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How to Get Pre-Authorization Download and print the form for your drug. Give the form to your provider to complete and send back to Express Scripts. Instructions are on the form. You don't need to send multiple forms. Your authorization approval will apply to network pharmacies and home delivery.
With Tricare Select you can get care from any Tricare-authorized provider, network or non-network. No referrals are required, but some care may require prior authorization.
However, if you're enrolled in one of the following plans, you need a referral before you visit a specialist: TRICARE Prime. TRICARE Prime Overseas. TRICARE Prime Remote. TRICARE Prime Remote Overseas. TRICARE Young Adult Prime. US Family Health Plan.
How long is the referral process? Your PCM will send a referral request to your regional contractor, who'll process the referral. It can take approximately three business days for your regional contractor to process your referral.
Q: How do I know if I need a referral? A: If you're an active duty service member (ADSM) or non-ADSM enrolled in a TRICARE Prime plan, then you need a referral from your PCM to seek most specialty care with another provider. TRICARE Prime options include: TRICARE Prime.
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Routine requests are processed within 2\u20135 business days of receiving the complete request from the provider. Urgent requests are processed in an expedited manner for care that needs to be delivered within 72 hours.
You can check the status of requests and view copies of determination letters online (log in to the Secure Portal), or use the automated self-service tools at 1-844-866-WEST (1-844-866-9378).
Medical Claims Fill out the TRICARE Claim Form. Download the Patient's Request for Medical Payment (DD Form 2642). ... Include a Copy of the Provider's Bill. Attach a readable copy of the provider's bill to the claim form, making sure it contains the following: ... Submit the Claim. ... Check the Status of Your Claims.
TRICARE Prime (active duty service member) If you get care without a referral, you'll pay out-of-pocket.
The quickest, easiest way to request a new referral or authorization or update an existing referral or authorization is through provider self-service. *Providers should submit referrals and authorizations (including behavioral health) through self-service.

tricare authorization form pdf