Welcome

How to Submit an Authorization or Referral Request

Avoid extra work and first check if authorization is needed

  • Use our Prior Authorization, Referral and Benefit tool to check requirements. 
  • Certain ancillary services do not require separate approval and are considered to be included in an evaluate or evaluate and treat referral as part of an approved episode of care.
  • Certain limited benefits require a letter of attestation (LOA). Attach the LOA when using CareAffiliate® to submit your request. We will notify you and provide instructions if we require additional documentation to process your request.

Submit your request online

Training resources: If you'd like to learn more about submitting online requests, watch our CareAffiliate® video tutorial, use our step-by-step guides and/or consider attending one of our provider webinar presentations

 

CareAffiliate (requires login) Web Authorization/Referral Form (does not require login)

Key features of this option include:

  • provides immediate responses
  • can be used for outpatient and inpatient requests
  • use to check status of requests
  • save frequently used providers, request profiles and diagnosis lists
  • allows for attachments

After clicking the "Submit" button below, you will be directed to our secure portal. From there, click on "Submit Authorization Request" to access CareAffiliate.

Tip: Use our step-by-step CareAffiliate Guide as a resource.

Key features of this option include:

  • does not require website registration 
  • can be used for outpatient requests only
  • provides the option to print and save a PDF 

Tips:

  • Use our step-by-step WARF Guide and the Request Type Guide.
  • Be sure to use the provider lookup feature when requesting a provider.
  • Do not select "multi-specialty" as a specialty. This will delay processing of your request.

Requesting changes to existing referrals/authorizations

Check the status of your request

HNFS processes routine requests within 2–5 business days of receiving the request. Urgent requests are processed in an expedited manner for care that needs to be delivered within 72 hours. Requests are processed using the clinical information submitted by the provider. Processing time for both routine and urgent requests may be delayed if sufficient information is not provided.

Visit our Check Authorization and Referral Status tool to check the status of your request and view a copy of your authorization/referral letter.

Additional information

  • Give the beneficiary or servicing provider necessary medical records, such as laboratory results or X-rays. 
  • TRICARE Prime beneficiaries may be redirected to a network provider or military hospital/clinic. See our 'Important Things to Remember Abour Referrals' section on our Referrals and Prior Authorization Requirements page to learn more.