Help with tricare appeal

delta27 · October 9, 2009

Well today I got the bad news that I was denied through Tricare Prime. I am sooooo upset. I cried for about 30 minutes straight. I don't know how I am typing this b/c I can barely see.

Anyway, I am going to appeal; Can someone help me with this process?

I am 220lbs.. My BMI is 36- I have high blood pressure, high cholesterol, acid reflux, diabetes, joint pains, and infertility.

Why did they deny me? Someone PLEAAAAAASSSSEEE HEP ME.

ParrotheadCathy · October 9, 2009

The denial letter should state clearly the basis for the denial. If not, there should be a number on the letter that you can call and ask for an explanation. It could something as simple as something was left out of the package by the doctor's office or something as difficult as for whatever reason you don't meet one of their requirements.

But you're not going to know unless you re-read the letter and, probably, make a phone call.

Let us know what the results are and maybe someone will have some suggestions when we have more information.

delta27 · October 10, 2009

I hope its not much. I haven't gotten the letter yet but I looked at my referral on line. I spent 350.00 of my own money for the psychologist and 275.00 of my own money for the doctor's program fee. he gives the program fee back if you don't go through with the surgery. But, I am out of 350.00 or the psychiatrist. I called the doctor's office today but no one has called me back as of yet.