How and When to File an Appeal

An appeal is how you ask us to review our actions. You might get a decision letter telling you that a service is ending or that a service is denied. You can appeal if you disagree. You must ask for one within 60 days from the date listed on the letter. You or an authorized representative can file an appeal.

You can file an appeal in one of these ways:

  • Call: CallMember Services at: 1-833-230-2050 (TDD/TTY: 711), Monday through Friday, 7 a.m. to 8 p.m. Central Time (CT).
  • Fax: 937-531-2398
  • Email: 
  • Online: MyLife.MSTrueCare.com
  • Mail:
    TrueCare
    ATTN: Member Appeals
    O. Box 1947
    Dayton, OH 45401

Who can ask for an appeal?

  • You
  • Your provider with your written consent
  • Someone that you say can act on your behalf
  • Your parent of legal guardian
  • An attorney with your written consent

When can you ask for an appeal?
You can ask for an appeal within 60 calendar days of the date listed on the decision letter. We will let you know in writing within 10 calendar days that we got it. We will give you an answer within 30 calendar days once we get your appeal. You can file an appeal by phone or in writing.

What must your appeal have?

✅  Your name

✅  Your member ID number

✅  The provider’s name

✅  The date of the service

✅  The reason for your appeal

✅  Information you want to attach

✅  A phone number where we can reach you

Who can help you file your appeal?

Member Services can help you file at 1-833-230-2050 (TDD/TTY: 711), Monday through Friday, 7 a.m. to 8 p.m. Central Time (CT).

Appeal Decision

If you are at an inpatient facility, TrueCare™ will tell you and your health care provider/facility the appeal decision. This will be done in writing on the day of the decision. The decision letter will be sent to you. It will also be sent to others acting for you with your written consent.

TrueCare will reply to an appeal in writing as fast as your health condition requires. We will reply no later than 30 calendar days from when we got your standard appeal. We will reply within 72 hours for an expedited appeal.

Expedited Appeals

You or health care provider can ask for an expedited appeal. Appeals will be expedited when TrueCare decides that going by the standard timeframe could seriously harm your life, health or ability to attain, maintain or regain maximum function. If it does not meet expedited review reasons, we will send you a letter in two calendar days to tell you. It will be handled under the standard appeal process.

Extending the Appeal Timeframe

You or someone acting for you with your written consent can ask that TrueCare extend the time frame to resolve a standard or expedited appeal up to 14 days. We can also ask for extended time up to 14 days. This will happen if we show that there is a need for more information and if a delay is in your best interest. We will give you written notice right away of the reason for the extension and the date that a decision must be made.

Before you can ask for an external review you must complete an internal appeal.

Do You Need More Help?

Please call Member Services at the number below if you have questions about your rights or need help. You may also write to us at:

TrueCare
ATTN: Member Appeals
P.O. Box 1947
Dayton, OH 45401-1947

If you have any problems reading or understanding this information, please call us. We can read it out loud for you, in English or in your primary language. We also can help you if you are visually or hearing impaired. If you ask, we can offer language services to help you file a complaint or appeal and to notify you about your complaint or appeal. You can get this service at no cost to you.

Member Services: 1-833-230-2050 (TDD/TTY: 711), Monday through Friday, 7 a.m. to 8 p.m. Central Time (CT).