If Tri-Care says no to a service or care you need you can you appeal?

TIA

thats a really good question i hadnt thought of that when you mentioned it

I hope you can because i might need to.

I am pretty sure you can but you may want to contact the EFMP about it more.

I have a friend here in Diego who has a little boy in speech therapy they only approved 3 visits however she fought them tooth and nail and he has been going 2 times a week for the last 3 yrs now. So Im pretty sure ya can.

so thats what youve gotta do - just fight it and fight it and fight it :D

yes you can appeal. tricare refused to pay for some things when i had madison. some of it was that the hospital i went to coded things differently and some of it was that they didn't understand the situation. but i'm pretty sure you can appeal any decision that tri-care makes. i appealed all the services that tri-care refused to pay and they changed their decisions.

yay i feel better now thank you all

You can most definitely appeal anything they say. And a lot of it is finding the right person to talk to or getting the right number to call in the first place. i help with referrals in the office I'm working in and I took some of the ladies advice on here when i got stuck with a girl who obviously didn't feel like helping anyone that day so i hung up and called again and got a really nice one who actually talked to me and treated me like a person and then we got what we needed to get done, done in a professional way. i've gotten to the point that when one of them gives me attitude I give it right back just to make a point if nothing else! LOL

I'll keep fighting for me rights thanks for the support everyone it means a lot :hugs.

yeah, if it is just a code thing, have them resubmit. They should pay for it.Make sure that the diagnosis is CP and that you need the services bc of it.