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luvbug02468 06-05-2010 05:51 PM

Intro
 
My Journey 6/5/2010

Hi Im Nicole and Ive begun my journey-
My doctor and I talked about the bypass in the fall of last year (2009) . We are currently at Ft Riley Kansas and my referral went to Dr Hachem and the Innovative Weight Loss Gals - huge thanks goes to them! My approval wasn’t easy although I had other problems and was 100 lbs overweight tricare didn’t recognize my other problems ..gallstones being one of the ones they denied. Tricare denied me twice then my doctor diagnosed me with high blood pressure and they finally approved but I had to call everyday or they keep returning it to my doctor saying it was a duplicate of the denied one or that I had to appeal. Finally they pushed through the new diagnosis it was just a matter of getting the right person at tricare and being very persistent. If you are 100 lbs over and been denied, three high BP readings qualify you for a diagnosis of high pressure and low dose meds which tricare accepts as a qualifier . Also the readings can be done by you at Wal-Mart’s machine I was told! I had a friend who was a nurse do mine but I’m sure the pharmacy gals could record it to make it more legit. This was a very emotional process from I’m going to get approved to denied to mustering the energy to try again. All I can say is IM APPROVED took three tries and me being a pain in the arse but I’m the one who cares about my future so I felt it was my responsibility to stay on top of the faxes and paperwork being sent and the progress of them through the tricare system. In the end it paid of and Ill be having surgery soon, I find out my date next week! Good Luck on your journey!


P.s.
My friend had no trouble and was approved with no problems!
I’m tricare west prime
Both of us received a phone call from a tricare RN telling us we were approved

*I’m not saying this is how Tricare always works just how it worked for me!*

PCM Referral: 11/09
Sleep Study: 12/10/09
*the months in between sleep study and next step is because I got denied and had to build up the courage to fight it( gallstone diagnosis pushed me to do it)
WLS Seminar: 5/11/10
Nutritionist Appt: 6/10/10
Psych Eval: 5/20/10 delayed to
Pre-op Appointment: 6/10/10
Surgery date:

jiffypop 06-05-2010 07:22 PM

WHEW!!!! reading your post, lovebug, made me BREATHLESS! you've sure had a time of it.

sooo, what's the next step for you? do you have more hoops to go through or do you have a date? how are you and your family handling this???

welcome to our corner of the world!

luvbug02468 06-06-2010 01:51 PM

My next step is my pre op labs and tests which is next Thursday! I set my date which I believe I am going to go for the first week in August , it seems to be best for my family and the Dr isnt booked out that far yet.

Coffee Luver 06-08-2010 08:29 AM

I am with Tricare North. I have my insurance appointment with the clinic at the end of the month for LB surgery. They didn't make it sound like it would be such an ordeal, but with Tricare you never know what you are going to get.

I was stationed at Ft. Riley! I loved it there, but I am more of a "country girl". Actually, Ft. Riley was the last place I was fit... the last place I saw 140 pounds. :?: I used to run up and down that hill across from the main gait on the other side of the freeway. It was a great workout. I would actually love to go back there. How do you like it?

missangelaks 06-08-2010 11:20 AM

my daughter's husband is a Marine stationed at 29 palms and has to deal a lot with Tricare because of the baby...what a pain! We are very grateful that they have insurance but still...All the paperwork! Glad you made it through the first real hurlte!

Angela

luvbug02468 06-08-2010 09:34 PM

Im getting used to Kansas- Im from Ny and will be going there during mu hubby's deployment to go to nursing school!

missangelaks 06-09-2010 10:57 AM

Woohoo! Ny helping you with that? I think that some of the military programs rock...Thank you for your husband's service and thank YOU, believe me I know what kind of sacrific you're giving too...

Angela

luvbug02468 06-16-2010 04:25 PM

Change in plans - Hubby's deployment got cancelled!!!! So I will be staying in Ks which is good because of all the support groups and the city has more to offer in gyms and such!


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