Clear and Legible Reports
Network providers must provide clear and legible reports (CLRs) – which include consultation reports, operative reports, and discharge summaries – to the referring* military hospital or clinic within the specified time frame listed below. The requirement to submit CLRs applies to care referred by a military hospital or clinic, and to care received at an urgent care center. Prompt submittal of these required reports to the military hospital or clinic facilitates beneficiary care and meets The Joint Commission accreditation requirements.
*Network urgent care centers should submit CLRs to the beneficiary’s assigned military hospital or clinic, as there may not be a referring provider.
For referred care, Health Net Federal Services, LLC (HNFS) will include the military hospital’s or clinic’s secure fax number for submitting CLRs in the approval letter. Additionally, we offer a CLR Fax Matrix for your convenience (see below).
Obtain beneficiary authorization when necessary before releasing sensitive information such as alcohol and drug abuse patient records, as required by law.
Submittal Time Frames
Submit CLRs within the following time frames:
- Urgent care centers: Submit within two (2) business days of delivering urgent care. The CLR must specify any referrals made during the urgent care visit.
- Other provider types (except mental health):
- Submit within seven (7) business days of delivering care to a beneficiary.
- For urgent and emergency situations, a preliminary report of a specialty consultation should be provided to the military hospital or clinic by telephone or by secure fax line within 24 hours of the urgent or emergent care (unless best medical practices dictate less time is required for a preliminary report). Telephonic preliminary reports should be followed up with a CLR sent to the local secure military hospital or clinic fax (see CLR Fax Matrix below), including civilian provider referrals, within seven (7) business days of the urgent or emergent care.
Mental health providers are required to submit brief initial assessments to the referring military hospital or clinic within seven (7) business days.
CLR Fax Matrix
Our CLR Fax Matrix lists all TRICARE West Region secure military hospital or clinic fax numbers and a local CLR mailing address should you prefer to mail the CLR. This matrix is subject to change. Always confirm fax numbers before sending reports.
Proper Coordination of CLRs
- What – Specialty care consultation/referral reports, operative reports, notes on episode of care and discharge summaries for beneficiaries referred by a military hospital or clinic.
- When – Submit within seven (7) business days of the date of service. Urgent care centers must submit with two (2) business days.
- Where – Submit CLRs to the referring (or assigned) military hospital or clinic provider.
- How – Fax CLRs to the local military hospital or clinic secure fax number as indicated on the authorization/referral letter or the CLR Fax Matrix.
To ensure CLRs are linked to the correct beneficiary and for the safety of beneficiary treatment, please include at least two sources of identification for each beneficiary. For example:
- First name, middle initial, last name and date of birth.
- First name, middle initial, last name and last four numbers of the sponsor's Social Security number.
Clear and Legible Reports to Civilian Providers
For care referred by a non-military (civilian) provider, reports should not be sent to the local, secure CLR fax line. Follow your normal office protocol and forward non-military referred consultation reports to the requesting civilian provider within the seven (7) business days of the service or sooner if clinically appropriate. Submission of CLRs to civilian providers is important as it ensures all treating providers are updated on the beneficiary’s care.