Tricare Prime and Dallas/Fort Worth Texas

Mommie_of_4 · 06-10-2008, 05:37 PM

Has anyone had Lap Band in the Dallas/Fort Worth area and Tricare Prime paid for it? I spoke with my PCM and he said I needed to find a surgeon. But tricare doesn't have bariatric surgeons listed on their site to find a specific doctor. How do you go about finding a surgeon that take tricare prime?

IntoLess · 06-10-2008, 06:19 PM

The best advice I can give you is to call Tricare directly. Anytime I have had to change a specialist for one reason or another, they have always been helpful. Just ask for a list of bariatric surgeons in the area, research them, decide who you want for your surgeon, call and ask if they are accepting new patients, and then tell your PCM to give you a referral to that doctor.

HF2008 · 06-10-2008, 06:45 PM

Here's a link to the Humana page that lists all the approved surgeons...
You have to go through the list and it will show some bariatric surgeons....I didn't find one until #64

But I don't know your specific zipcode....so try your zipcode and see what you find. Let me know if you need help!

http://hmd.humana-military.com/ProviderListDistance.asp?SelZipCode=75205&SelSite=BR&Select=&ProvNbr=& SelDistance=100&SelProviderName=&SelSpecialtyCode=02&SelSortField1=Pro viderName&SelSortField2=&SelSortField3=&SelSortField4=&NotFirstTime=Ye s

64 Ferrara, Craig A DO
Laparoscopy Bariatrics and Surgery PA 2501 Parkview Dr
Ste 560
Fort Worth, TX 76102
(817) 850-1100

Since there is not a filter for bariatric surgery, I would suggest searching the bariatric surgeons in your area and then go to the humana military web site and seach by the surgeons name and you can find one that way. Good luck with that!!!!

Peanutngp · 06-10-2008, 06:59 PM

My Doctor is Richard Carter in Arlington. He is with the Arlington Bartaics Group. He has a website Carter Lapband. he is great

RhondaD · 06-10-2008, 08:15 PM

I have Tricare and my surgeon is Dr. Joseph Cribbins with Presby Plano. They have a great program and I really like Dr. Cribbins. I am scheduled for the procedure on the 24th. Tricare has approved everything except for the Nutrition appt. that is required, but I was willing to pay that out of pocket.

Email me if you would like more information.

Mommie_of_4 · 06-11-2008, 10:05 AM

Thanks for such a great response...

RhondaD and Peanutngp ~~~~ can you tell me a little something about how your referral process worked and tricare approval went. Who are your PCMs. I live in grand prairie (75052). So I'm willing to drive to Fort Worth or Dallas for the surgery. Do you have Tricare Prime? Any insight into getting tricare approval would be great!

Thanks

Mommie_of_4 · 06-11-2008, 10:53 AM

Has anyone been told that Tricare prime insurance requires you to stay overnight? I just called TrueResults.com for a free consultation and they stated that Tricare requires you to stay overnight and since they are on an outpatient service...the referred me to Centers of Excellence facilities.

Anyone told this?

minpinmom · 06-11-2008, 11:56 AM

Yeah, they made me stay overnight - it wasn't too bad.

RhondaD · 06-11-2008, 06:25 PM

My PCM is Dr. Mike Lee in Frisco. He was great. I went to see him, and he put my referral in the same day and it was approved before I left his office. For the surgeon I am using Dr. Joseph Cribbin with Presby Plano and they put in for the authorization on the same day as my consultation and it was approved by the time I got home that day. I understand that some people are not that lucky but I don't think it takes more than a few days. Dr. Cribbins is requiring me to stay overnight. I'm not sure if it's a Tricare requirement or not.

Hope that helped.

irideaqh · 06-17-2008, 08:53 AM

I think it is up to the surgeon whether or not you stay overnight. I have Tricare Prime and did not stay overnight. Tricare did call me before they approved me to request that I have my surgery w/ a Center of Excellence facility, which I did.

minpinmom · 06-17-2008, 09:05 AM

My surgeon told me it was going to be outpatient, then his office called and said they require an overnight stay. HOWEVER, I was one of the first to go through the new system, so things may have changed since then.

NavywifeJenn · 06-17-2008, 08:02 PM

I had to stay overnight too. My surgeon said he would have let me leave yesterday because I was doing so well, but that Tricare required that I stay overnight? I dunno maybe it's different in each state

IntoLess · 06-17-2008, 08:20 PM

I think maybe it has to do with the hospital, it seems that everyone who has had their surgery at a Center of Excellence has gotten to go home, those who haven't have been required to stay overnight.

minpinmom · 06-17-2008, 09:46 PM

Mine was at a Center of Excellence and Tricare, not my Dr., required me to stay. It was nice thought - cushy hospital.

zeama · 06-18-2008, 09:34 AM

As far as getting started, when I found out that Tricare was going to approve the Lap Band, I made an appointment with my PCM in the white clinic and that was where I got the referral to have the Lap Band done. I found that contacting Tricare directly is the best way to go. They had me approved, but it ended up being approved for the wrong Dr (he on did gastric bypass) and I was able to get it switched by just talking to someone at Tricare.

As soon as you get approval to see the surgeon, I would try to go ahead and schedule all of the pre-op tests that you need. I was able to get an EKG done by just walking into the white clinic without an appt. The only thing I have done that was not covered by Tricare was the diet and nutrition class which was $60.

I started on this journey in Feb and my surgery date is July 8. I'm having it done at Gateway Hospital in Clarksville, TN and it also requires an overnight stay.