Appointments & Referrals

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.  

 

1. 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. 

2. 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 

Ask your specialist to fax the results of your visit to 402-232-6406 to have them added to your electronic military health record for your PCM’s review. 

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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