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

It looks to me like you have authorization to see the doctor for a new patient evaluation and then have 5 authorized visits to his office for something other than seeing the doctor, like maybe seeing the nurse practioner or PA or possibly labs.

Thanks, that's what someone on another board was saying as well.

Does your surgeon or insurance want you to do a medically supervised diet?  That is what I thought of when I saw the five visits.

 

Red

Nope, but they do require a nutrition education class and the surgeon did say I would have a couple of appt's to go over test results (psych eval, bone density exam, etc.) so that does make sense that it's for follow up's :0)

Good luck to you. Red