Can the MTF request referrals for a longer period of time?
Some referrals designated by the MTF will be valid for a 365-day period, allowing the beneficiary to receive the appropriate care from the civilian specialty provider without requiring new referrals as often. You may notice that your referral/authorization approval letters from TriWest may have varying valid timeframes depending on: • Whether a beneficiary is assigned to an MTF vs. civilian PCM • Whether an MTF may choose to use the usual 180-day period or the 365-day option for certain services • The types of services approved Providers should always review the “Valid Dates” in their referral/authorization approval letters to avoid having claims paid under the POS benefit or being denied.
