Tricare west region prior authorization form 2025

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A prior authorization form will include information about you, your medical conditions, and your health care needs. Its important to fill out the form completely and accurately. Incomplete or incorrect information could delay your request or result in a denial.
East RegionHumana Military: 800-444-5445.
Call 1-877-363-1303 and have your prescription bottle handy. A patient care advocate will work with your doctor to transfer your maintenance medications to Home Delivery. Or, you can activate your account online.
Want to know how to call TRICARE? Regional ContractorsPhone Number TRICARE East Humana Military (East Region Contractor) 1-800-444-5445 TRICARE West TriWest Healthcare Alliance 888-TRIWEST (874-9378) TRICARE Overseas International SOS (Overseas Contractor) Country specific phone numbers
Submit a Referral/Authorization Online for New Care Requests Go to Availity.com and access the TRICARE West TriWest payer space. Select the Applications tab. Choose the Submit Referral/Auth tile.
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Go to the provider portal at .tricare-west.com. Under the Secure Tools section, select Authorization Status. If you are not already logged in, you will be directed to do so. Step 2: Search by Social Security number (SSN) or Department of Defense Benefits Number (DBN) and enter in the required information.

triwest prior authorization form pdf