Appeals must be filed with Humana Military within particular deadlines. If you are not satisfied with a decision rendered on an appeal, there are further levels of appeal. For specific information about filing an appeal in your region, contact Humana Military.
Prior authorization denial appeals may be either expedited or non-expedited, depending on the urgency of the situation. You or an appointed representative must file an expedited appeal within three calendar days after receipt of the initial denial. A non-expedited review of a denial must be filed no later than 90 days after receipt of the initial denial.
Appeals should contain the following information:
Beneficiary’s name, address, and telephone number
Sponsor’s Social Security number (SSN)
Beneficiary’s date of birth
Beneficiary’s or appealing party’s signature
A description of the issue or concern must include:
The specific issue in dispute
A copy of the previous denial determination notice
Any appropriate supporting documents
Send your appeal to Humana Military. See Figure 6.2 for regional appeals filing information.
Regional Appeals Filing Information
Figure 6.2
TRICARE South Region
Claims Appeals:
Prior Authorization Appeals:
Behavioral Health Appeals:
TRICARE South
Region Appeals
P.O. Box 202002
Florence, SC 29502-2002
Humana Military
Healthcare Services
Attn: Clinical Appeals
P.O. Box 740044
Louisville, KY 40201-9973
ValueOptions Behavioral Health
Attn: Appeals and
Reconsideration Department
P.O. Box 551138
Jacksonville, FL 32255-1138
