TRICARE Provider News image

Adobe PDF print image Print

Good Work!  Keep the Consult Reports Coming!  (Article 1)

Humana Military continues to be impressed with the rate of return and the accuracy of your consult reports—and we’d like to see the pace and compliance of these reports remain strong.

As you know, the more smoothly the consult report return process runs, the better follow up and continuity of care your beneficiaries will receive. This is especially true for TRICARE beneficiaries assigned to local military treatment facilities (MTFs), because they are referred to network providers for evaluation and treatment.

The following serves as a quick consult reports recap—complete with information on where and when to send consult reports and how to contact Humana Military should you have questions.


Where to Fax Your Reports

You will find the return fax number on the referral or authorization confirmation fax sheet itself and on any consult report reminder sent to you by us. We urge you to remember to use the correct fax number, which is where you need to send the consult report (not to the MTF). It is also your responsibility to ensure that your transcription service knows where to send the faxed reports.

In addition to using the correct number, you must use a cover sheet.

When to Fax Your Reports

Consult reports must be returned to the primary care manager (PCM) or initiating provider within 10 days following the patient’s appointment unless an urgent situation exists. For urgent consults that need to get back to the PCM within 24 hours, contact the PCM by phone and follow up by sending the formal consult report to Humana Military within the next 10 days. Obviously, the reports must be complete and legible in order to be compliant with Humana Military standards.

To serve as a reminder, we also send an auto-fax confirmation when the patient’s referral or authorization has been established. This confirmation contains the fax number where you should send your consult report.

If you receive an auto-fax confirmation for a new or existing patient, you need to keep that confirmation until the TRICARE beneficiary makes an appointment and then include it in the patient’s chart.

Where to Get Help, If You Need It
You can visit Provider Resources or call 1-800-444-5445.
 
Special Consideration:  BHC Consult Reports

Behavioral health care (BHC) providers must submit behavioral health care consult return reports to PCMs within 10 working days following the patient’s initial date of service. (If inpatient care is provided, the BHC provider must send a discharge summary to the PCM as well.) If treatment was provided on an emergency basis, you must submit a report within 24 hours. Consult reports (and discharge summaries, if applicable) must be submitted to Humana Military.

For your convenience, the consult report form is available online.

Behavioral health consult reports should contain information ranging from the beneficiary’s name and identification number to the chief complaint, history of problem, clinical assessment, diagnosis, discharge planning, treatment plan goals, and legible provider names and signatures. When receiving behavioral health care treatment, some patients may be worried about their privacy. Should one of your patients not wish to disclose specific information related to their treatment, you must document the patient’s refusal and fax that documentation to Humana Military.

If you have any BHC-specific questions, please contact ValueOptions, the BHC subcontractor for Humana Military, directly at 1-800-700-8646.
 


Back to Top