Tricare Help

Fdiljn · 05-13-2008, 07:01 PM

I have a referra lfor Dr Reddman in Covington LA but I do not find that the Surgical Center in Slidell onTRICARE list. Has anyone using Tricare used that center? I am so confused. It seems the more I learn the more quetions I have.

Long2BFree · 05-13-2008, 07:43 PM

From what I've been told, Tricare will not cover a surgical center but most hospitals. They need to meet certain guidelines.

Fdiljn · 05-13-2008, 07:47 PM

Thanks The doctors office has told me twice that Tricare is ok at the Surgical center but it is not on the list. Guess I will have to keep trying to find out.

trell · 05-13-2008, 10:51 PM

Hi, my hospital was not on the list, but they added it after it was approved. They will approved non listed facilities.

Cadets71 · 05-14-2008, 02:07 PM

The very best thing to do is to call Tricare directly. Go to www.tricare.com and you will find the numbers for your regional contractor. Ask to speak with the authorization and referral staff. That is the only way to get accurate information.

Good luck,

IntoLess · 05-14-2008, 02:53 PM

If you are tricare prime, it will be covered 100%, tricare standard requires the deductible be met.

Fdiljn · 05-14-2008, 03:41 PM

Thanks so much for the info you all are providing

Keleka · 05-14-2008, 06:42 PM

Hi! I really understand your confusion! I also am Tricare Prime Remote. I was told by Healthnet to look on their site under "find a provider" to find a surgeon to do the Lap Banding. I looked under Gastro ad General Surgeon and none of them offered Lap-Banding let alone Bariatric Surgeries of any type. So that was a bust. I did call authorizations and referrals and they told me to have my PCP send in a referral (which they did) and they would find me a provider. That was just a couple of days ago and nothing yet. But I figure this could take a while! Good luck with everything~ Will keep checking to see how you are doing!

Fdiljn · 05-15-2008, 10:30 AM

I again spoke with the Tricare referral section and am finally a little comfortable with the way things are going. I went ahead and changed my referral to Dr Reddman even tho I cannot find the Surgical Center on the authorized provider list. Referrals told me that if that is the only place the "Authorized Surgeon" provides the service they will pay and that decision will be made when the surgeon requests authorization for the surgery. BTW it took 3 days from the time I say my PCM for my authorization to show on the website.

IntoLess · 05-15-2008, 12:12 PM

All of their approvals come fairly quick. The longest part for me is waiting for the girl in my doctor's office to put the referral in. It takes her almost a week to put in the referral, then within 48 hours I have my answer. I have my appointment Monday afternoon, hopefully the insurance girl at the surgeon's office is quite a bit faster at putting in requests than the one at my PCM's office.