We treat a lot of soldiers, and many are confused with their healthcare benefits. Here we present a simple and easy to follow guide to obtaining specialist care.
Most service members and their dependents would probably agree that TRICARE is one the most confusing benefits offered by the military. The information provided in this blog is to help you understand your benefits, but is not in any way meant to take the place of your TRICARE representative. All members of TRICARE should consult their TRICARE rep before making any medical decisions.
With TRICARE, most of your health care will come from a military treatment facility, along with the TRICARE contracted civilian medical provider. When health care services are needed, your primary care manager (PCM) will see you first. Your PCM’s duties are to provide and/or coordinate your care, maintain your health records and refer you to specialists, if necessary. It is very important that you understand that in order for your specialty services to be covered by TRICARE, the specialty care must be arranged and approved by your primary care manager. Care may be provided in a military treatment facility, but civilian clinics may be used in some cases.
It is always advised that all TRICARE members seek the advice of their PCM before seeking medical attention from any specialists or other medical facilities. Below you will find steps to help you get an appointment to see your podiatrist or any other specialist that you may need to see. Step 1:
You will need to see you PCM for a referral to the specialist needed. Step 2:
The referral team within the Military Treatment Facility will check to see if there is a specialist appointment available at your Military Treatment Facility or nearby Military Treatment Facility. Step 3:
If the referral team finds that there are no specialists available in the Military Treatment Facility, the referral team will contact health net to arrange for a referral to a civilian specialist. Step 4:
Health net will find a civilian provider who is conveniently located to you. Step 5:
Health net will send you a letter that will include the doctor’s name, address and telephone number. It his highly recommended that you make sure that your information in DEERS (Defense Enrollment Eligibility Reporting System) is up-to-date. The contact information located here is what will be sent to your specialist, and this is information will be used by your specialist to contact you for your appointment. Step 6:
Your referral will have an expiration date. If you do not receive a call from your specialist with in 5 to 7 business days, you should contact the specialist at the number provided to you in your referral letter. Step 7:
If your appointment has been scheduled and you cannot keep or wish to change the date of your appointment, please call the specialist to reschedule your appointment, then notify TRICARE of your new appointment date. Step 8:
Certain services or procedures performed by a specialists may require prior authorization. Prior authorization can be obtained from your PCM.
TRICARE is in place to serve the active duty service member, National Guard and Reserve member, retires, and their families. TRICARE brings together the health care resources of the uniformed services and civilian health care professionals to provide you and your family access to high quality health care services. The information provided in this blog is our effort to arm you with the knowledge to help you take care of yourself and your family. We at Atlantic Foot & Ankle Specialist take great pride in serving you, our service members as you have served us. For further billing information you can contact our billing department at 912-201-1764 or your local TRICARE representative. To check the status of a TRICARE referral call 1-800-444-5445 or log on to www.humana-military.com TRICARE Information Line: 1-800-538-9552 Winn Army Hospital & Tuttle Army Clinic: 912-435-6633