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How can I challenge the denial of an FEHB claim?
Follow the directions in the disputed claims section of the plan’s brochure. You must explain why (in terms of the applicable brochure coverage provisions) you feel the services should be covered. If the plan again denies the claim, you will receive instructions on how you may request the Office of Personnel Management to review the claim. If you are dissatisfied with OPM’s decision in turn, you may file a complaint in the appropriate federal district court by December 31 of the third year after the year in which you received the disputed services, drugs, or supplies.

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