Q&A: Getting and Using Referrals With TRICARE

[Tony]

FALLS CHURCH, Va.  –  You’ve likely heard the term “referral” in connection with health care. But what exactly is a referral—and how do you know if you need one? A referral is when your primary care manager (PCM) or primary care provider sends you to another provider or specialist for care.
 
“When you receive a referral for care, your provider has determined the care will benefit your health,” said Tonya Utterback, referral and authorization expert with the TRICARE Health Plan at the Defense Health Agency. “Once your referral is approved, it’s important to use it in a timely manner. For example, if you’re referred to a cardiologist to evaluate a heart problem, diagnosing and treating the problem as soon as possible may result in a better health outcome.”
 
Read on to learn when you need a referral and helpful tips for using them.