Question:
Please anyone who has dealt with Tricare and written authorizations HELP!!!!
A friend of mine and I have been waiting for Tricare to approve our surgery's. We are both on a time limit becuase of husband's work schedules and Tricare is telling us that it will take six weeks to get aproval if it indeed takes this long we both will not get surgery this year. Have any of you recently since Jan 03 submitted to Tricare and gotten approval faster than 6 weeks? And I was also told there was nothing I can do to speed things up is this also true? Thank you in advance for any responses. — S C. (posted on June 1, 2003)
June 1, 2003
i was approved very quick, it didnt take 6 weeks it was about 2 weeks. are
you goingto a sergeon tri-care sent you to. if not it may take longer.
— terri R.
June 1, 2003
The first thing that you must remember is that you are the customer.
Tricare is not doing you a favor by doing their jobs. Make sure you have
copies of everything that you have done and personally walk everything
through yourself. I received my approval within a week. My surgery date
is June 10, 2003. What I did was got the fax, contact number and name of a
person from my local Tricare office. I had my doctor's office fax the
request to that person. That person submitted the requests and tracked it
for me. She said that Tricare has a goal (requirement) of a 5 day turn
around. If they are telling you 6 weeks, someone is not doing their job.
You HAVE TO BE PROACTIVE! Never accept no from someone that does not have
the power to tell you yes and always Follow Up within days of speaking to
somebody. If you would like, send me an email we can speak in more detail
of my experience.
— Janella R.
June 1, 2003
it took me about 2 weeks and i am seeing a civilian doctor and my bmi was
42. i think i submitted mine january 15th. call and speak with a
supervisor. ask them why it is taking so long...is it under appeal or
something? but i really would speak to a supervisor.. good luck
— franbvan
June 1, 2003
hi there joe here 6 days post-op i have tricare prime and they only took a
little under two weeks for me.but i called them EVREYDAY so that could have
been why.any other quistions feel free to e-mail
— J. Ellis
June 1, 2003
Hi there! I just read your profile, and it sounds like the ball did get
dropped. The good news, is your paperwork is where it is supposed to be
and I bet you will have your approval by Friday this week. (think
positive) I am Tricare Prime, and had my surgery on Feb 26th this year. 6
weeks is an outrageous amount of time for surgery approval. Did Tricare
tell you this? Tricare has access standards which they must follow. They
have a time table in which to get auths done. (I believe it is 10 working
days) Go to the tricare website and check it out. On a positive note, it
only took me a week to get approval and from the sounds of other responses
a week to two weeks is the norm. You will have your surgery, and I can't
wait to read where it says you are approved!
— dimpkd
June 1, 2003
I just had surgery on May 19th and I have Tricare Prime. I had no problem
at all! Once they had the paperwork in their office, I was approved in
24hours! Good luck to you!
— Tami H.
June 1, 2003
I wish you all could come here and talk to the people I have been talking
to on the phone. To start off with I was told that it might take 4 weeks to
get authorization from Tricare then 4 weeks turned into 6 weeks and now 6
weeks has turned into 8 weeks. This was all told to me by the people I call
at the Tricare number this one 1-800-931-9501 I know that number by heart
since I call it every day. Some of the people have been sympothetic to my
plight and really try to get me information while others like the last one
I talked to who said she had been doing this for two years has NEVER seen
anyone get approved in less than 2 weeks and that they are told to tell
everyone who calls that it will be between 6-8 weeks. I was never told this
before Friday. I have been to the office here and the woman there tried to
help by calling WPA in FL didn't help all that did was mess up my dates so
I don't know where I stand for the 6-8 week wait now. It could either be
the 13th, 21st, 29th of May depending on who I talk to at what time of day.
I have had my papers in for 14 working days tomorrow and that is almost
three whole working weeks for them. They should have this done by now. I
think the reason I am sweating this approval so much is becuase I expect to
be denied, I want time to appeal or gain weight to qualify by there
standards which are vague. High cholesterol is not a co mobidity but
gallstones is can gallstones kill you? Anyway thank you all for your help,
well wishes and encouragement. I hope that all of you know how truely
appreciative I am for the responses.
— S C.
June 3, 2003
Well I now know that I have been lied to not happy about it at all but that
is the past and I am moving on. I talked to Tricare and kept insisting that
it should not take this long I was right and so were you all. 5-7 days for
authorization. So now you ask why did it take so long? My Tricare office
sent my paperwork and didn't really check to make sure it had reached it's
final destination even after frequent requests to do so. They finally got
it there so they say last week on the 29th of May so by the 5-7 day rule I
should know on Monday at the latest. Thank you all for your answers to my
question and your encouraging words.
— S C.
June 4, 2003
Hi~ my name is Jackie~ I have Tricare also and have some VERY HELPFUL
information to give you. I have tried to Email you but for some reason its
not going thru. Email me and I will give you numbers to PWA in Orlando the
name of the administrative assistant that you need to talk to and the
number to the office where it goes for the docs to approve it. I would not
go any further with the locals. You never get anywhere with them!!
OBVIOUSLY!! Email me at [email protected] Talk to you soon : )
— Jackie T.
June 5, 2003
My surgeon submitted for approval on Jan 30, 2003 and had approval on Jan
31,2003. Yes that is correct 24 hours. So it doesnt always take the 6 weeks
quoted by Tricare. I don't know why it was so quick, because I too had
heard that Tricare could take a long time. I was actually quite surprised
with a 24 hour turn around. Good
luck.************************************************************ lap rny
03/03/03 253/188/125
— kaysjourney
June 6, 2003
Original poster again, I have been round and round with Tricare, just to
update the reason supposedly now for my authorization being held up is
because I don't really qualify for the surgery by Tricare standards and it
is I LOVE THESE WORDS "STILL IN REVIEW". I have also gotten the
ball rolling to start a formal complaint to the hospital here where the
Tricare service center that has barely been any help. I have a 7 page
history of everything I have gone through to get this surgery with names of
the people who I had contact with for the last month of trying to get
approval. I will update this so all the people who come to the library can
see for themselves that it isn't always as easy as you hear and even when
you are the squeeky wheel sometimes you don't get the grease.
— S C.
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