Print

Active duty service members (ADSMs) using TRICARE Prime or TRICARE Prime Remote (TPR) must have prior authorization for inpatient and outpatient services, except most ancillary services (laboratory and X-ray), from a TRICARE Network or non-network civilian provider.

Note: TPR ADSMs can also obtain primary care outpatient services and clinical preventive care from a local TRICARE-authorized provider without a prior authorization.

If you don’t obtain a prior authorization when one is required, or you exceed the scope of an approved prior authorization, you risk not being paid or being assessed a penalty.

1. Submit a request online.
2. Fax a completed Patient Referral Authorization Form to 1-877-548-1547.
3. Call a Health Care Finder at Humana Military’s TRICARE Service Line at 1-800-444-5445.

Most authorization requests can be completed while you are on the phone or within 24 hours of receipt of all required information.

You can check the status of your prior authorization request online or by calling the TRICARE Service Line at 1-800-444-5445. Humana Military’s Referral/Authorization staff also sends an autofax confirmation to providers to ensure they have received notification of a confirmed authorization for a TRICARE Prime beneficiary.

Back to Top

Contacts (Article 6)

Back to Top

Created:  March 21, 2007