TriCare waives authorization, referral requirements
Since the transition of TRICARE managed care services from TriWest to UnitedHealthcare Military & Veterans, April 1, KMS members have been reporting significant delays in processing authorizations and referral requests.
To address the delays, the Department of Defense (DoD) has waived authorization and referral request requirements for all TRICARE Prime covered services from April 1 through June 18, 2013. Physicians, during this timeframe will not be required to seek or wait for an approval from UHC for any covered services. After June 18, you will need to submit referrals and authorizations as normal.
KMS hosted on June 5 a teleconference with UHC regarding the transition. Handouts from the call are available here. If you have any questions about the TRICARE program please contact Ruth Cornwall, KMS Director of Health Care Finance at firstname.lastname@example.org.
TriCare transitions to UnitedHealthCare
On April 1, 2013, the managed care support contract for the TRICARE West Region will transition to UnitedHealthcare Military & Veterans (UHC). TriWest Healthcare Alliance (TriWest) will remain the TRICARE West Region managed care support contractor through March 31, 2013, and will continue to provide service to all customers throughout the transition.
To help you understand the timing and key information about the TRICARE transition, TriWest created the Provider Transition Update Center for specific information on important deadlines, online submission, status of referrals/authorization and claims issues resolution.
UHC has a Tricare Provider Handbook available online.