Susan - Thanks for responding and I so desperately need your help.
I am working with a urologist in my area who is very experienced in the DaVinci method. I spoke with the doctor's nurse on Thursday who is setting up the surgury and submitted it to Tricare Prime. Today, I checked my Tricare account on line and found that the "robotic surgical system" was dissapproved with a reason of "Not a Tricare Benefit". According to the dissapproval letter, it states "The requested procedure is not recognized by Tricare and cannot be used for a benefit decision. If the requested service is provided, you will be held financially responsible for all related charges." That almost sounds to me like the person reviewing the request from my doctor did not understand what was meant by "robotic surgical system" and without knowing what it was simply dissapproved it.
Do you know off-hand what procedure(s) were specifically requested by your doctor? I'm hoping my doctor simply submitted the request wrong, but I am now so stressed-out and scared and just don't know what to think.
I would sincerely appreciate any additional info you might be able to provide. If you want, you can e-mail me directly at **Removed by site staff ** Thanks so much.
Post Edited By Moderator (Steve n Dallas) : 5/7/2011 8:32:41 AM (GMT-6)