New Online Referral/Authorization Form Available to Providers
A new fill and print version of the TRICARE Patient Referral/Authorization Form has been developed to assist providers in completing
the form. Providers are now able to complete all fields of the Referral/Authorization Form online, print the form, and submit it to
TriWest via fax.
Here are links to samples of
page 1
and
page 2
of the new form. Please visit the Forms page on the Provider Connection at
www.triwest.com/provider
and click on the
printer icon next to the TRICARE Patient Referral/Authorization Form to access.
The online referral/authorization form is an optional alternative to handwritten forms.
Published Date:
10/29/2008