Accessing Electronic Authorization Letters (West Region)

This article contains information specific to beneficiaries living in the West RegionAlaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (excludes Rock Island arsenal area), Kansas, Minnesota, Missouri (except St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (southwestern corner including El Paso), Utah, Washington and Wyoming.. Check the map to find your region.

Referrals and pre-authorizations serve a unique purpose. If you’re enrolled in TRICARE Prime, your primary care manager (PCM) handles your basic primary health care services. Your PCM may need to submit a referral for you to see a specialist for other treatment, like from a cardiologist or dermatologist. Some health services may also require pre-authorization before you receive them, regardless of your TRICARE health plan.

As a regional contractor, Health Net Federal Services, LLC (HNFS) reviews referral and pre-authorization requests submitted by your health care providers. HNFS posts electronic authorization letters to its secure portals for you and your providers to view.

Below are the answers to some questions about electronic authorization letters to help guide you through the process.

How can I check the status of a referral or pre-authorization request?

You can check status online. Log in with your DS Logon and click on “Authorization Status” in the “Secure Tools” box. HNFS also offers self-service prompts through its customer service telephone menu.

Be sure to allow HNFS 2–5 business days to process routine requests. It may take less time if your PCM determines the request to be “clinically urgent.” The PCM must mark it that way.

Sign up to get a text or email alert once HNFS has completed its review. Go to “My Account” and then “Manage Preferences.”

Where can I access my authorization letters?

Using the same “Authorization Status” tool, you can view and download electronic authorization letters. Look for the “View authorization letter” on the status details page. Download and read HNFS’ Authorization Status Tool Guide to learn more.

What information does HNFS include in its authorization letters?

Be sure to look for the following key items:

• Who requested the services. HNFS may list the clinic name only.
• The approved specialty provider. Keep in mind, TRICARE allows military hospitals and clinics to “accept” the care. This means HNFS may approve you to see a military provider, even if your PCM is in HNFS’s network.
• Patient details. This includes name, phone number, plan type, date of birth, and other patient details.
• What was approved. You’ll see what services were approved and for how long the authorization is valid. 

For more information, visit TRICARE’s Referrals and Pre-Authorizations and HNFS’ Check Authorization Status or Make a Provider Change.