Most of the providers in our office are in-network providers with TRICARE plans. This means that we submit claims to TRICARE, and receive reimbursement directly from TRICARE for covered services according to the terms of your benefits plan.
It also means that we accept whatever fee reduction/discount TRICARE may impose, according to the terms of our provider contracts with TRICARE. You are not balance-billed for the difference between our usual fee, and the reduced fee allowed by TRICARE. You are financially responsible for any co-payments/co-insurance, deductibles, and non-covered services.
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Except for active duty service members, TRICARE Prime beneficiaries no longer require a referral or prior authorization for outpatient, office-based behavioral health visits when rendered by a network provider. This includes:
- psychotherapy visits (individual, family, collateral, group), including those beyond the initial eight
- psychological testing
- neuropsychological testing
TRICARE Standard beneficiaries may self-refer for the above-listed outpatient, office-based behavioral health visits to a network or non-network provider. TRICARE Standard beneficiaries who choose to use network providers may save five percent on their cost-share.
Active Duty military can request a referral from their PCM to receive services from any provider in our group.