Advertisement

You will be redirected to the page you want to view in  seconds.

How to get a referral waiver if you're in Tricare Prime's West region

May. 7, 2013 - 01:54PM   |  
Comments
  • Filed Under

The Tricare Management Activity has released details on how military beneficiaries in the West Region can access specialty health care without first receiving approval by Tricare West Region contract manager UnitedHealth Military & Veterans.

Tricare Prime customers who are referred to a specialist by their primary care provider should ask their doctor for a paper copy of their referral — or have it faxed to the specialist — and have them complete a copy of a waiver letter from UnitedHealthcare, available at www.uhcmilitarywest.com.

The waivers will be available through at least May 18, according to a letter sent from Assistant Secretary of Defense for Health Affairs Dr. Jonathan Woodson to the military services on May 2.

Tricare officials said the unprecedented move was necessary to ease a referral backlog that has mounted since UnitedHealthcare assumed responsibility for the West Region contract on April 1.

Woodson described “inordinate delays” resulting form the contractor’s “failure to meet the contract requirements for referral and authorization management.”

In addition to the delays in referral care, UnitedHealth’s call center and website are experiencing tie-ups with customer service, with some callers being placed on hold for more than an hour.

A UnitedHealthcare Military & Veterans spokesman said last week that since the company took over management of the contract, its call centers have received 531,000 calls with an average wait time of about five minutes.

TMA officials said they are working with UnitedHealthcare to address the problems, and Woodson said the waiver period could be extended if the backlog is not adequately reduced by May 18.

“Through on-site visits to the contractor’s facilities and daily meetings with the contractor, Tricare Management Activity leadership is closely monitoring UnitedHealthcare’s effort to improve customer service,” TMA spokesman Austin Camacho said.

The waiver does not apply to beneficiaries using Tricare Standard, Tricare For Life or Prime enrollees in the U.S. Family Health Plan, available to some beneficiaries in Washington state.

Answers by RallyPoint

Join trending discussions in the military's #1 professional community. See what members like yourself have to say from across the DoD.

More In Pay & Benefits

Start your day with a roundup of top defense news.

VA Home Loan
Rates

Search By:

Product Options:
Zip Code:

News for your in-box

Sign up now for free Military Times E-Reports. Choose from Money and Education. Subscribers: log in for premium e-newsletters.


This Week's Marine Corps Times

This Week's Marine Corps Times

'My career was defaced'
Sergeant major tells his side of viral video confrontation

Subscribe for Print or Digital delivery today!

Classifieds
MilitaryTimes Green Trusted Classifieds Looking to buy, sell and connect on Military Times?
Browse expanded listings across hundreds of military installations.
Faces of valorHonoring those who fought and died in Operations Iraqi Freedom and Enduring Freedom.
hall of valorThe Hall of Valor is a searchable database of valor award citations collected by Doug Sterner, a Vietnam veteran and Military Times contributing editor, and by Military Times staff.
Woman who cried rape
(3 replies)
   Last Post: TJMAC77SP
        May 3, 2014 1:32 PM
   Last Post: garhkal
        May 1, 2014 5:03 PM
Cliven Bundy
(45 replies)
   Last Post: Chief_KO
        Apr 26, 2014 9:49 AM
Handbooks

All you need to know about your military benefits.

Benefits handbook

Guard & Reserve All you need to know about the Guard & Reserve.

guard and reserve handbook