Appealing Insurance Decision

#1

My son started seeing an Endoconologist in Novemeber of last year. At our last visit in Feb he decided that I son should start the shots. Well I just go a letter from Tricare saying he was denied and now I have to appeal it. I sure my Doctor will help us but, I am so p.o.ed about being denied for the medication for my son. First off they say the medication is not approved for his diagnois, but I just went on the the website for the medication and it says is approved for his diagnosis. So why should appeal when whoever handled our case is stupid. First I am going to contact the doctors office to converse when and see if what they say. But I have never had to appeal anything. Has anyone dealt with successfully and give me advice? We are military and have Tricare prime, but unfortanely they are now managed by Humana. Thank you

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#2

I had to go through the appeal process when I first went on GH. My doctor
had to talk directly with the top Doc at Aetna. They called to arrange an
appointment with her. After that everything was fine and I received it at no cost
to me but it was a gulling process. Once you get to the top it is not a
problem! Good luck! I will be taking my son into the endo in June to an eval. if
he needs GH as well.

HUGS,
Tina

Tina

“If a cluttered desk is a sign of a cluttered mind, of what, then, is an
empty desk?” Albert Einstein

In a message dated 4/6/2008 3:16:17 P.M. US Mountain Standard Time,
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My son started seeing an Endoconologist in Novemeber of last year. At our
last visit in Feb he decided that I son should start the shots. Well I just
go a letter from Tricare saying he was denied and now I have to appeal it. I
sure my Doctor will help us but, I am so p.o.ed about being denied for the
medication for my son. First off they say the medication is not approved for
his diagnois, but I
just went on the the website for the medication and it says is approved for
his diagnosis. So why should appeal when whoever handled our case is stupid.
First I am going to contact the doctors office to converse when and see if
what they say. But I have never had to appeal anything. Has anyone dealt
with successfully and give me advice? We are military and have Tricare prime,
but unfortanely they are now managed by Humana. Thank you

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