posting this to the insurance forum for obvious reasons and the military and NC forum since I visit those often and see a few people that have or are using tricare as well. Thanks in advance! Here is what the tricare site says to me, and after that I will post the burning questions lol Referral #1: Begin date of service: 08-22-2007 End date of service: 11-19-2007 Place of service: DOCTOR'S OFFICE Decision: APPROVED Reason: APPROVE, MTF COMMANDER OVERRIDE -------------------------------------------------------------------------------- Approved service type: MEDICAL CARE, SKILLED NURSING Approved procedure range: Beginning procedure: OFFICE CONSULTATION FOR A NEW OR ESTABLISHED PATIENT, WHIC Ending procedure: OFFICE CONSULTATION, 3 KEY COMPONENTS: COMPREHENSIVE HX;CO Quantity: 1 UNITS Frequency: AS NEEDED Referral #2: Begin date of service: 08-22-2007 End date of service: 02-17-2008 Place of service: DOCTOR'S OFFICE Decision: APPROVED Reason: APPROVE, MTF COMMANDER OVERRIDE -------------------------------------------------------------------------------- Approved service type: MEDICAL CARE, SKILLED NURSING Approved procedure range: Beginning procedure: OFFICE/OP VISIT, EST PT, NOT REQUIRING PHYSICIAN PRESENCE, Ending procedure: OFFICE/OP VISIT, EST PT, 2 KEY COMPONENTS:COMPREHENSIVE HX Quantity: 5 UNITS Frequency: AS NEEDED Did my Dr already submit the approval for the surgery OR is this just for the consult visit? If it's just for the consult visit why would there be 2 approvals? The first one looks to me to be the obvious consult appt. but the 2nd referral really does make me curious. Am I dreaming or imagingin it? I thought maybe someone who has seen their claim online might be able to offer some assistance for this impatient newbie If no one knows I will come back and post Monday night after I get back from work with an update Crissy

Ok, here is my opinion. To me it looks like it is for the consultation. The first is the intial consultation and the second referrals are for follow up visits Because the first one says 1 unit (visit?) and the second says 5 units(visits?) Linda

Thanks Linda. I didn't think my Dr had submitted that stuff yet, thought they waited until all the pre-op testing was complete first...wishful thinking 'eh

Hey Crissy -

Nice to meet you! Virtually speaking, of course! I don't have experience w/Tricare, but we have a nice contingent who do and I'm sure that you'll get plenty of support w/Tricare specific issues.

I look forward to seeing your posts and getting to know you.

All the best in your quest for a healthier you!

Barb

Thank you Barb! It's nice to virtually meet you as well. I will be posting more in the next month or so I am in the process of going through a divorce and would rather not put a lot of info out there until it's finalized because there are too many snooping eyes  

Crissy -

Sorry to hear of the difficulties you are currently experiencing. I hope that things start looking up soon.

All the best,

Barb

Hey Crissy, dont know the answer to your question,, but I see we will have the same surgeon(he is good as gold) and I wanted to ask YOU a question. Does Tricare cover the band? Is that what you are trying to get? Let me know. Steve Que

Hi Steve, To my knowledge tricare DOES NOT cover the band, except in rare cir****tances. I know that if you go to an MTF (military treatment facility) they will sometimes cover the band just so the surgeons can keep their credentials up to date, but from all the research I did the list is very long (when I checked it was 2 years) and the military is good for changing things at the drop of a dime, I'd hate to wait 2 years and find out just prior to my date that they switched their policies.  Originally I was scared to death of bypass...I only wanted the lapband...then after a lot of research I found that the band probably wouldn't be MY best option and that the bypass after learning a little about it wasn't as scary as I thought it was originally. Anyhow, hope this helps :0) I loved Dr. Mitchell when I met him. I felt as if I had known him for years and I'm very confident in using him.

If you care to read my profile,, you will see that I too was scared to death of the rny. Sheessh,, I still am. I tried to get comfortable with it,,, but could never get there. I like Mitchell too. So I knew he would be my doc. I went up to Raleigh(to see Enochs and Moran) but I felt more comfortable right here in Pinehurst. Plus, I knew I would need fills, and Mitchell was right here.

Hey, another thing,,, I heard that they LOST a patient, on the table!!! Is that true? Que