Documentation for Tricare Prime Active Duty Clients
A referral from Tricare is required when working with Tricare Prime Active Duty clients when the actual active duty member is the IP. No referral is needed for Tricare Select Active Duty, retired service members, or the spouse of a Tricare Prime Active Duty member.
The Support Team usually collects and adds the referral to the client’s file before the intake. The referral lists the number of sessions allowed and the client’s Military Treatment Facility (MTF) to which the clinician must report.
To know if a client is a Tricare Primce Active Duty member, the support team will add a note in the Admin Reminders and set the Payer to Tricare (West) - IP Prime Active Duty.
Send Treatment Summary to Tricare MTF Facility
No more than 7 days after the intake appointment AND after discharge, clinicians are required to fax a treatment summary/discharge to the MTF. If the MTF calls you at any given moment during treatment, you’ll need to send a treatment summary to them ASAP.
- Use the “Treatment Summary - Tricare Prime Active Duty” template in the Template Gallery. The last four digits of the SSN are in the Referral doc.
- ROI is NOT needed - HIPAA guidelines do not apply.
- You can explain to your client that this is a requirement.
Learn how to fax here: Faxing.