Question:
Anyone have tricare prime and win on the appeal?

I was denied by tricare prime and I am waiting on the denial letter to submit my appeal - any helpful suggestions to win this battle would be greatly appreciated.    — Laurie G. (posted on October 2, 2002)


October 2, 2002
I am surprised that you are having difficulty with Tricare Prime. I am assuming that you meet the eligibility requirements of at least 100# over max and/or have obesity related health problems. I was just over the 100# with no obesity related health problems and was approved in 3 days! Keep trying and don't give up!
   — Lynn H.

October 3, 2002
I was approved immediately by Tricare Prime. I'm not sure what your situation is, but I am a retiree with a history of futile documented attempts at weight loss. Make sure you have your PCP file the pre-authorization - not your surgeon. And, it would help if the doctor included a letter stating your co-morbidites and diet history. My doctor faxed it over one day and I was approved the next. My prayers are with you.
   — Janelle G.

October 3, 2002
I also had no problems with Tricare. I found out your biggest hurdle is making sure that your PCM refers you to every appt. you make. Other than that I was approved within a week. If you don't mind, email me with some specifics and maybe I can help you with some of the leg work. Stephanie Teal @ [email protected]
   — Stephanie T.




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