TRICARE PRIOR AUTHORIZATION:
Tricare Standard puts the power to manage
>> your health care in your hands by not requiring referrals.
However, some
>> services may require prior authorization.
>> Under TRICARE Standard prior authorization is required for the
following
>> services:
>> . Adjunctive dental services
>> . Home health services
>> . Hospice care
>> . Non-emergency inpatient behavioral health care, including
non-emergency
>> inpatient admissions for substance use disorders
>> . Outpatient behavioral health care after the eighth visit in a fiscal
>> year (Oct. 1-Sept. 30)
>> . Transplants (solid organ and stem cell)
>> . Tricare Extended Care Health Option services
>>
>> Your network provider can coordinate the authorization with the
regional
>> Tricare contractor. Once an authorization is granted, the
contractor
>> will
>> also issue service beginning and ending dates for medical or surgical
>> services. For behavioral health authorizations, the contractor
will
>> specify a certain number of visits, in addition to the beginning and
>> ending dates. All authorized care must be received before the
>> authorization's end date. If not, your provider must acquire a
new
>> authorization. Additional authorization rules may apply, so it's
best to
>> call your regional Tricare contractor if you have questions.
[Source:
>> NAUS Weekly Update 13 Jun 08 ++]