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Network providers agree to comply with all Prime contract requirements applicable to TRICARE network providers.
Network providers (both professional and institutional) must maintain medical malpractice insurance coverage as required in the state in which services are provided. In the absence of state law requirements for medical malpractice insurance coverage, Humana Military will determine the local community standard for medical malpractice coverage for network providers. Each network provider must maintain the required medical malpractice coverage.
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Consult reports are required to be returned to the primary care manager (PCM) or initiating provider within 10 working days of the patient encounter. Routine specialty referrals for initial office visits, all outpatient services, and inpatient services must provide complete and legible documentation for these reports to be accurate and useful. Consult reports, operative reports, and discharge summaries returned to the initiating provider are important for timely follow-up and continuity of care. Please be responsive to the request when asked to return a consult report for TRICARE beneficiaries.
Providers who treat TRICARE beneficiaries coming from the local military treatment facility (MTF) may receive a fax reminder (as shown in Figure 2.3) to return a consult report for a recent visit or service. Your office should return the consult report, operative report, or discharge summary requested and use the designated fax reminder as the cover sheet. Please use the fax number shown in the center of the reminder page. This fax number is shown only on the fax reminder sent to providers for each beneficiary consult return request. This is to avoid having providers send documentation on all other TRICARE beneficiaries.
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