Follow the Proper Procedure for Photograph Requests

In order to help TriWest to make an appropriate medical necessity determination and process certain types of authorization requests, photographs may be requested by TriWest for the authorization of various surgical procedures.

Please adhere to the following procedure for photographs requested by TriWest:

• Mail the photographs to the appropriate Hub address listed below after you submit your referral/authorization form to TriWest.
• TriWest is unable to accept faxed or electronically submitted photographs or dental X-rays. 
• Make sure that the sponsor’s Social Security number and beneficiary’s name and date of birth are on the photo(s).

The following table lists the Hubs, the areas they service and their addresses:

Hub & States	Address
Northwest Hub Washington, Oregon, Alaska, Northern Idaho	TriWest Healthcare Alliance 1501 Market St. Suite 200 Attn: HCS Documentation Tacoma, WA 98402
Southwest Hub California (except for Northern California), Nevada and Yuma, AZ	TriWest Healthcare Alliance 9275 Sky Park Ct. Suite 250 Attn: HCS Documentation San Diego, CA 92123
Mountain Hub Arizona (excluding Yuma), New Mexico, Utah, Montana, Southern Idaho and El Paso, Texas TRICARE Prime Remote Regional Support Group (services Northern California)	TriWest Healthcare Alliance 16010 N. 28th Ave Attn: HCS Documentation Phoenix, AZ 85053
Central Hub Colorado, Nebraska, Minnesota, Iowa, North Dakota, South Dakota, Wyoming, Missouri, Kansas	TriWest Healthcare Alliance 5475 Mark Dabling Blvd. Suite 210 Attn: HCS Documentation Colorado Springs, CO 80918
Hawaii Hub Hawaii only	TriWest Healthcare Alliance 3375 Koapaka St. Suite C310 Attn: HCS Documentation Honolulu, HI 96819

Once the authorization is approved, the photographs that were mailed to TriWest will be returned to the requesting provider’s office. If the procedure is not approved, the mailed photos will be stored in a secure, central area at the corporate office in Phoenix until the filing deadline for appeals has passed, then the photos will be returned to the sender.

All registered providers on the secure provider portal at www.triwest.com/provider have the ability to submit referrals/authorizations online, which is the preferred way to submit a referral/authorization request to TriWest.

For more information, go to www.triwest.com/provider or call 1-888-TRIWEST (1-888-874-9378).

Published Date: 07/23/2009