Select your view:
What is the difference between an authorization and a referral?
When your Primary Care Manager (PCM) cannot give you the treatment you need, he or she refers you to a specialist. The PCM must then file the referral with TRICARE.
An authorization is different from a referral. TRICARE must authorize certain medical treatments before you can receive them. The doctor who is going to provide the treatment must seek the authorization from TRICARE.
Please note: Authorizations do not guarantee payment. They simply document the medical necessity of the treatment. Authorized medical care must still follow all government program guidelines.
Your TRICARE network doctor should be aware of procedures or circumstances that must have referral or authorization. When in doubt, please ask your doctor if you need a referral or authorization.
BACK