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Policy for Tricare Referrals
Once our office has inputted the referral(s) for you in the Tricare system.
You may do the following to check on the status.
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​Call (800) 444-5445 or Log-in to the beneficiary self-service tab at www.humanamilitary.com to
check on the status of your referral/s.
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Humana military will allow up to 12 months for each approved referral. Please know the
allowed # of visits. -
Do not make an appointment without a valid authorization. We will NOT be able to
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facilitate same day referrals.
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If you require additional visits other than what is authorized, your specialist office can request an extension or continuation of visit.
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Tricare allows a specialist that you have an approved referral to see to also submit referrals for care related to their specialty. You will not need to request it from us.
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(www.Humanamilitary.com website for further information about Referrals and Authorizations)
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​Ensure that the approved specialist sends us a report of their findings after every visit. As
your PCM and referring provider, it is best that we have information on your treatment
for your files. -
We will also need your office visit notes to refer to for visit extensions or other long-term
referral needs.
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An appointment with us is necessary when:
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It has been a year since the initiation of a referral, and it has expired.
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We do not have any medical records from the specialist office stating continuation of care
is required. -
When the specialist office refuses to request a referral for you to extend, change and
approve you for any procedures that they will do. -
A referral is needed for a medical condition that has not been evaluated by your PCM.
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It has been more than 6 months since your last appointment with your PCM.
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WHAT WE CAN HELP WITH
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Send an authorization request to Tricare within 5 business days after your Appointment with us for any service we are unable to perform as your PCM (Primary Care Manager).
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Facilitate your appointment with the approved specialist – we will send the medically necessary
information to them once the referral has been approved. -
Inform you of the outcome of the authorization.
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If possible, make your appointment for you and let you know. You may also contact them
directly to schedule.
WHAT WE CANNOT HELP WITH
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Retroactively request a referral for you.
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Mark your referral as URGENT unless deemed necessary by our treating provider. All your
referrals will be marked routine. -
Request a referral if your referral has EXPIRED.
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Create additional referrals requested by the specialist office.
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Create an out of state referral.
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