Revision denied by Tricare
I was hoping to have revision surgery from my gastic by-pass Rou-Y. I had my first surgery done in Portsmouth 10 1/2 years ago and it seems with the numerous problems I had my pouch and it's opening grew in size. My new doctor at ECU Dr. Chatman told me this was due to no fault of my own but I still feel so guilty. It also seems my connecting piece grew back to the original source or something like that????
Anyway I have followed all the requested procedures that Tricare requires but learned Tuesday I had been denied. When I called they stated it was a coding error but after talking with the nurse at the doctors office the code they used was the same one they always have used. Now I am worried that I paid $150 for opti fast (to use two weeks prior to surgery) and no matter what I won't be approved.
Has anyone else run into this problem with Tricare and/or with Dr. Chatman's office and if so what can I do to help things along???? Prior to my first surgery I was no diabetic, had high BP, etc. now I have all those risk factors and more.
I feel like giving up but don't want to do that, I want to dig my heels in and fight for my health. Also do you think it would be okay to slowly start to introduce exericese (say walking) into my routine so that if and when I am approved I have the exercise part down? Any help you can provide would be greatly appreciated. You can email me at [email protected].
Thanks for allowing me to vent and ask so many questions.
Dot
Anyway I have followed all the requested procedures that Tricare requires but learned Tuesday I had been denied. When I called they stated it was a coding error but after talking with the nurse at the doctors office the code they used was the same one they always have used. Now I am worried that I paid $150 for opti fast (to use two weeks prior to surgery) and no matter what I won't be approved.
Has anyone else run into this problem with Tricare and/or with Dr. Chatman's office and if so what can I do to help things along???? Prior to my first surgery I was no diabetic, had high BP, etc. now I have all those risk factors and more.
I feel like giving up but don't want to do that, I want to dig my heels in and fight for my health. Also do you think it would be okay to slowly start to introduce exericese (say walking) into my routine so that if and when I am approved I have the exercise part down? Any help you can provide would be greatly appreciated. You can email me at [email protected].
Thanks for allowing me to vent and ask so many questions.
Dot
I think you should appeal this decision as I have Tricare and they approved my intestines to be re sectioned as I started to gain weight back. I also had my gall bladder, appendix and had a hernia done at the same time.
Honestly I think the problem is improper coding or some sort of error at Drs office or with
Tricare.
I hope your surgeon is willing to go the extra mile for you. I think we might have even had the same RNY surgeon?? Dr Jefferey Lord ?? He used to be navy now is in Pensacola.
Honestly I think the problem is improper coding or some sort of error at Drs office or with
Tricare.
I hope your surgeon is willing to go the extra mile for you. I think we might have even had the same RNY surgeon?? Dr Jefferey Lord ?? He used to be navy now is in Pensacola.
Most Active
Recent Topics
