Attention TRICARE Beneficiaries! If you live in the TRICARE West Region (Colorado is part of the TRICARE West Region), or in a state or ZIP code moving to the West Region and you pay an enrollment fee or premium by recurring credit card, debit card, or electronic funds transfer, you must set up payment information with TriWest before Dec. 31, 2024. If you don’t take action, you’ll risk getting disenrolled. Learn more

Patient Resources

Referral Support

Referral Process Explained

We have developed a complete Referral Guide to help guide you through the referral process in the Colorado Market. Due to the uniqueness of our market, you may be referred to one of the military hospitals or clinics within the Colorado Market, or to a TRICARE network provider. These are the steps you need to take:

Step 1

If your care can be provided at a military specialty clinic, Colorado Patient Access Services (PAS) will contact you within 3 business days, to book your appointment. If you don’t get a call within 3 business days, please contact us.

719-524-2273

Monday–Friday: 6:00 a.m. to 4:30 p.m. MST

Three attempts will be made to contact you by phone. If unsuccessful, you will be notified of your referral through the MHS GENESIS Patient Portal. You will be notified via email about this message as well.

Step 2

If you’re enrolled in TRICARE Prime or TRICARE Select, and referred to a TRICARE-authorized provider off-base, Health Net Federal Services will help you with your request at www.TRICARE-West.com.

Sign up to receive text and/or email alerts for status of your referral. Click on “Beneficiary” under the “Register” tab.
Once your referral is approved, you can view, and print your authorization letter. It will include contact information for your authorized provider. This may take up to 7 business days.

Note: Authorization letters are no longer mailed to home addresses unless you request for each referral.

1-844-866-9378

Monday–Friday: 6:00 a.m. to 10:00 p.m. MST

Step 3

If you have other health insurance (OHI) or Medicare, TRICARE is the secondary payer, ONLY after a claim is filed with primary insurance. Be sure to let the doctor’s office know you OHI or Medicare as well as TRICARE. If you have questions, please contact the Referral Management Center for assistance.

Referral FAQs

Q: How can I access my authorization?
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.
Q: How many visits does my authorization cover?
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.
Q: When does my authorization expire?
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.
Q: Can you fax my referral to my 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.
Q: My provider needs procedure codes (CPT) added or changed. Can you do that?
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.
Q: What are my options to receive an off-base referral for specialty care?
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
Q: If I’m referred to a Colorado Military Health System (CMHS) military hospital or clinic, how do I get it released?
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).
Q: How long does it take for a referral to be processed?
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.
Q: What do I need to do to activate my referral?
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.
Q: Where can I call to get more help with my referral?
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.
Q: How do I get a second opinion?
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.
Q: Can I change my off-base referral to a different provider?
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.

Contact Us

Phone

Referral Management Center (RMC)

719-524-1006, 719-524-1009, or 719-524-1007

Health Net Federal Services

844-866-9378

RMC Fax

719-570-6360

Locations

Main Clinic

4102 Pinion Drive
Air Force Academy, CO 80840

Behind the Beneficiary Services office window just past the Pharmacy

MHS GENESIS Patient Portal Name

USAF Academy Referral Management

Helpful Links

Don't forget to keep your family's information up to date inDEERS!