by Kenneth Humphries
10th Medical Support Squadron
8/21/2009 - U.S. AIR FORCE ACADEMY, Colo. -- TriCare Prime beneficiaries are now authorized a single visit to an urgent care clinic without prior approval from their primary care managers when traveling outside the local area.
The local area is defined as a 100-mile radius of the 10th Medical Group.
The beneficiary must ensure the clinic accepts TriCare Prime. Beneficiaries may contact TriWest at 888-874-9378 or online at http://www.triwest.com to find urgent care providers that accept TriCare Prime. If the urgent care clinic does not accept TriCare Prime, care is not authorized, and the beneficiary may be held responsible for payment.
Authorization will be allowed for each beneficiary covered by TriCare Prime, one time per travel episode. Once seen, the patient or guardian must contact his PCM to set up any needed follow-up appointments upon his return to the local area.
This benefit streamlines access to care for beneficiaries outside the local area. This does not include urgent care authorization for patients in their local area. Patients must still contact their PCMs for authorization and referral to be seen at an after-hours urgent care clinic in their local area.
If you have any questions about this new benefit, call Glenda Philips of the 10th Medical Support Squadron at 719-333-5281.