Appointments and Referrals
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Referrals
What is the Referral Management Office?
The referral management office is responsible for facilitating the referral process for all Active Duty Service members and TRICARE Prime beneficiaries enrolled to a Military Treatment Facility (MTF) on Fort Campbell, Kentucky. The referral team will help facilitate the referral process for all Active Duty Service members and TRICARE Prime beneficiaries enrolled to a Military Treatment Facility (MTF) on Fort Campbell or the Screaming Eagle Medical Home located in Clarksville, Tennessee.
Referrals are requests for specialty services or procedures that are not considered primary care. This includes urgent care that is not provided by the Primary Care Manager (PCM). Exceptions include emergency care, certain preventive and diagnostic services, and the first eight (8) behavioral health visits.
What is the Referral Process for TRICARE Prime at the MTF or Direct Care System?
Your PCM or specialty provider enters a referral into the military health system at your MTF. If the specialty is available, the clinic will contact you to schedule an appointment. If the specialty service is not available, your referral will go to the referral management office for processing to the network. Within seven to 10 business days, you should receive an authorization letter with instructions on scheduling an appointment with a civilian specialist. The patient may call Humana Military at 1-800-444-5445 for assistance before actually receiving the letter. The patient may then contact the civilian specialist’s office to schedule an appointment. The access-to-care (ATC) standard for scheduling an initial appointment for routine specialty care is 28 days.
Urgent specialty referral requests are coordinated doctor-to-doctor.
What is the Referral Process for TRICARE Prime in the Network and TRICARE Prime Remote?
Civilian Primary Care Managers send a Humana Military Health System (HMHS) TRICARE Service Request/Notification electronically to Humana Military. The form is available on the HMHS website at https://www.humanamilitary.com.
HMHS enters the referral into their system and then forwards it to the BACH Referral Management Center, which enters it into the military system. The appropriate specialty clinic reviews the referral entry. BACH has Right of First Refusal (ROFR) for all referrals. If the specialty care is available at BACH, you can schedule an appointment by calling the specialty clinic you are referred to. Please wait at least seven (7) business days before contacting HMHS at 1-800-444-5445 for the disposition of the referral.
If the specialty care is not available at BACH, Humana Military Health System will inform you when you make the call that the care is being deferred to the civilian network, and the referral will be processed by HMHS. Within 7-10 business days, HMHS will send you (the patient) an authorization letter with instructions on scheduling an appointment with a civilian specialist. You may call HMHS at 1-800-444-5445 for assistance before actually receiving the letter. The patient may then contact the civilian specialist’s office to schedule an appointment. Please remember that the access-to-care (ATC) standard for scheduling an initial appointment for routine specialty care is 28 days.
Alcohol and Substance Abuse Program (ASAP) or urgent specialty referral requests are coordinated doctor-to-doctor.
What is the Referral Process for TRICARE Extra/Standard, TRICARE Reserve Select, TRICARE Plus & TRICARE For Life (TFL)
Patients who are not enrolled in Prime (non-Prime) do not require referrals for most specialty care or certain diagnostic services (such as an MRI) if the referral is from a civilian provider. Patients with Other Health Insurance (OHI), such as an employer health plan or Medicare, must follow their plan requirements; a review will be performed at the time the claim is submitted to TRICARE after payment by the OHI.
Non-Prime patients may receive specialty care at BACH on a space-available basis; a referral request is needed.
The patient’s civilian doctor may fax a request for specialty or diagnostic services to the BACH referral management center at 270-798-8570. The referral management center enters the referral into the military system. The applicable clinic will review the referral entry.
If the requested specialty clinic at BACH does have space available, an appointment will be scheduled when the clinic calls the patient. If BACH does not have space available, the patient will have to choose a civilian specialist.
How Can I Contact the RMO?
To verify a referral status, contact the BACH Referral Management Office at 270-798-8421 or 270-956-0613.
For assistance with referral concerns, please call 270-798-8421 or 270-956-0613, or email USARMY.CAMPBELL.MEDCOM-BACH.MBX.BCACDCAO@MAIL.MIL.
What is My Service Region?
Eligible beneficiaries located within a 40-mile radius around Fort Campbell will be enrolled in the TRICARE East Region.