Referral/Authorization Form Updated

TriWest has updated the TRICARE Patient Referral/Authorization Form. The changes included adding Ambulatory Infusion Suite (AIS) as a place of service option and removing references to hospice since a new Hospice Authorization Form was implemented. Both forms can be found in the Find a Form section of www.triwest.com/provider.

While the forms are new, we strongly encourage you to use the new online referral/authorization submission tool on the secure provider portal at www.triwest.com. This is the preferred way to submit referrals and authorizations to TriWest. Registered users can enjoy the following benefits:

• Verify patient eligibility
• Submit referrals/authorizations online
• Determine status of referrals/authorizations
• Submit claims online
• View claims and check claim status
• Download Explanations of Benefits

Register for secure access to the TriWest website now! Simply click the “Register Now” button on www.triwest.com/provider to get started.

Published Date: 05/20/2009