Yes Minnie that does help, thank you. I'm in the process of getting copies of all my MRI and CT films and reports from the various locations around the country. I've gotten the CT's from the local ER, and am going to pick up the MRI's from the local civilian hospital, and I have faxed the authorization to the hospital in NY that did the original MRI's from 2000-2002 (those are the ones that initially showed the intrasellar cisternal herniation). I'm hoping with the actual films I can have them sent to OHSU (or someone else if need be) and have them evaluated as a patient-not-present consult (thanks, I didn't know what you called it hehe). Then I will be able to take that information and use it to bargain with. The Tricare referral and authorization letter reads like this: "You can choose another network provider for this service. To review network providers in your area, go to our website at www.triwest.com. If you choose a different network provider, you do not need a new authorization. This authorization covers the service(s) listed above when performed by any network provider." OHSU is part of the tricare network, and my area is triwest. We currently have a friend (federal lobbyist lawyer in DC) reviewing the letter. I should be able to book the appt with OHSU and tricare will have to pay for it, and he is reviewing it to make sure that I am within my legal rights. If I am (and he feels certain I am) then tricare will have no choice but to pay for the appt and if they don't it will land them in court. I hate to have to resort to litigation, but I refuse to sit back and let them ignore a medical problem that could result in failing health or worse. My GP has given a 2nd referral letter to the neuro for a 'second opinion' and is trying to get it through tricare and have it changed to Dr. Ludlam, so he is still working on it, he just wouldn't commit to it verbally. I think at this stage I'm beyond frustration, despair and depression. Now I'm just plain mad. Once I get mad, I tend to not stop until things are done properly. The support of everyone here has been one of my saving graces. I can't thank you all enough for all the help and information you've provided. Cathy | 