Hangman

Cori T.
on 7/2/04 12:43 pm - Neah Bay, WA
Hi, I see you're in the Silverdale area. Mind if I asked who you used for your psych. eval? I'm really leaning to just pay out of pocket since Triwest and the Dr. I found in Sequim are being a PITA. How many hrs. did it take w/whatever Dr. you did use? I just wish this process wasn't so complicated!
Chanise D.
on 6/29/04 10:42 am - Lakewood, WA
Congrats.. I have been keeping up with your tri west issue...I also read your profile...WOW.... My PC nurse was not in on the 25th when I had my appt. She called me today and left a message for me to call her back...I am nervous. Good luck and if you need anything or any help, let me know...I'm in Lakewood. Keep us posted.
JustHat
on 6/29/04 3:00 pm - NM
Dang, you guys are good. Next time I am going to make it harder. Yes, I am approved. I had called TriWest last Thursday. They said there was no record that I had applied for surgery and it must not have been received. I needed to apply again. Pam said hogwash. So, yesterday I called again. I was on hold for a long time. But, the woman that answered was really nice. When she looked it up, she said there was a whole bunch of stuff for me. She started reading from the top. First, gastric bypass surgery, approved. Second, (This is where I stopped her.) I pulled my jaw up from off the floor and started asking questions. This is the surgery, not just to discuss the surgery, right? Right. I mean, this says that they can actually cut me open, right? Right. OK, just to be clear, your saying that I can go ahead and have the surgery, not just discuss it more with the surgeon, right? Right. By this time, she must have thought I had lost my mind. But, approval was totally unexpected. I have expected to be denied. She told me that I was also approved to have my gall bladder removed. Third, I was denied the request to have stomach surgery. OK, hold on just a minute there. You just said I could have stomach surgery. That is right. Then you tell me I can't?! No, you can have gastric bypass surgery. But you can't have stomach surgery. At this point, I asked her if she knew that GBS WAS stomach surgery. She did. So, she asks me to hold on and looks up the code. Then she said the code wasn't a covered surgery. But, the code for GBS was listed as being approved. We were both confused. LOL But, I did make her confirm 5 more times that I was approved for GBS and I have the authorization codes. OK, so I call Pam. She was out yesterday. Summer didn't know what was going on either. So, I went online. Apparently, the code that was denied was the code they use for lap surgery. What it comes down to, as I understand it, is I was approved for open but denied for lap. Fine with me, I don't want lap. But, since I thought Dr. Weber only did open, I wonder why they applied for lap unles they were just checking to see if the new contracter would approve it. I didn't hear from Pam today. But, we were gone from the house until 5. So, she might have called but couldn't get me. She had told me that if she hadn't heard anything by today, she was going to give them a call. So, she might or might not know by now. But, I should have a date soon. Oh, and here was another interesting thing. During the orientation, she said that when Tricare approves, the surgery has to be done within 30 days. TriWest apparently has changed that. They gave me 90 days to have the surgery. I don't want the surgery before July 15. But, I don't want to wait 89 days. OK if that story didn't give you a headache, your more woman (man) than I am. Nip Tuck is on, so I must go watch TV. Thanks to everyone for playing my game and the well wishes. --Hat
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