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Specialty Care Authorization and Referral Process

Has your Primary Care Manager (PCM) decided to refer you for specialty health care? Using QuickAlert, TriWest’s automated authorization and referral status notification system, you can receive your notice and schedule your appointment within a day of TriWest processing the request, shaving 7-10 days off of waiting for notification by mail.

Just follow these five easy steps:

  1. Obtain a referral request. Your PCM will send this to TriWest.
  2. Register on www.triwest.com, or just log in if you’re already registered. Registered users are automatically enrolled in QuickAlert.
  3. Set your QuickAlert preferences. Once logged in to your secure www.triwest.com account, change your QuickAlert preferences. You can choose to receive your QuickAlert notifcation by e-mail or by phone. New to your QuickAlerts are claims notifications.
  4. Schedule your appointment once you receive a QuickAlert notice that your referral is approved. Use the recommended provider, or select a provider of your choice from TriWest’s provider directory.
  5. Notify TriWest at 1-866-876-2383 of your appointment. Have your appointment date, tracking number and Sponsor’s SSN ready, and remember to notify TriWest again if you reschedule your appointment. TriWest will then help to ensure that your consultation and test results are returned to your PCM in a timely manner.
QuickAlert is free to use and does not disclose any confidential or protected health information; it simply lets you know the status of your request is available for viewing online. Once you log on, you’ll be able to see whether your request for authorization or referral has been approved. For your convenience, e-mail notifications contain a direct link to the login page.

Whether enrolled in QuickAlert or not, you will continue to receive written notification by standard mail. As always, you are welcome to contact TriWest at 1-888-TRIWEST (874-9378) with any questions about your authorization, referral or claim status.

Published Date: 12/15/2008