What to do....
I am so mad/sad/frusterated right now. My consult with my surgeon was over a month ago (she is a civilian that tricare referred me too) and she requires me to see a physical therapist along with getting my psych eval done before she submits my package to tricare. Tricare denied me for my physical therapy appointment on the 24th of this month. I called my surgeons office and asked what I should do at this point and the secretary said she would talk to the surgeon and get back to me. Well, that was this morning and now the office is closed for the day. I offered to go on Fort Gordon to their physical therapy department and get the necessary paperwork done since its free for me there, but she sounded hesitant like the surgeon wont accept that. I am so aggrivated right now. I have studied this surgery so much that if I had the right tools I could probably perform it on myself. I just wish this could go by easier. I just don't know what to do with myself and I am SO NOT A PATIENT PERSON! I am scared that before this all gets approved my surgeon will have moved by then and I will be left to start all over again. She informed me at my initial consultation that she may be moving this summer and my aftercare checkups would be with her colleague who will also be assisting with my surgery. Did anyone else have this problem with tricare or with their insurance provider? Please give me some advice or positive words, I feel like this may never happen for me....
Oh yeah, Happy Valentine's Day!
Kathy
Kathy,
It's probably not going to be a problem to go on the Fort for the physical therapy. I'm not sure why that is required, but each insurance is different. You do have to be patient because without the following info they will deny you. It can happen, you have to be your own advocate. I know they have a therapist for the psych eval on the base. I can't remember the name right off hand, are you going to see him? The secretary was probably very busy today, I think it's also Dr. M's secretary (Nancy). They are in clinic today usually so she probably didn't have a chance to ask her. What are they wanting exactly for the physical therapy? That's probably and insurance requirement mostly. If so then I doubt it's going to matter to the surgeon who does it as long as the info needed is provided. Keep on top of it though.
Amy
Hello, I am so sorry you are comming up against a brick wall. I just had my surgery Feb 10th and I have Tricare. They referred me to Dr. Appel who did not require any type of physical therapy. I did have to pay for my MMP 2 test through my phyc. doctor - but that was the only thing Tricare did not pay for. Just be persistant and a squeaky wheel - keep up the faith. I can't begin to tell you how many times I broke down or had a panic attack trying to get this surgery done. Good luck to you !
Kathy,
Why the physical therapy appointment? I have Tricare Prime and had my surgery 6 months ago. Tricare was very quick with the approval process. They accepted whatever testing the surgeon required. They did not pay for the psych eval or the dietician (only if it is diabetes related), but did great with everything else. The physical therapy appointment must be a requirement of the surgeon, not Tricare.
Like Kia, I had my surgery with Dr. Appel. He is wonderful!
Patti
Thank you ladies for replying. I have no idea why she wants me to have a physical therapy appointment. From what I understand she wants me to have them so they can teach me things for aftercare. I have tried asking the secretary (it wasnt Nancy, it was Takisha) but she didnt know either. I really want to see my surgeon again to ask more questions because my initial consultation only lasted like 15 minutes, but they keep telling me I have to have these appointments first (phys.therapy and psych). Thanks for your encouraging words, I appreciate it. Where is Dr. Appel? I live in Augusta and from what I understand the only doctor who accepts Tricare is the one I am seeing (for the LAP RNY). I guess today was just a over emotional day for me with this run around, but I appreciate knowing that other people out there will listen and offer advice. Thank You!
Kathy
Kathy Most Active
Recent Topics
