Appeal denied. Am I denied forever or can I resubmit?

usmc_honey
on 9/6/07 11:21 am - Oceanside, CA
Hi All. I have Tricare Prime.  My PS submited a request for an abdominoplasty in April.  In May it was denied.  I submitted an appeal within a week.  It was denied. Can this procedure ever be requested again, or because my appeal timelines have been exhausted, I am now out of luck? Thank you all for your help and input.
moore972003
on 9/7/07 5:13 am - IN

I'm not an insurance expert, but I am going through the appeals process myself.  I asked my insurance to send me a copy of their appeal guidelines.  I found out how many internal appeals I got, how long I had to appeal at each level, how they handled each appeal (ex:  the first appeal is handled by their employees, the next includes people not employed by them, etc), who could appeal for me, and on and on.  Do you know if you have any appeals left?  Is that what you mean by your "appeal timelines have been exhausted"?  What about an external appeal?

Hope I didn't just confuse you more!

Mandy                                     ***See my blog for appeal info***

  

usmc_honey
on 9/8/07 8:44 am - Oceanside, CA
Thank you so much for your reply. I appreciate the time you took to respond to my question. I have actually (hopefully) been able to resolve some of my question.  Only time will tell.  I hope that you are having a great weekend. Andrea
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