If you disagree with United Concordia's
reconsideration decision and the amount remaining in
dispute is $50 or more, you may request a
formal review from the TRICARE Management Activity
(TMA). The letter containing the reconsideration
decision will include a notice of your right to a formal
review and instructions on how to request one.
How to Request a Formal Review
A request for a formal review must be made in writing
to the following address:
TRICARE Management Activity
Appeals, Hearings and Claims
Collection Division
16401 East Centretech Parkway
Aurora, CO 80011-9066
The request must include copies of the reconsideration
determination and any other information not supplied
with the original appeal request.
The formal review request must be postmarked or
received by TMA within 60 days of the date of the
reconsideration determination. Because the request
for formal review must be filed within 60 days, the
request should not be delayed to obtain supporting
records if these records are not readily available.
You may submit supporting records at a later date;
however, you should include the expected date of
submission in the formal review request.
