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Humana Military Gives an Array of Options for Streamlining the Referral and Authorization Process

When it comes to referrals and authorizations, Humana Military knows the value of choice.

TRICARE South Region providers now have a number of ways to make both referral and authorization requests.

Referrals
Your practice can submit a referral in any of the following ways:

• Via the Web through "Online Provider Services"
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• By calling health care finders (HCFs) at 1-800-444-5445 during normal business hours.
• By faxing a Patient Referral Authorization Form (PRAF) to 1-877-548-1547.
  

Each referral should include the sponsor’s Social Security number, patient diagnosis and clinical data explaining the reason for the referral.

For referrals involving patients with behavioral health care needs, providers should fax ValueOptions at 1-904-363-1504
and 1-904-363-1710 or call 1-800-700-8646.

To check the status of referrals, providers can use the Web or call 1-800-444-5445 and select “To check the status of an authorization or previously requested service.”

Prior Authorizations
There are three ways to obtain authorization for a service, procedure, or admission that requires medical necessity review before services can be rendered (see the TRICARE Provider Handbook for more information).

• Submit a request through Online Provider Services
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• Fax a completed Patient Referral Authorization Form (PRAF) to 1-877-548-1547
• Call HCFs at 1-800-444-5445

Be sure to include the sponsor’s ID, Social Security number, and address; the patient’s name, date of birth, and relationship to sponsor; the admitting hospital, date, time, physician tax ID, name, and mailing address; and the clinical conditions requiring authorization, including CPT codes.

For other questions about referrals or authorizations, call Humana Military’s provider service line at 1-800-444-5445.