how long did it take
jennadweeb
on 8/17/07 4:22 pm
on 8/17/07 4:22 pm
ok so i know that it can vary how long for the approval for tricare, but what i want to know is how long the process took from the day you went into your pcm and put the request in until the day you were scheduled for the surgery. i just put my stuff in today, the dr said she thinks i will be approved but to make sure she had me give some history, and a letter to give to tricare with the request. so i am just wondering is this a lengthy process..like several months or several weeks. thanks in advanced
jennifer
Jennifer it all depends where you are and how they do the surgery. Like for me I went in in January and was referred to our military hospital because they have a program you go through to get the surgery, I was accepted into the program and then found out the wait list was 18 months to 3 years, needless to say I did not want to wait so I found a civilian clinic that specialises in WLS and asked them if they except tricare, they did so my PCM referred me to them in Feb, I had my 1st appointment April 9th did all they required submitted my final approval request July 9th and had surgery July 23rd. So it was pretty quick Overall it just depends how your area works
I agree with Rebecca. I am not sure what area you are in ; but go to that states message board and post that you are looking for a good surgeon in your (area) of coarse list it on your post. Also, that you have Tricare Prime and ask if anybody has any suggestions. If you find someone in your area with your insurance that has already had the surgery you can find out things from their profile and ask for their help and suggestions. Even though I have had to start over twice, and I am just beginning my appointments I would really have to say that Tricare has never given me a problem. It does depend on your Dr. and how they do things there; but most people seem to get their surgery around fourto five months after their first appointment with the WLS Dr. I hope this helps!!
It really depends on a lot of things, but I started trying to have the surgery in February. I started seeing a doctor, got everything underway, then Tricare said I couldn't see him becasue he wasn't a "Center's of Excellence" (even though they referred me to him). Then I had to find another doctor and start the process over. This was in June I believe. Then I had problems with the paperwork, got denied, and appealed it, and finally had my surgery on the 6th of August. So once I finally got the right doctor it only took about 2 months.
It went to my PCM on base June 6th. I told them I was interested in WLS. His Nurse wrote up the refferal that day and a week later I had a refferal to a WLS Dr. I had a consultant with him July 3rd, His office submitted my packet to Tricare on July 12th, I was approved on July 17th and got my suegery date of August 13th. So my entire process took 9 weeks. I was right at 100 lbs overweight and I have Diabetes and PCOS along with High Cholesterol. My BMI was 39.7
Good Luck!
Short version: PCM March 29th, Surgery July 6th. So 3 months and a week.
Longer version: I went to my PCM, like I said, on March 29th. My surgeon's program requires you go to 2 information seminars before they'll submit to insurance. I did these on April 20something (just missed the March one) and May 20something. My surgeon's program is small but an excellent one. He only does surgeries 1 week out of the month, because he is also the trauma medical director for the regional medical center, and the vice chair for the trauma advisory board for the whole state of Oregon. I missed June's (first week in June) because of my psych doc taking so long to get in the eval. So I got a July surgery date.
If I had a surgeon that did baratric surgeries all month, only had one info seminar required, a psych doc that had her stuff together, then it could have happened within 1-2 months. Like the others have said, it just really depends on your surgeon's program/requirements.
Good luck on your journey!!
Andi
I got my referral in July, and it looks like i might be having surgery in April or May....assuming that all goes well.
My WLSurgeons have about a 6-8 month wait list just for the consultation, then I have to go to see a NUT and a psychologist, then the surgeon again and if I do all that and pass all that, I can schedule an appointment at that point!
It took me about 6 weeks from PCM to surgery. It was really fast. I am grateful. My surgeon didn't require a liquid diet for me or much of anything, except the psych eval and all my testing. Mostly blood and my results on my heart and lungs from my PCP. So, that helped it go fast and it isn't hard to get a date for surgery around here. Diana