Page 125 - R2P Front Desk Manual v1

How to Submit a Tricare Referral/Auth Request

When a Tricare Prime patient has used all of the visits authorized on their referral, a request for
continued treatment must be submitted with supporting documentation. This request can be
submitted via fax or through the online Tricare portal. An authorization request may also need to
be submitted for Tricare Select patients after they have had 16 visits in order for Tricare to
continue paying (even though Select patients do not need referrals). Requests are reviewed and
updated in the portal within 2-3 business days. Updated referrals with authorization will be faxed
to the Frederick clinic.

To request authorization via fax (according to Tricare rep, this is easier & faster!):
1. Call 800-444-5445
2. Press 2 for calling from a Medical Facility
3. Press 2 for All Others
4. Press 7 for All Other Questions to speak to a representative. Inform the rep you are
calling to request additional visits/auth for a patient, and they will provide a fax number
(may not always be the same #) for where to send clinical notes.
5. From the patient’s WebPT chart, add clinical notes and any other supporting
documentation to the fax. You may need to Add Outside Contact to add the fax
number.
a. In the Message box of the New Fax window, indicate the # of visits requesting,
extended end date (if necessary), and patient ID # (use 11-digit benefits #) (i.e.
“Requesting ___ additional visits through ______ for patient ID # _____.”
b. Uncheck Include Thank You Message and Send Fax.

6. Add a Chart Note detailing when/where the authorization request was faxed and what
notes were included (i.e. “Faxed request for 8 additional visits thru 8/31/19 with DN 2/25
- 3/15 to Tricare @ 2:20pm”). Check the WebPT Fax Log to confirm fax was completed.
7. Update the appropriate clinic’s Authorization Log in Google Drive with the Date
Submitted.

Last Update: 7/12/19