Question:
Tri-Care Prime Remote ???'s

I was just wondering.. I am not on a base and not within an hour of one so therefore we see cilivian drs that is in our network, so when my dr's office called to set up my referal the insurance co said that they would only approve one appointment,, what exactly does this mean, does it mean one at time then they keep getting just one? or are they saying ONE?? I did not get a chance to call the insurance co back and ask and now it's driving me crazy wondering, and of course i can't call them til monday. thank Kelly    — kelkel319 (posted on June 21, 2003)

June 21, 2003
More than likely, the referral is for only ONE appointment- a consult. The doctor you see will submit the work needed for further follow up or surgery. If he recommends that you come back, then, I would again have your civilian doctor put in for another referral, if the surgeon does not do that. I do not have Tricar Remote- but with my Tricare referrral it was for one initial consult and then all was submitted for surgery. I then automatically had authorization for the pre-op appt. and all follow-up appointments for 3 month post-op. Better check though with your insurance- it could be mighty expensive( out of pocket costs to you) if it is not done right. Good luck.
   — Jan S.

June 21, 2003
Tricare approves the 1 consult visit. Then the surgeon takes over for surgery approval. Don't sweat it, once you get your consult approved, (which you did) you are on your way!
   — dimpkd

June 21, 2003
Start documenting everytime you call the Tricare number, time day and who you spoke with. From my experiance you will get a differant answer from everyone you talk to and it is pretty hard to get the same person on the phone for every conversation. Do a search on the web through a search engine with wording about Tricare PRime Remote and Gastric Bypass surgery. You will get lots of webs pages mainly from the Tricare handbook which can be like reading stereo instructions. Everything can be hooked up a different way depending on who is interpreting it. At the first sign of confusion get a supervisor on the phone since you are not near a base you are at a disadvantage. Not sure why you were only approved for one visit I was approved for 60 visits with the surgeon but then denied the surgery, doesn't make sense does it. If you check my profile you will see why I am adament about keeping up on things. Good luck to you and arm yourself with information.
   — S C.

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