Anyone approved by Tricare who gained weight during 30 day nutrition period?

Susanb2117
on 9/8/14 10:05 am

I went to the surgeon's office today for my last appointment which was the 30 day check up with the nutritionist and exercise coach.  The exercise coach was excited because my log was just what she wanted and I was right on track where I should be.  The nutritionist weighed me and I am up 2 lb!  She never told me to measure or anything, just said cut back on carbs, not sweets, carbonated beverages, etc.  She said that Tricare does not like to see a weight gain before surgery and she believes I will be denied.  I am devastated.  The girl at the front desk said she doesn't think I will get denied for 2 lb.  Has anyone had this experience prior to surgery?  

Oxford Comma Hag
on 9/8/14 11:16 am

Since the nutritionist does not do insurance authorizations, she should probably keep her opinions to herself.

I doybt you will be denied for two pounds, especially if you have been compliant in every other aspect. Any chance of going back in a few days for a weigh in, and if it is down the two pounds using that?

I fight badgers with spoons.

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Susanb2117
on 9/9/14 11:29 am

Haha, good one.  I agree.  She was so negative and made me feel horrible. You are right, she is not the insurance specialist. I am just going to try to ignore her and keep my fingers crossed for an approval.  I did ask if I could come back and weight (because this weight in was also at 4pm, instead of morning.).  She said no.

jpm
on 9/9/14 2:52 am

My surgery was through Tricare, I had a 6 month requirement but I think now the requirement has changed.  I bounced around a bit in the 6 months up 2 down 3 or stayed the same.  From what the insurance person at the surgeons office told me was the main issue for insurance is to show them you will keep up with follow-up programs and follow doctors orders.  I did not have to see a nut. just my regular pcp each month for 6 months, he reported to my surgeons office my progress regarding exercise and weight loss.  He just told me to lower my carbs eat "Smart Ones" for lunch at work and up my protein.  My approval through Tricare was easy once they received the letter that my primary insurance did not cover wls at all.  I was notified in about 1 week after the resubmit with the primary insurance letter.  They have paid all my hospital bills except 25.00 which is our co-share.  Good luck. Don't stress and just work with the surgeons office.

Jaq

Susanb2117
on 9/9/14 11:30 am

I think the requirement changed.  The surgeon said I had to do 6 months but I go to the insurance specialist and she said no it was 30 days - 2 nutrition appointments.  I hope they don't kick it back.  Glad to hear you got yours.  I try not to stress :)

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