Tricare/TriWest stuff

First, for those of you that have tried to get out of Madigan to a civilian doc in the last month, how has it gone? I would hate pass on bad advice. As for my bills, Tricare has agreed to pay for my civilian care over this last weekend and next Monday. They had to pay for my civilian ER visit because it was an emergency. But, the stretching a few hours later might not have been concidered emergency care. And, without pre-approval, I was worried I would get stuck with the bill. I can't even imagine how much it will be. I went to talk to a TriWest rep today. My PCP's nurse gave her the wrong phone number, so she was happy to see me since she needed some more info. They couldn't figure out how I ended up north of Seattle for care. But, after I explained, they said the completely understood. I put her in touch with the billing woman from Dr. Dines office and everyone was happy. TriWest put a rush on my approval for care on Monday. In fact, I already have approval. She said that Dines isn't a network doc. She didn't say, but I assume I might have a co-payment. She said that my PCP also put in a referral for continuation of care for Dr. Weber. But, Madigan hasn't released me yet. They haven't released me yet. But, that shouldn't be a problem. Surgeons don't like to touch each other patients especially when there has been a complication. Something else that she told me was new. She said that TriWest is requiring Madigan to cost share when they send someone out. So, sending us out is going to hit Madigan where it hurts...the budget. I had also heard that if you can't be seen in a reasonable amount of time (30 days), Madigan had to send you out. This is only partially true. Since having WLS isn't all that improtant (to them I guess), a 2 year wait isn't unreasonable. That sucks. I still think it is worth trying. For those of you that don't have TriWest, I am sorry that I can't be of more help to you. Every time I read someone is having trouble with their insurance company, it drives me nuts.

Hi Hat, You must be feeling much better. I called on Monday to get a referral from Dr. Egge at general surgery. I didn't hear anything back so on Thursday I called again and spoke to Mary. She said she would pass the word onto Dr. Egge but I still haven't heard anything. Don't really know what that all means. But someone else also said they might be dropping all those people off the list that aren't really physically here anymore. I think there are a few changes going on out there. Arlene

My heart is breaking.... I knew what Dr Egg. said sound too easy....I should have known after all these years dealing with the millitary.....it just sound too easy... I am going to call Tri west next week and feel out the process....I am praying that if a change is in the work, I am blessed to get in umder the wire... If you have a number please help me out...Thanks... BTW...How are you feeling...did the stretch help...how about the dehydraytion?????

I am feeling tones better. But, I am still tired. I have thrown up once but that was my own fault for eating a bite to many. I am kind of surprised that it is still too small because everything seems to go down fine. But, it would be nice to have the comfort of a little more room so that maybe I can take my pills. Dehydration isn't any more of an issue for me now that any other post op that is 3 weeks out. I am drinking tons of water. I was slow to start on any type of food because I was worried about getting sick. I have been not going to my son's football practices because of the heat. I went to one and it really kicked my butt. The down side of being to tired is that I am not back to exercising yet. I promised my sons that we would start up again tomorrow. We did go swimming yesterday. But, that doesn't seem like exercise. At least it is movement. Thanks for asking.

Hi Hat, I just got back from Madigan. I guess I'm just a little impatient. I kept calling Mary at General Surgery trying to get my referral. They started something new. Now we have to make an appointment with the surgeon at Madigan (see them one on one) and then they may refer you out. I made my appointment for Sept 1st. I guess then I will see how it goes from there. Arlene