Referral Management Center
Seeking care from a civilian provider without prior authorization can result in significant out of pocket costs to you. Please ensure that you have the proper authorization before seeking any off-base provider for non-emergent care. All active duty personnel must have prior authorization for all urgent and non-emergent civilian services.
Why do I need to go to Referral Management?
The Referral Management Center will:
- Verify your eligibility and contact information.
- Verify your referral is in the system.
- If services are available in the military treatment facility, we will book your appointment with a specialist at the MTF, unless it needs to be reviewed by the MTF specialist first.
If services are not available in the MTF, we will explain the authorization process through Health Net Federal Services.
What if my referral needs to be reviewed by the MTF specialist first?
Your referral will be sent to the MTF specialist to determine if we have the capabilities to meet your needs, and if we can book your appointment within access to care standards.
What if my referral is deferred off base?
- If the MTF has the requested services, then the RMC will call you within 48 hours to book your appointment.
- After three unsuccessful contact attempts (within a 10 day span), your consult will be pended for 30 days before being closed.
- If you have not received a call within 48 hours, you may call the RMC at 402-294-4010 to check the status of your referral.
Be sure you are registered at TRICARE West. Set your preferences to receive email and/or text alerts. Once registered:
- You will receive an email or text alert when your referral has been authorized by HNFS.
- Check the status of the referral online.
- View the authorization letter, which will contain the number of authorized visits, approved services, the specialist’s contact information, and the approved timeframe for treatment.
If you do not register online, then you may still check the status of a pending off-base referral by calling HNFS at 1-844-866-9378.
What do I do once I obtain my authorization letter?
How do I request that my medical history be sent to my off-base specialist?
- Schedule your appointment with the designated off-base specialist. If you choose a different off-base specialist, make sure to check tricare-west.com to ensure it is an in-network specialist with the same specialty.
- After you schedule your off-base appointment, call the RMC at 402-294-4010
to inform us of the day and location of your appointment. This helps us ensure we receive your results.
- If you do not provide this information, you will receive up to four automated phone calls to remind you.
How can my off-base specialist send my results to my PCM?
- Use TRICARE Online Patient Portal to send a secure message to your primary care manager.
- At least eight business days before your appointment, send a Secure Message to your PCM to request pertinent copies of your medical history be faxed to the authorized off-base specialist (not an entire copy of your medical record).
- In your secure message, be sure to include the following off-base specialist contact information:
Ask your specialist to fax the results of your visit to 402-232-6406 to be added to your electronic military health record for your PCM to review.
For Information & Assistance: