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

Hi Crissy, Welcome to the board!! I am sorry, I can't tell what the second one is for. It may be for the testing you will have to have done. Let me know. Talk to ya soon. ~~Mindy~~

I have some that look like that. One they have 2 different dates. So you will be able to get all your appointments. Some places may not be able to see you right away. They did not submit for your surgery yet. They submitted these so that you can see the other doctors that you need to see before they submit for the WLS surgery. They did this to me. The nurse at the surgeons office put in all the referrals for me. They were for me to see the psychatrist, for my endoscopy, the nutr. consult (even though it was denied), and my ultrasound. If you don't have a referral, then you will have to pay out of pocket. Where it says not requiring a physician present, that means you will be seeing a nurse or lab tech. You can also call tricare(1-877-TRICARE) or go to www.mytricare.com and register. It is a great website to check on claims and referrals and authorizations too. Good luck. I am in the same boat as you. I have my ultrasound tomorrow and my endoscopy Wednesday. Then all I have left is my pscyh. evalu before I submit for WLS. I am so ready.

Hi Crissy, When I got the referal to see my surgeon I got two different ones, too. Not the same lingo (I'm in the TriWest region) as yours but for the same visit reasons. The first was for the consultation visit and then the second was for additional office visits. (the consultation and office visits have different billing codes, so they refer them seperately.) I know you are so excited, cause I know how excited I was to finally get this ball rolling!! HTH! Andi