Frequently Asked Questions (FAQs)

Q: How do I submit an authorization request to TriWest Healthcare Alliance?
A: The preferred and most expedient way to submit an authorization is to upload the 7078/7079 with the SF 513 Consultation and any other supporting documentation to the VA Portal. Fax is also acceptable. Please upload or fax the 7078/7079 and SF 513 Consultation (and medical documentation if applicable) as one full document with the 7078/7079 as the first page.

Fax number: 1-866-244-6002
Q: How do I upload an authorization on the VA Portal?
A:
Q: Is there search functionality on the VA portal?
A: Yes. You can search by Social Security Number (all 9 digits), the VA Authorization number and by a date range. You can also sort columns by clicking the column header.
Q: What is a Secondary Authorization Request (SAR) and what do I do with it?
A: You can go to detail “pop up” and click on the “Look Up Clinical Submission” button. There you will find the SAR form and other appropriate documents for you to review.

Within 5 business days, TriWest will need a response of one of the following so that we can communicate your decision to the network provider: *If approved to the network, TriWest expects a new 7078 or 7079 as indicated.

Currently, your responses can be uploaded to the VA Portal or faxed to 1-866-244-6002. The "easiest" way, is to use the SAR form TriWest sent you with a cover sheet that contains your response.
Q: What happens if I need to request multiple specialty appointments for a Veteran?
Example: A diabetic patient that is in need of a podiatry appointment for a diabetic foot exam and ophthalmology for a diabetic eye exam.
A: Two separate authorizations are required in situations like this.
Q: Can I submit an authorization for services for greater than 365 days?
A: No. In general authorizations should have a validity date of 90 days. There are exceptions for authorizations with a validity date greater than 90 days. Maternity care is one example. Chemotherapy can also exceed 90 days if necessary. In some cases, an authorization may be submitted for less than 90 days.
Q: If I submit a 7078/7079 how long does it take before TriWest can see the request?
A: Once submitted (faxed or uploaded) the request goes through a system process which displays the information in a task list which is then worked by our staff. This process can take up to 20 minutes.
Q: What types of documents should NOT be uploaded to the VA Portal?
A: At this time, PEG, radiology disks or films cannot be uploaded to the VA Portal. Acceptable document types are PDF and TIF with a maximum size limit of 5MB.
Q: Can I submit more than one authorization request for a Veteran or multiple Veterans at a time in a batch fax or upload?
A: TriWest prefers that you do not send faxes or upload in batches. Submissions sent in batches can delay data entry, as TriWest staff must sort the batched documents into separate files to be entered and eventually displayed on the Provider Portal. If you do fax or upload authorizations in batches, it is helpful if you place a separator sheet between each authorization to help TriWest separate the documents.
Q: Do I need to submit a new authorization if the Veteran declined the original appointment or was a "no show?"
A: It depends on the status of the authorization. Contact TriWest 1-855-722-2838 to have a representative assist you.
Q: Should the network provider submit medical documentation directly to VA? What if VA gets it and TriWest does not?
A: No. Network providers should send medical documentation to TriWest in order to get their claims processed for payment. TriWest is happy to reach out to any providers who submit medical documentation to the VAMCs to clarify submission processes.