delta27 0 Posted October 29, 2009 I need help writing an appeal letter to Tricare; When my information was first submitted; I weighed 219.5 and am 5'6". It was denied. My doctor resubmitted my information on my frame size which is small and my new weight of 228.5; I gained weight after having surgery on my leg and being off for 6 months. Anyway, I am now according to Tricare over 100 pounds and I have HBP, diabetes, infertility, hight cholesterol, arthritis, acid reflux. Where do I start? What do I say? If you have any examples you can send them to delta27@earthlink.net or attach them to an email on here to me. Thanks Share this post Link to post Share on other sites
untfluter 3 Posted October 29, 2009 I need help writing an appeal letter to Tricare;When my information was first submitted; I weighed 219.5 and am 5'6". It was denied. My doctor resubmitted my information on my frame size which is small and my new weight of 228.5; I gained weight after having surgery on my leg and being off for 6 months. Anyway, I am now according to Tricare over 100 pounds and I have HBP, diabetes, infertility, hight cholesterol, arthritis, acid reflux. Where do I start? What do I say? If you have any examples you can send them to delta27@earthlink.net or attach them to an email on here to me. Thanks I would be interested in answers to this as well. My insurance turned me down stating that it was a true contract exclusion... but in the letter they stated that our policy doesnt' cover stomach stapling or bypass... the band is NEITHER... so.. instead of dealing w/them for months on an appeal, I didn't want to wait..I was at 358.5 lbs 2 wks before my surgery w/HPB, high cholesterol, type 2 diabetes and a degenerative issue w/one of my knee and they said no.... so I took the money from my 401K and was a self pay... now I am planning on sending an appeal to try to get them to reimburse me... which will be less then if they originally paid for it as my surgeon gave me a good break on his fee... I have my pre-op and consult notes from my surgeon along w/the pulmonary and cardiac evals as well as copies of my blood work from before my surgery and this month, which was about 4 1/2 months post-op... my cholesterol has gone from 238 10 days before my surgery to 177... so any help would be greatly appreciated... Share this post Link to post Share on other sites
SuzanneG 1 Posted October 29, 2009 Delta, I've sent you copies of my letters. untflutter, if you would like a copy too, just send me your email address. Share this post Link to post Share on other sites
untfluter 3 Posted October 29, 2009 Delta, I've sent you copies of my letters. untflutter, if you would like a copy too, just send me your email address. Suzanne.. that's awesome.. my email is untfluter@comcast.net Thanks!! Share this post Link to post Share on other sites