Re Tricare denied me!!!

[Guest guest]

,

Hang in there

I am one of nine co-workers with the same insurance that have had WLS. One,

who's BMI was 58 with many co-morbidities was denied. Seems they needed letter

of medical necessity from PCP. She obtained it, gave it to the surgeons office

to submit - bingo! She was approved.

I took a lesson from her and got letters of " Medical Necessity " from THREE of my

doctors. I was approved in 48 hours and my BMI was only 37, under the required

40. Everyone else that followed did the same and got approved. I also prepared

a list of previous diet attempts over the past 30 years.

Keep on submitting. And, dont let much time lapse between appeals. They will

see you wont go away.

Good Luck

~~Pat~~

Orlando, FL

252/203/160

BMI 37/

52 Years Young

LAP-RNY 12/10/03

Wayne English, MD

Ft Lauderdale, FL

Message: 3

Date: Sat, 20 Mar 2004 23:32:01 -0000

Subject: Tricare denied me!!!

I know no one really knows me. I pop on and off but I always read

what everyone has to say. My surgery date is for May

4th.....exciting right? NO! Well it was until today when I got

my 'DENIED' letter. I have never heard of my ins. denying anyone! I

know a lot of people are going through this same thing and I am no

different but I guess the blow doesn't come any easier to take.

Monday I will call everyone to see how fast we can get in an appeal.

As far as I know I have all of the necessary requirements met to get

approved I have to pray that maybe when they sent in the original

request maybe they left something out. Wish me luck and if anyone

has any experience w/denials from Tricare.....I would love to hear

them. Thanks for listening to me.

pre-op

268/268/130

May 04, 2004

[Guest guest]

Pat,

Thank you for the encouragement. I will be calling on Monday to get

an appointment with my primary care Dr. to see what she can do for

me .I am hoping to even talk to my ins. people at the clinic on base

to see what they say. I will have the appeal in as fast as humanly

possible.lol I am praying that it will be something simple. I will

keep everyone posted.

> ,

>

> Hang in there

>

> I am one of nine co-workers with the same insurance that have had

WLS. One, who's BMI was 58 with many co-morbidities was denied.

Seems they needed letter of medical necessity from PCP. She

obtained it, gave it to the surgeons office to submit - bingo! She

was approved.

>

> I took a lesson from her and got letters of " Medical Necessity "

from THREE of my doctors. I was approved in 48 hours and my BMI was

only 37, under the required 40. Everyone else that followed did the

same and got approved. I also prepared a list of previous diet

attempts over the past 30 years.

>

> Keep on submitting. And, dont let much time lapse between

appeals. They will see you wont go away.

>

> Good Luck

>

> ~~Pat~~

> Orlando, FL

> 252/203/160

> BMI 37/

> 52 Years Young

> LAP-RNY 12/10/03

> Wayne English, MD

> Ft Lauderdale, FL

>

>

>

> Message: 3

> Date: Sat, 20 Mar 2004 23:32:01 -0000

> From: " stinardclan5 " <stinardclan5@s...>

> Subject: Tricare denied me!!!

>

> I know no one really knows me. I pop on and off but I always read

> what everyone has to say. My surgery date is for May

> 4th.....exciting right? NO! Well it was until today when I got

> my 'DENIED' letter. I have never heard of my ins. denying anyone!

I

> know a lot of people are going through this same thing and I am no

> different but I guess the blow doesn't come any easier to take.

> Monday I will call everyone to see how fast we can get in an

appeal.

> As far as I know I have all of the necessary requirements met to

get

> approved I have to pray that maybe when they sent in the original

> request maybe they left something out. Wish me luck and if anyone

> has any experience w/denials from Tricare.....I would love to hear

> them. Thanks for listening to me.

>

>

> pre-op

> 268/268/130

> May 04, 2004

>

>

>

>

>