Appeals must be filed with Humana Military within specific 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, contact Humana Military.
Prior-authorization-denial appeals may either be 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.
Regional Appeals Filing Information
Figure 5.2
TRICARE South Region
Claims Appeals: TRICARE South Region Appeals
P.O. Box 202002
Florence, SC 29502-2002
Prior Authorization Appeals: Humana Military Healthcare Services
Attn: Clinical Appeals
P.O. Box 740044
Louisville, KY 40201-9973
Behavioral Health Appeals: ValueOptions Behavioral Health
Attn: Appeals and Reconsideration Department
P.O. Box 551138
Jacksonville, FL 32255-1138
