Appeals and Hearing Division Tricare Management

MysteryMe J.
on 6/6/08 2:43 am

Has anyone had to appeal to this level ,and if so what was it like, and how long did it take?

codeebrown1
on 6/10/08 11:49 am - Bradenton, FL

Hi, I'm not sure what your insurance is like. I just faxed my paperwork with my appeal letter to the moderator for my level 2 appeal hearing. It will be June 25th via conference call. I am permitted to talk for 10-15 minutes and they will be able to ask me questions. They say it is informal, but I'm nervous. I was told I will receive an answer 5 days after they make a decision, but it didn't say how long they have to make a decision. Good luck with your. Have you found out anything? Peace, Linda

MysteryMe J.
on 6/10/08 12:18 pm

RNY on 08/04/08

I have Tricare and I know they have my information , just don't know what's next and it's driving me crazy not knowing and not knowing what to do next

codeebrown1
on 6/10/08 9:10 pm - Bradenton, FL

RNY on 07/07/08

Sorry, my insurance is Aetna HMO. I know exactly what you mean. They had everything they wanted, except the nutritionist consult.I got that and was waiting to send it in until they told me what to do and I get notified that I've been denied again, sooooo now I'm at this level. I really wish you all the best. Peace, Linda PS- do you get jealous and depressed when you see these posts..."GOT APPROVED... GOT MY DATE..." I do, but boy I can't wait to be able to do that, IF I'm ever going to be able to do that

MysteryMe J.
on 6/10/08 10:19 pm

RNY on 08/04/08

Yes, that gets me every time. What makes it worse is that my husband has had his surgery and has lost between 70-80lbs and I am still fat (like the slimquick commercials) I am just tired of the waiting for a denial game.

codeebrown1
on 6/16/08 11:57 pm - Bradenton, FL

RNY on 07/07/08

I have been wondering how you have been and if you have heard anything from your insurance company? Next Wednesday is my conference call. I just don't understand how they can deny it when everything they've asked for, I've sent in. Hope you are well and having luck with your insurance. Peace, Linda

MysteryMe J.
on 6/17/08 3:13 am

RNY on 08/04/08

I'm still hanging in their the last I heard was that my paper work had to be reviewed by their lawyers and they would let me know something. I have done everything also and I would be upset if they denied either one of us again.

codeebrown1
on 6/17/08 4:32 am - Bradenton, FL

RNY on 07/07/08

I truly wish you all the best. I just have a feeling it will go well for both of us, we use close to the same screen name, LOL, I'm sure yours doesn't mean what mine does though. Prayers for both of us. Peace, Linda

MysteryMe J.
on 6/17/08 4:55 am

RNY on 08/04/08

I try not to think about it , I am trying to figure out my next move no matter what the out come. My name means Carolyn Brown 4 kids

codeebrown1
on 6/30/08 1:30 am - Bradenton, FL

RNY on 07/07/08

I will send this as a reply also. How have you been Carolyn? I have not seen you on the boards lately. I did get news Friday the 20th, but was waiting to see if you heard anything. I did get approved and my surgery is scheduled for Monday Jusy 14th. I started my s week South Beach diet today and go for pre-ops, UGI and consult with the dietician tomorrow. I really pray you have good news. My screen name Codeebrown1 is from work. I am an RN in the operating room (where I will have my surgery), well, have you heard about code blue and code red for cardiac arrest and fire? Well, my patient's all seemed to have BM's for a period of time, so they started to call me the "S--T magnet". Well, I was just getting onto computers then and was trying to come up with a name, and they came up with Code Brown, which is a little nicer for online than S--T magnet. Hope you are well. Peace, Linda

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