process?

I had an appointment with my PCP today to get a referral to be banded. My Dr. said he would write one, but I am confused on what happens from here. I know I have to call in 2 days to activate my referral, but what happens after that?? Does anyone have tricare prime that knows what's up? I'm so anxious and can't wait to find out if I will be able to have the surgery

You might want to call your insurance yourself. Even if someone else has tricare, their plan could be totally different from yours. I called my insurance and asked exactly what they covered including all the things they required for approval. This is your journey and your body, so learn as much as you can!

I agree. Call your insurance carrier and request in writing their requirements for weight loss surgery approval. Congratulations on taking the 1st step and welcome.

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Elisabeth :)

Highest Wt 440 lbs
Banded on 3/30/06 (351 lbs) in U.S. (11 cm VG Inamed Band, 11 fills in 2.5 yrs)
Never felt restriction and developed SEVERE ACID REFLUX

4/1/09 Revision from Band to VSG in Mexico
4/2/09 Acid Reflux Gone!
VSG Starting weight 285/Goal 130

Thread Starter

will do! thanks to you both

I have tricare prime and the policy regarding Lap-band® is standard across the Tricare Prime system.

Once your PCM submits the referral, tricare will then evaluate it to make sure you meet their criteria. Your PCM should already know what the criteria is and will make sure you meet it. A couple of days after the referral is submitted Tricare will fax your referral to the approprite surgeon and most likely the surgeons office will call you to make an appointment. I was a little inpatient and called tricare to check the status to find out if i was approved, and I was. In my case both Tricare and the surgeons office called.

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Do or do not, there is no try!

Thread Starter

thanks! ... How long was it from the time you had your seminar until the date of your surgery??

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Angie<3
NOT YET BANDED

i called tricare myself and got all of the info from them and they think it will take me around 7-14 days

Thread Starter

wow! that is quick and awesome! i'm hoping i will be approved and having the surgery ASAP!

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Angie<3
NOT YET BANDED

I actually didn't have a chance to attend a seminar. From the time I met with my PCM to the surgeon's office consult was about 7 days. As for the surgery I was told it would be about two weeks after I get the surgery approved. The approval "should" come in today or tomorrow.

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Do or do not, there is no try!

Thread Starter

I just got home from the seminar...and there is a 6month waiting list. I'm kind of upset. I think I am going to call tricare and see if there is anywhere else I can have the surgery

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Angie<3
NOT YET BANDED

that is really long. good luck finding an other surgeon!

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Do or do not, there is no try!