Referrals and Pre-Authorizations
A referral is when your primary care manager or provider sends you to another provider for care that they don’t provide.
An authorization is when TriWest Healthcare Alliance approves your care before you go to your appointment. When referred, your provider will get you a referral and pre-authorization (if required) at the same time. You’ll receive an authorization letter from TriWest letting you know what steps to take next.
Does my service require a referral or pre-authorization?
For care on or after Jan. 1, 2025, use the TriWest Referral and Authorization Decision Support tool (Coming soon!) to learn which of your services need referrals. Log in to the West Region beneficiary portal now and access the tool to manage your care.
Will my ongoing care be affected with the change in regional contractor?
Starting Jan. 1, 2025, TriWest is the new regional contractor for the TRICARE West Region.
Do you have current and ongoing care that was issued before Jan. 1, 2025? Don’t worry! These referrals and pre-authorizations are valid through their expiration or June 30, 2025, whichever comes first for you.
How can I view my referrals and pre-authorizations?
You can view your referrals and pre-authorizations by creating an account through the West Region secure beneficiary self-service portal. On the portal on or after Jan. 1, 2025, you’ll be able to:
- Manage your care.
- View your pre-authorization and referral details, update your address, and find out if your care needs a referral.
- Enroll in a Clinical Care Support Program.
- View your eligibility and enrollment information.
- Find a network provider for your care.
Last Updated 1/15/2025