Frequently Asked Questions (FAQs)

A: Your referral authorization is only accessible through the TRICARE-West Online Portal. Use the same MHS GENESIS Patient Portal DS Logon to log in TRICARE-West. For a video explanation on how to set up your DS logon, access your authorizations, and other useful pages, visit: https://vimeo.com/451369629.

Your referral authorization will not be mailed to you unless you are 65 or older, or enrolled in Medicare. Only beneficiaries enrolled in TRICARE Plus (Age 65+/Medicare+ at the military hospital or clinic) will receive a letter about their referral.

These authorizations will be used to find (location/phone #) where to book your specialty care appointment, or obtaining Durable Medical Equipment. 

A: The number of visits authorized on a referral can vary. The number of visits authorized can be found on your authorization document. See page 16 of the Referral Guide. Many referrals are written with one evaluation visit and additional visits for treatment. For example, if you need a diagnostic visits, such as MRIs or Mammograms you are authorized one visit. While, a referral to Neurology or Cardiology may include an authorization for one evaluation visit, and follow up visits for treatment.

A: Referral authorizations can range from 30 days to 365 days. However, a large majority of referrals cover 180 days of treatment. This information can be found directly on the authorization document. See page 16 of the Referral Guide. When your referral expires, a new referral will need to be written by your primary care manager (PCM) or the referring provider.

A: Referrals for TRICARE Prime patients are faxed by Health Net Federal Services to the assigned provider. If the referral has not been received by your provider, contact Health Net Federal Services (1-844-866-9378) to let them know that the office has not received your referral. If you’re not getting adequate assistance, or there are continued problems with the receipt of the referral, contact the Referral Management Center at 719-333-5752 or on the MHS GENESIS Patient Portal.

A: We can’t adjust the procedure codes generated on a referral authorization. To add or change your procedure codes, please ask the referred provider to contact Health Net Federal Services (1-844-866-9378). If these actions are not successful, please contact the Referral Management Center at 719-524-1006, 719-524-1009, or 719-524-1007. You can also reach Referral Management on the MHS GENESIS Patient Portal.

A: if you are a beneficiary enrolled in TRICARE Prime, you will first be referred for care within a Colorado Market military hospitals and clinics, if the specialty service is available and within access to care standards. Each referral is reviewed for capability and continuity of care to establish history of care with an off-base provider. If you haven’t seen the provider in more than three months, or if there are no other compelling continuity reasons, you’ll be sent to a Colorado Market hospital or clinic. You may choose to use your TRICARE Prime point-of-service (POS) option to visit a specialist in the network. If you decide to use the POS option, expect to pay extensive out of pocket costs. For more information, visit: https://www.tricare-west.com/content/hnfs/home/tw/bene/claims/pos.html

A: You will be referred to a military hospital or clinic within the Colorado Military Health System (CMHS) first. You will only be referred to a TRICARE network provider in specific situations. We recommend that you go to your appointment with a specialist at the CMHS hospital or clinic to discuss your care options. You may also choose the point-of-service option, as described in the previous question (#6).

A: Referrals that are kept within our hospital and clinics are processed within 1-2 business days. This allows you to make an initial appointment within 2-3 business days. Referrals that are sent off-base are processed within 3-5 business days. There are no follow up regarding the approvals off-base. It is crucial that you continue to check www.tricare-west.com after 3 business days, if not contacted for an appointment at our facility. From www.tricare-west.com, you may obtain the authorization and begin making your specialty appointments.

A: You do not need to activate your referral. Continue to check www.tricare-west.com after 3 business days for a referral, especially if you have not been contacted for by us for your appointment. You must make your own appointment if you were referred to an off-base provider.

A: If the referral has been sent to an off-base provider, we suggest that you contacts Health Net Federal Services for further assistance. The phone number to Health Net Federal Services is 1-844-866-9378. If the referral is for one of our hospital or clinics, contact the Referral Management Center at 719-524-1006, 719-524-1009, or 719-524-1007. You can also use the MHS GENESIS Patient Portal.

A: This depends on whether you were referred to, on or off-base. If the referral was originally for one of our hospital or clinics, contact the clinic directly to check if there are any other providers available to see you within our hospital or the Colorado Market. If unsuccessful, contact the Referral Management Center at 719-333-5752 for assistance. If you were sent off-base, a new referral will need to be written by the PCM requesting a second opinion. We suggest contacting the PCM through the MHS GENESIS Patient Portal to make your request.

A:  You can change your off-base referrals to a different provider if you have not used any visits on the referral authorization. In this case, you can contact Health Net Federal Services (1-844-866-9378), or follow the steps on page 17 of the Referral Guide, through the www.tricare-west.com beneficiary portal.

Call or visit your nearest Urgent Care facility if you have a non-life-threatening health issue. If you have a life-threatening health issue, call 911 immediately.
 

Call 911 immediately to get emergency care if you have a life-threatening health issue.
 

Call the Military Health System Nurse Advice Line to speak to a registered nurse about your health concern.

No. Call 911 in case of an emergency.
 

Yes. Call 719-526-7111.