TRICARE August 2025 Provider Pulse

Authorizations Issued Prior to January 1 Expire September 30

On September 30, 2025, authorizations issued before January 1, 2025, by former contractors for states in the current West Region will expire.

TriWest is currently accepting referrals and authorizations issued prior to January 1, 2025, through their expiration or Sept. 30, whichever comes first.

Effective October 1, standard referral and authorization requirements apply.

Please review your patients' current referrals and authorizations to identify those that need a new one issued by TriWest for care beyond September 30. Failure to obtain new referrals or authorizations by that date could lead to interrupted care or coverage issues for your TRICARE patients.

Please be sure to:

• Review patients' current referrals and authorizations and identify if they are from a previous contractor (not TriWest). If so, you’ll need to obtain a new referral or authorization through TriWest for care beyond September 30.
• Review the referral and authorization guidelines on the TRICARE website.
• Obtain new referrals and authorizations to avoid interrupted care or coverage issues for your patients.
• Act Now: Go to TriWest’s online referral management system in Availity, within TriWest’s TRICARE Payer Space, to submit your referral or authorization request before September 30.

If you are not a network provider, please consider joining the network. Visit https://joinournetwork.triwest.com/ to sign up.

Availity Account Required for TRICARE Referrals and Authorizations

The fastest and most efficient way to submit and view TRICARE West Region referrals and authorizations is through the secure provider portal, Availity. To ensure continued care for your patients, you will need to join our provider portal on Availity if you haven’t already done so.

In addition to submitting your referral and authorization requests using the online referral management system or alternative referral and authorization form, there are several benefits of joining Availity, including:

• Determine if a referral or authorization is needed using the Referral and Authorization Decision Support (RADS) tool.
• Access the TriWest Learning Center.
• Submit claims and claim documents.
• Update your data in the provider directory.
• Find resources and quick reference guides.
• See key announcements to stay updated.

Get started in two easy steps:

1. Register – Visit Availity to create your free account, enroll in training, and find other helpful resources. To help walk you through this process, explore the How to Register as a New User Quick Reference Guide.
2. Complete recommended training courses on Availity under “Help and Training” in the upper, right corner. There are a variety of training types including:
1. Webinars – live, interactive virtual classes where providers can ask questions in real time.
2. Microlearning videos – short, bite-sized video snippets that cover various aspects of TRICARE.
3. eSeminar Learning Paths – Microlearning based on a variety of topics that, when viewed consecutively, form a complete eSeminar; think of microlearning as individual songs and the Learning Path as the playlist.

Once you’re logged in, check out the Introduction to the Provider Portal Quick Reference Guide.

Need additional registration assistance? Call Availity Client Services at 1-800-AVAILITY (282-4548) Monday through Friday 8 a.m. - 8 p.m. ET.

DHA Launches Survey on TRICARE Select Civilian Providers Awareness

Civilian medical providers are an integral component in providing care outside of the military, and as a TRICARE provider, you may receive the TRICARE Select Survey of Civilian Providers. This short survey gathers information about civilian provider awareness and acceptance of TRICARE Select health plans.

The objective of these surveys is to evaluate and monitor satisfaction levels, as well as access services provided under the TRICARE Select health plans to uncover problems and implement changes.

By law, the Defense Health Agency (DHA) must conduct ongoing surveys of both beneficiaries utilizing health care services and providers offering care to those covered by the Military Health System (MHS).

If you receive this survey in the mail, submission instructions will be outlined in the cover letter. The survey is mailed to network providers, and can be returned via mail or fax, or submitted online.

Your participation is greatly appreciated and will contribute to our understanding of the healthcare landscape available to this patient population!

TRICARE Provider Handbook Updates

There are currently no updates to the TRICARE Provider Handbook.