Consult and Treatment Reports Help Providers, Beneficiaries

Consultation and treatment reports help facilitate continuity of care for all TRICARE beneficiaries. In addition, having a complete medical record is necessary for the military to assess "combat readiness" and "fitness for duty" of troops. To help the Service branches, both civilian and Military Treatment Facility (MTF) referring providers need timely feedback to properly manage their patients’ care, including active duty Service members (ADSMs), retirees and their family members.

TriWest would like to stress the importance of getting consult reports back as soon as possible for ADSMs as they may be unable to deploy until the consult reports are submitted. To help you in this effort, TriWest has created a consult report tracking system to assist the MTF with receiving and tracking the reports.

For your convenience, TriWest provides a fax cover sheet that you can use to fax your consult reports. This fax cover sheet is the last page of the referral/authorization approval letter that is faxed to the servicing provider. Using this cover sheet and faxing to the referring provider fax number pre-populated on your fax cover sheet will streamline the return of your consult reports to the referring provider.

It is also important to remember to fax only one consult or treatment report at a time; sending in several reports within the same fax can cause unnecessary delays in the return of your consult and treatment reports to the referring provider. When multiple reports are sent on one fax, TriWest must manually separate the reports and refax them to create separate electronic files.

Please submit your consult or treatment report within 10 days after the patient’s initial appointment. By submitting your report to TriWest after the initial appointment, it will eliminate the follow up phone calls, letters, and e-mails from TriWest seeking your report. For urgent care, the preliminary report should be submitted within 24 hours.

Both providers and TRICARE beneficiaries benefit when consult tracking reports are submitted in a timely manner, as noted below:

• Improves the patient’s quality of care
• Improves the patient’s continuity of care
• Assesses the ADSM’s combat readiness and fitness for duty
• Ensures all consult and treatment reports are received and routed to the referring provider for all beneficiaries (ADSMs, retirees and their family members)
• Archives consult and treatment reports electronically
• Provides referring provider access to archived reports, decreasing duplicate report requests from the servicing provider
• Decreases unnecessary work for servicing and referring providers

For more information about the consult and treatment report tracking process, refer to the Provider Handbook. The online version of the Provider Handbook is available in the Resource Library section of www.triwest.com/provider. You may also call TriWest at 1-888-TRIWEST (888-874-9378).

Published Date: 09/02/2010