Yorkie_Luv
Phone call from Dr. Halmi's office......
Dec 06, 2007
Today the insurance lady from Dr. Halmi's office called. She said that Tricare is about to approve Lap-Band after the first of the year!
So, she told me what Tricare requires and to go ahead and work on those things and by the time they are done she should have an approval. So the fun begins! Tricare requires the following in case you wanna know; psychologist eval, nutritionist eval, letter from PCM saying that I am cleared cardio and pulmonary wise, lab results from a H-pylori test (peptic ulcers) and TCH levels (thyroid). That's it! Yippeeee! 
My consultation with Dr. Halmi......
Dec 06, 2007
Today I had my first visit with Dr. Halmi. He seems like a great surgeon. Most importantly...I qualify for surgery!
So I guess basically that means that I'm fat enough! He'll submit my request to Tricare along with the letter on my behalf and we'll see what happens. 
First appt......
Nov 29, 2007
My first appointment with Dr. Halmi is scheduled for next Tuesday, Dec. 4. I'm nervous, but excited. I'm sure he'll approve me....but Tricare, not so much! I have my letter ready to take that I wrote on my behalf and also I'm getting letters from my PCM, cardiologist and endocrinologist.
Cardiologist and Endocrinologist visits......
Nov 12, 2007
November 12, 2007
Today I had an appointment with the Endo. He okay'd the surgery, but wants me to wait 3-6 months so he can rule out Cushing's Syndrome. I also saw the Cardio today and he said he has no problem with me having LapBand done and he will give me a letter of approval for the surgeon and/or Tricare.
The letter......
Nov 11, 2007
Today I received a letter in the mail from Tricare with an APPROVED for my referral! I am approved for 6 office visits with Dr. Halmi, who is a civilian surgeon in Virginia. Office visits don't mean an approval for surgery, but it's a first step in the right direction!
The second call......
Nov 11, 2007
November 7, 2007
I called Tricare back today. My referral is still pending so I asked her to explain the process to me. She said that it pends in their system until an approval or denial. Since I have a civilian PCM but want to go to a MTF it takes until the MTF approves it. SO, I called Walter Reed and spoke to Gretchen Burns in General Surgery. She is the one that looks at the referrals. She hadn't come across mine yet and told me that they have one surgeon that does LapBand. They only do 2 surgeries per week and get 30-40 referrals a month...YIKES! So, it's not looking too good for me as far as getting it done there.
The first call.....
Nov 11, 2007
Today I called Tricare. The referral is still pending in their system.
Beginning the journey....
Nov 11, 2007
November 2, 2007
I called my civilian PCM today and she put a referral in the Tricare system for me to see a surgeon at Walter Reed. We'll see what happens with that! 
