So Frustrated with Tricare Prime

So on my blog I posted how I started the process here in Hampton Roads on Dec 3. My PCP submitted a referral to the Tidewater Surgical Specialists Group for an evaluation. I attended the seminar and then saw Dr. Gregory Adams who indicated I was a good candidate for Gastric Bypass surgery. I did the all the pre-reqs in late December (Psych, labs), and attended a support group meeting in early Jan. His surgery scheduler gave me tentative date of 21 Feb, and on the 24th she submitted my paperwork to Tricare Prime (North) for the approval for surgery. Today she contacts me and tells me that I was denied. The reason---------- My PCP put the wrong diagnostic code on the original referral. They put an upper respiratory problem instead of morbid obesity. So now I had to contact my PCP and have them resubmit for a new referral with the correct code and hope that it gets approved so that the surgery scheduler can resubmit the surgery paperwork before my tentative date, else I will have to wait until march or april. The kicker, is that Tricare said that there is a good chance that Portsmouth Naval will override the referral and assign me to the Naval hospital for it. And they have a 3 year wait for the surgery. And to make matters worse, all the stuff tricare paid for under the old wrong referral may be taken back, and I would be responsible for everything so far.  So to say the least I am is peaved big time.

Have you been to Portsmouth yet?  Because they told me it was a 4-8 month process.  also, another poster had her hers done in a 2 month time window after her initial orientation.

Tricare Prime sucks!  I have a BMI of 42.6, I weigh 212 but because tricare uses the metropolitan life weight chart (to determine if you are over 100 lbs overweight) I fall short of that requirment - thus denied!  I have to now figure out how to get them to understand that I'm 4'11" and that I'm not a medium frame........argh!