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Changes to TRICARE referral system

COLORADO SPRINGS, Colo. -- Some patients in the Colorado Springs area have experienced delays in the processing of referrals to care outside of the military treatment facilities of Evans Army Community Hospital, 10th Medical Group at the U.S. Air Force Academy, and 21st Medical Group serving Peterson and Schriever Air Force bases since the April 1 transition between TRICARE contractors. UnitedHealthcare Military & Veterans, the new TRICARE contractor, is now allowing patients with referrals from April 1 through at least May 17 to obtain care without a UHC M&V authorization for care.

That means that local TRICARE beneficiaries recently seen in a military treatment facility who are waiting for such an authorization can obtain care from a civilian provider as long as the referral is for a TRICARE covered benefit and not previously denied by UHC M&V. If UHC M&V has already provided an authorization for specialty care, patients should obtain care as instructed in that authorization letter.

Beneficiaries can now call a specialty provider directly to make their appointment, but will need to visit their local medical facility's TRICARE Service Center to obtain a copy of the original referral and a letter from UHC M&V to the specialty provider indicating UHC M&V's willingness to reimburse the provider for the care. Should patients need assistance in locating a provider, the military hospital's TSC can help or patients can go online at www.uhcmilitarywest.com.

For referrals beginning May 7 and continuing until UHC M&V resumes management of all referrals, patients will receive letters from the military treatment facilities via the Colorado Springs Central Referral Center with a copy of the information that local providers will require in order to provide the requested care, including pertinent clinical and administrative information as well as instructions on where to send the results. Additionally, the letter will provide a list of some local providers able to provide the requested care as a convenience to patients. As always, urgent referrals will be made at the time of the visit with providers.

Your local military hospitals regret any inconvenience that these delays may represent. Patient advocates are available in each facility to address individual concerns if beneficiaries continue to experience problems in obtaining care.

Questions for all referrals between April 1 and May 6 are best resolved at the local TRICARE Service Centers, conveniently located in each military medical treatment facility. UnitedHealthcare Military & Veterans customer call center can also be reached at 877-988-WEST.

For referrals created May 7 or later, patients will be contacted within seven business days by either phone or mail with information for their referral. If you are not contacted within that time period, call 719-524-CARE.

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