Insurance DENIED!

I'm devastated! I was waiting for a surgery date, because all indications were that everything with TriCare Prime would be fine. Checked online today and there was a BIG "D" for denial. Of course everyone is closed and there is no reason code. I'm gonna suffer this weekend.

Melony, I'm sooooooooooooooooooo sorry...I'm puzzled...Tricare is usually so quick and easy to approve. I read your profile...you said your PC Dr. didn't think too highly of surgery because you don't have the co-morbidities, but your BMI qualifies you without them...did your PC Dr. submit a referal to tricare so that you could see Dr Bour...if he didn't, that could be the problem. When you find out on Monday, please post and let us know...I'm curious as to what happened. Melony, I know this is easier said than done...but don't suffer through the rest of your weekend...this will all get taken care of soon. I've found tricare will help you as long as you qualify...and you DO qualify. So chin up Sista, this too shall pass. Tonya

Thank you so much for the post. I just took the kids to see Ice Age and I'm trying to keep my mind off things. Only people on this site could possibly understand how I feel. I hope and pray it is a simple misunderstanding or paperwork problem. I thought hypothyroidism helped me qualify. Dr's office didn't seem to be worried at all. Pray, Pray, Pray...

Melony, I am so sorry to hear that. I am sure that Kim at Dr. Bour's office can straighten it all out for you. I am glad to hear you are trying to keep busy to pass the time and not dwell on it this weekend. I will certainly say a prayer for you Keep us posted!! Melissa

Hi Melony! I am sorry to hear of your struggles with Tricare. I have Tricare Prime and my BMI qualified me with no co-morbs. I hope that you get this straightened out next week. Hugs, Britt

Melony- Don't sweat it, Kim will take care of it for you. They know how to handle these things. Just relax. You will have a surgery date before you know it! Kathy

TRI CARE PRIME IS ONE OF THE EASIEST TO GET WLS APPROVED SO NOT TO WORRY BUT, THEY WILL DENY YOU WITHOUT EVEN LOOKING AT YOUR FILE IF YOUR DOCTOR REFERRED YOU TO YOUR SURGEON AS AN "EVAL ONLY". CHECK TO MAKE SURE THAT YOUR DOCTOR'S REFERRAL WAS FOR "EVAL & TREAT". IF HE DIDN'T ADD "TREAT" OR IF IT WAS ENTERED INCORRECTLY AT TRI CARE, THAT SIMPLY MEANS THAT YOU WEREN'T REFERRED FOR THE TREATMENT (SURGERY), JUST FOR AN EVALUATION. THIS IS EASILY FIXABLE ... YOUR REFERRING DOCTOR SIMPLY HAS TO RESUBMIT A NEW REFERRAL FOR "EVAL & TREAT". NOT TO WORRY, MS MELONY. THERE ARE SO MANY OF US WITH TRI CARE PRIME THAT WE'LL GET YOU THROUGH THIS TO APPROVAL! GOD BLESS YOU DAWN & NICK