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Electronic, paper scripts, and faxes are accepted. Fax 402-294-0711 for off-base providers faxing non-controlled prescriptions. We also accept electronic scripts from off-base providers. Paper scripts can be dropped off at the Clinic Pharmacy (2501 Capehart Road) drop box. The drop box is in the hallway near the pharmacy’s customer service windows.
This issue has been fixed by modifying our texting software and the text message notifications that it generates.
Please speak with a pharmacy representative and inform them of the time-sensitive nature of the medication, and we will do our best to fill your prescription the same business day. For all urgent medications, go to the Clinic Pharmacy and get a kiosk ticket. A staff member will be happy to assist you to prioritize your medication.
TriWest has recently added staffing and improved processes, and the wait time is currently less than 10 minutes. All related contact information is available in the graphic below:
While TriWest experienced occasional outages of its secure beneficiary portal at the start of health care delivery, they recently made several portal improvements to help enhance the beneficiary experience.
To create an account and manage your health information, you need to use the same email that’s in the Defense Enrollment Eligibility Reporting System. Make sure to check that your information is current in DEERS before creating your account. Our staff is available to assist you with this process and answer any questions. Please reach out to our Patient Administration team at 402-294-3549.
TriWest is actively loading 2024 referrals and authorizations to their portal. This means they’ll be available to you and your providers. Many referrals and authorizations are now available in the portal. More are being added daily.
On Jan. 25, DHA announced that it waived the requirement to obtain approval for referrals to outpatient specialty care for TRICARE Prime enrollees in the West Region. This means TRICARE-authorized specialty care providers don’t need to wait for TriWest to assign an authorization to a referral if there is a referral in place issued by your primary care manager. However, you must still need to get a referral from your PCM before getting that specialty care.
There are exceptions for certain services. The waiver will be in place through March 31 and is retroactive to Jan. 1. Check out “Defense Health Agency Announces TRICARE West Region Referral Approval Waiver” on the TRICARE Newsroom to learn more.
Do you have an unexpired referral or authorization dated before Jan. 1, 2025? TriWest will accept all unexpired referrals and authorizations approved by the previous contractor (Humana Military or HNFS). These will be accepted through their expiration date, or June 30, 2025, whichever comes first. Your PCM doesn’t need to take additional action to get these approved again.
Do you have a question about a referral or authorization dated before Jan. 1? Beneficiaries may continue to call Health Net Federal Services until 30 April 2025. After this date, beneficiaries will need to call TriWest.
If you have questions, you may visit the Referral Management Center or call 402-294-4010. The RMC will:
Verify your eligibility and contact information
Verify your referral is in the system
If services are available in the military treatment facility, we’ll book your appointment with a specialist
If the services are not available at the MTF, we’ll explain the TriWest authorization process
Referral Management will review your referral to determine if the specialty is available in the MTF or if it needs to be sent off-base.
If the MTF has the requested services, the RMC will call you within three business days to book your appointment
After three unsuccessful contact attempts (in a 14-day span), your consult will move to ‘pending’ for 30 days before being closed
Be sure you’re registered at www.tricare-west.com.
Set your preferences to receive email and/or text alerts when your referral has been authorized by TriWest.
Your authorization letter will contain the number of authorized visits, approved services, the specialist’s contact information, and the approved timeframe for treatment
You may also check the status of a pending off base referral by calling Triwest at 888-874-9378
If you have a commercial health insurance plan, you must follow the rules of that plan; TRICARE is your secondary coverage.
Schedule your appointment with the recommended off-base specialist. If you choose a different off-base specialist, make sure to check www.tricare-west.com to ensure it’s 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 retrieve your results.
You can access your military medical record through the MHS GENESIS Patient Portal and print or download any necessary medical information.
You may also send a MHS GENESIS Patient Portal message to your PCM asking for pertinent copies of your medical history to be sent to the off-base specialist.
In your Secure Message, be sure to include the following off-base specialist contact information:
Specialty Provider Name
Office Name
Telephone Number
Fax Number
If you disagree with the balance on your bill, call the phone number listed on the bill to ensure the off-base provider has a copy of your referral authorization and correct sponsor/guarantor information. If they have your referral authorization, but are still unable to resolve the bill, then go to https://www.tricare.mil/west to see how your claim was processed. You may also call TriWest at 1-888-874-9378. If you disagree with how the claim was processed, you may file a formal appeal in writing within 90 days of the date on the explanation of benefits or provider remittance.
You can submit your appeal by using TriWest online appeal submission form, or by submitting an appeal letter via mail or fax. If you need further assistance, please call us at 1-888-874-9378 and request to speak to a Beneficiary Counselor and Assistance Coordinator.
Seeking care from a civilian provider without prior authorization can result in significant out of pocket costs to you. Please ensure you have proper authorization before seeking any off-base non-emergent care.
Active duty members must have prior authorization for all urgent or non-emergent off-base services.
For additional information on TRICARE benefits, visit https://www.tricare.mil.
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