TRICARE Management Activity is temporarily waiving the requirement for authorization of care in order to expedite service in its West Region, served by UnitedHealthcare. The waiver applies to any referrals obtained, or care received, from April 1 to May 18, 2013.
Referrals are typically entered electronically, generating an authorization from the managed care support contractor. While UnitedHealthcare works to clear pending referrals, West Region enrollees who are referred to a network specialist for TRICARE covered services will not need an authorization. Beneficiaries should request a written copy of their referral or ask their care provider to fax a copy to the specialist. The waiver does not apply to beneficiaries using TRICARE Standard.
UnitedHealthcare Military & Veterans began serving the TRICARE West Region April 1, 2013. Since then, the company has experienced referral and care authorization volumes that exceeded historical norms and related challenges processing them in a timely manner.
Effective immediately, referrals submitted by 412th Medical Group providers between April 1 and May 18, 2013 are authorized treatment in the TRICARE network without an authorization. When a provider determines the need for a medical referral to an off-base provider, enrollees will be sent to the 412th MDG Referral Management Center for assistance in booking appointments with a TRICARE network provider. Additionally, enrollees will be given a paper copy of their referral and the UnitedHealthcare waiver letter authorizing care. Please call the Referral Management Center at (661) 275-2259, if you have questions.
“UnitedHealthcare has committed the full resources of the company – at all levels and in all areas – to provide beneficiaries, care providers and Military Treatment Facilities with high-quality service and support,” said UnitedHealthcare Military & Veterans CEO, Lori McDougal. “We understand issues have arisen that need immediate improvement, and we are taking aggressive actions to fix them. We sincerely apologize for any delay in services that TRICARE beneficiaries and care providers are experiencing as a result of these challenges.”