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July 5, 2013

Referral, authorization waiver expired July 2

The temporary referral and authorization waiver for TRICARE Prime enrollees (e.g., Prime, TRICARE Prime Remote, TRICARE Young Adult Prime) expired on July 2 at midnight.

Beginning July 3, 2013, providers should resume submitting referral and authorization requests for TRICARE covered benefits to UnitedHealthcare for approval in accordance with TRICARE procedures.

The normal referral and authorization approval rules will apply to all referrals issued beginning July 3, 2013. This means that the TRICARE program will assess a 10 percent penalty on provider claims if an authorization is not present at the time services are processed when a prior authorization is required.

If a referral and/or authorization was issued between April 1, 2013 and July 2, 2013, the waiver still applies for care to occur through Sept. 29, 2013. No additional action is required.

For more information, please visit uhcmilitarywest.com at http://www.uhcmilitarywest.com.

 




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