TRICARE has created a claim appeal process to have your claim reviewed in the event you disagree with payment. There are a few different types of claim appeals:

• Network provider claim appeals: Network providers who are dissatisfied with the denial of a claim can appeal under the administrative review process. The process for administrative review and general claim appeals are similar and require the same information to process your request.
   
• Non-network provider and beneficiary claim appeals: Non-network, participating providers (those who accept assignment) and beneficiaries can appeal a TRICARE claim.
   
• Claim adjustments: An allowable charge review can be requested by a provider or beneficiary if either party disagrees with reimbursement allowed on a claim. This includes appeals for “By Report” or unlisted procedures where a provider can request an appeal.
  
  Refer to the Provider Handbook for more information.