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COLORADO, SPRINGS, Colo - On April 1, 2013, UnitedHealthcare Military & Veterans became the TRICARE health care support contractor for the West Region. UnitedHealthcare's website and call center are getting increased usage and, for TRICARE Prime enrollees, there are delays in the processing of referrals. A delay in processing of referrals also delays the authorization for that care.
To reduce the impact this has on Prime enrollees in the West Region, TRICARE Management Activity (TMA) is temporarily waiving the requirement for authorization. The waiver applies to any referrals obtained, or care received, from April 1 through May 18, 2013.
Referrals are typically entered electronically, generating an authorization from the health care support contractor. While United Healthcare works to clear their backlog of referrals, West Region enrollees who get a referral from their primary care manager (PCM) will still be able to seek TRICARE covered services from a network specialist.
Beneficiaries will receive letters from the military treatment facilities via the Colorado Springs Central Referral Center. The letter contains a list of local providers and a copy of the referral with instructions on where to send the results
As always, beneficiaries who feel they are in need of emergency care should call 911 or go to the nearest hospital emergency room. TRICARE Prime enrollees must contact their PCM within 24 hours or the next business day after receiving emergency care.
The waiver does not apply to beneficiaries using TRICARE Standard. Under TRICARE Standard, patients do not need referrals for covered specialty care.
TMA officials are working closely with United Healthcare to address issues, reduce backlogs and ensure beneficiaries get the quality health care and service they deserve. TMA leadership is closely monitoring United Healthcare efforts to improve their customer service.
West Region beneficiaries can get more information and sign up for updates at www.tricare.mil/westtransition.
| Date Taken: | 05.09.2013 |
| Date Posted: | 05.09.2013 13:29 |
| Story ID: | 106641 |
| Location: | COLORADO SPRINGS, COLORADO, US |
| Web Views: | 234 |
| Downloads: | 0 |
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