FAQ: Mental health referrals

  • Published
  • By Mental Health Flight
  • 341st Operational Medical Readiness Squadron

This past year and a half came with plenty of its own hurdles on top of unique military challenges from deployments, family separations, long hours and missile field tours. Yet, stress doesn’t always cause mental health issues because resilience, social support and coping skills can help us manage it.

When one does have prolonged stress, anxiety or depression, what resources are available to military members and their families? The answer is a long list: Military One Source, the on-base Mental Health clinic, Military and Family Life Counselors, Behavioral Health Optimization Program, Airmen and Family Readiness Center, and off-base counselors.

Referrals are a great resource, but they can also be confusing. Our goal is to answer some common questions and address common errors about mental health referrals off base.

1. How do I get a mental health referral?  

For any beneficiary, both active duty and dependent, the process is the same. A referral can be requested by your primary care manager. Additionally, dependents have the added benefit of seeing a MH provider in the local area that is networked with Tricare, without an initial referral, until subsequent referrals are needed.

2. How can I check if I have a referral?  

Both active duty members and dependents can look up their Health Net approved referrals on www.tricare-west.com.

3. What if my referral expired or I need more visits?

Ultimately, the responsibility of keeping track of referrals or authorizations lies with the beneficiary. Unfortunately, it is difficult and rare to backdate referrals or cover expired referrals. Please keep track of expired referrals on https://patientportal.mhsgenesis.health.mil. When you are running low, get with your PCM or the provider that entered your referral.

4. Where can I find a list of networked Tricare providers?

Visit www.tricare-west.com in the “Beneficiary Portal” under “Network Provider Directory.” There is a quick-search tool using the health specialty and zip code, where you can find local off base providers’ names, phone numbers and addresses.

5. What can I expect with an off-base mental health provider?

The care you receive and your experience varies provider to provider. Finding a therapeutic relationship that fits your needs takes time and sometimes takes trying different providers before you find the right fit. Always advocate for yourself and let your providers know your concerns.

6. What is covered?

A variety of therapeutic techniques and treatment levels are covered. Visit www.tricare-west.com and click on “Covered Services” on the top banner for more information.

7. Will off-base mental health care affect my career?

Mental health care has the ability to improve many symptoms, increase productivity, elevate relationships and improve overall functioning. Overall, mental health is more likely to improve your career than to harm it because when we feel better, we work better. Any medical care can possibly place a service member on a profile depending on the situation, which can limit mobility or duties temporarily. If you are concerned about career impact, speak to your provider about these concerns.

8. What are some common referral errors?

According to Malmstrom Tricare Operations and Patient Administration, common errors they see that can cause unexpected costs are not keeping track of expired referrals, asking a provider “do you accept Tricare?” versus the correct verbiage of “are you an in-network Tricare provider?” and verifying on www.tricare-west.com. Additionally, seeking care that is not covered can make it difficult to reimburse beneficiaries and in many cases, the beneficiary is responsible for the medical bill. Always consult with your referring provider on the type of care you will be receiving and verifying your referral or “authorization” details in www.tricare-west.com.

Although the referral process can be complex, there are additional resources that can help you navigate your referrals including:

- Health Net Federal Services at 1-844-866-9378

- TOPA, your PCM, or referring provider: 406-731-4633

- If your referral came from the on base mental health clinic: 406-731-4451

- www.tricare-west.com FAQs