Question::::Okay I'm almost ready to submit for approval from Tricare BUT

Tamara D.
on 6/20/07 10:46 am - Jacksonville, FL

I am still waiting for my primary care doctor  to fax my thyroid profile to my surgeon's office. I have been asking for this for the past two weeks. What sucks even worse is that there is no way I can contact him directly. I have to leave a message through Central Appointments and he still has up to 72 hours to call me and if I miss the call, he just leaves a message to call C.A. and leave him another message. Its so annoying. I cannot depend on him for anything. It took me three weeks to get a letter from him, but how hard is it to fax something? Over the phone, he will verify the fax number and everything to make it seem like he's going to hang up and fax my profile, but he still hasn't.  Question: Could I get my thyroid profile results myself and fax them from my house?  This is the only thing we are waiting on before we submit my stuff for approval from Tricare. One other question.........and I'm only asking because I'm really bad at second guessing certain people as well as myself.  I have: * letter from my husband and i stating that we understand the risks of this surgery and that we both feel it would benefit me, etc. * letter of medical necessasity from my primary doctor stating my bmi of over 42 and my co-morb's * 5 year diet history chart * psych eval * i will have my thyroid profile showing theres nothing wrong with my thyroid * letter of medical necessasity from my surgeon Will this be enough to get approved through Tricare Prime? My husband is active duty. Do you have any other suggestions as far as extra things to include to help get approved????  Any suggestions would be greatly appreciated!  Thank you!!!!!!!!!!!!

Tamara

    
Andi190827
on 6/20/07 6:28 pm - Fort Leavenworth, KS
B Girl
on 6/21/07 11:29 pm
Hey Tamara!!! I'm in J-ville, too.  Everything I've ever heard about TriCare is they just need to see a certain BMI.  No hoops, no loops.  Don't know if that will be true for your particular plan.  My sister and brother in law both had RNY using TriCare.  They didn't do anything but show up for the appt.   Good luck to you!
Tamara D.
on 6/22/07 9:20 am - Jacksonville, FL
Thank you for your input!

Tamara

    
deniseg
on 6/22/07 1:36 am - Monticello, AR
Hi Tamara!  Sounds like you've all your ducks in a row.  As for the tyroid report, I say go up there and tell them you want the results and you'll fax them yourself OR tell them you want them faxed RIGHT NOW and your not leaving until its done and you've seen proof that it has been faxed.  Don't worry about ticking anybody off, they're supposed to be there to help you.  I had to do that with Tripler in Hawaii when I wanted my surgical report on my c-section...I told them I wasn't leaving until I got it and they could just sit and listen to my newborn scream...30 minutes later I had it in hand  Its your report and its your LIFE they're putting on hold, you have the right to demand it.  You have more than enough info to get you approved. Good luck and let me know how things turn out!

    DENISE          
Day of surgery weight/BMI:  246/44.9
Goal weight:  135
Current weight/BMI135/24.6---GOAL!!!!!!!!!
Total pounds lost:  111
    
      

                                                            

Tamara D.
on 6/22/07 9:24 am - Jacksonville, FL
Denise -

Your idea worked girl! Thank you so much! I ended up going to see my PCP and he looked wide eyed, but I politely asked him for a copy of my profile and faxed a copy to my surgeon's office myself this afternoon. They recieved it without any problems! Now I'm just waiting for them to recieve my psych eval and we can submit to Tricare. I'm a little worried though because when I called my psych office, they said someone had intialed that it was already faxed but surgeon's office said they never recieved it. I'm just gonna call and have them re-fax it on Monday. Hopefully it goes smoothly.

Thanks again Denise!!!!!!!!!!!!!!!!!!

Tamara

    
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