Appealing a Tricare decision may take nearly a year but that doesn’t necessarily mean those decisions go against beneficiaries. Of 124 cases that made it to the highest level of appeal from 2009 to 2013, 106 (85 percent) of medical rulings in favor of beneficiaries were upheld.
The appeals process can involve up to three levels. After beneficiaries receive an initial denial for reimbursement, they can appeal to their regional Tricare contractor; if the denial is upheld, the appeal goes to Defense Health Agency Appeals or Quality Monitoring Contractor, depending on the nature of the case; and finally, an appeal can be made to an independent hearing officer.
The Archuleta Law Firm focuses its practice on the Federal Tort Claims Act by helping military members, veterans, and their families when they are injured or killed by the negligence of U.S. government employees. If you or a loved one has been injured by medical malpractice at a military or VA facility then contact Archuleta Law Firm as soon as possible since there are strict time limitations with regard to filing military medical malpractice claims.