TRICARE referrals, specialty care

  • Published
  • By Tyler Patterson
  • TriWest Healthcare Alliance
Has your primary care manager (PCM) decided that you need to see a specialist? Getting the care needed is just four simple steps away:

1. Get a referral
For TRICARE Prime beneficiaries who needs specialty medical care, those people will need to get their PCM to submit a referral request. If they use TRICARE for Life, TRICARE Standard/Extra, TRICARE Reserve Select or TRICARE Retired Reserve, they don't need a referral to see a specialist, although they may need a prior authorization for some services. Call TriWest at 1-888-TRIWEST (874-9378) to find out.

2. Wait for the authorization letter to arrive
Good news: There is a way to shave a few days from the process in this step! Register for paperless authorization letters at and the beneficiary will receive the authorization letter electronically within 24 hours of TriWest authorizing the referral. If the beneficiary isn't registered, they'll receive the letter in the mail about a week after the referral is authorized.

3. Set the appointment
Either schedule an appointment with the specialist referred to, or use the Provider Directory at to find another TRICARE network provider. Remember to call TriWest and let us know who the new provider will be if the beneficiary uses the Provider Directory to find a different specialist.

4. Notify TriWest at 1-866-876-2383
To help manage care, it's important that the PCM receives the consultation or treatment records from your specialist quickly. TriWest can help with scheduling appointments. Be ready to have the appointment date, tracking number and Sponsor's Social Security Number ready. Don't forget to let us know if the appointment date changes.

That's all there is to it! The only thing to do after letting TriWest know about the appointment date is to go to the appointment.

Want to make things even more convenient? While signing up for electronic authorization letters at, don't forget to check out our other online features like paperless claims, paperless explanation of benefits statements, online enrollment fee payments and more!