Network Provider Referrals
What paperwork is required for civilian hospitals, clinics or providers outside Military Health System after receiving a referral from a Military Treatment Facility?
When the military treatment facility refers a patient to a civilian network provider, Clear and Legible Reports (CLR) must be submitted by the network provider within two business days from the encounter.
I am a network provider who has seen an Active Duty Service members or TRICARE Prime beneficiaries enrolled to a Military Treatment Facility (MTF) on Fort Campbell, Kentucky, when do I send in my records?
Urgent care center CLRs must be submitted within
two business days of the encounter and shall include the patient’s encounter specifics (histories and physicals, progress notes, notes on Episodes of Care (EOC), other patient information (laboratory reports, x-ray readings, operative reports) and discharge summaries. In addition, the report will include any referrals made during the urgent care visit.
Specialty care CLRs are due within
seven business days of care delivery and include consultation reports, operative reports and discharge summaries.
Behavioral healthcare network providers must submit brief initial assessments within
seven to ten business days. Network providers must follow the instructions included on the referral authorization for Humana Military.
What fax number do I send my CLR to?
1-877-813-1754
Where can I find the TRICARE Provider Handbook East Region 2021?
Open the following link to the
TRICARE Provider Handbook East Region 2021.