Referral Management

When your provider submits a referral request to a specialty clinic, it is reviewed by the TRICARE Service Representative before being approved. Your PCM does not authorize or approve referrals or services—that is done under the TRICARE business rules after your provider has determined a need and made a request. The business rules require that a specialty appointment be arranged within 28 days of the request, unless your provider determines that you need to be seen sooner. When your specialty appointment has been approved, the referral office will notify you by phone or letter, so it is important to confirm that your personal contact information is up to date. The front desk staff or TRICARE service desk (located on the first floor of the Ft. Sam Houston clinic) can help you validate your information and contact numbers.

In some cases, the specialty appointment may be either at the Wilford Hall Ambulatory Surgical Center on Lackland Air Force Base or with a TRICARE network provider off base. To check the status of your referral, or if you must cancel or re-schedule a specialty appointment, please call Central Appointments at (210) 916-9900 option 3.