TRICARE

Spectrum Medical Inc. will file your TRICARE primary claim and submit the balance to your secondary/tertiary insurance after TRICARE payment is received. In many instances, payments are made directly to the patient. Please forward the payment and Explanation of Benefits to Spectrum Medical Inc. for proper crediting to your account.

Physician Written Referral

A Physician Written Referral is required for most supplies and/or services. It is your responsibility to check with your local health-benefits adviser at a military treatment facility near you to find out if you need a Physician Written Referral.

TRICARE types of coverage:

Although Spectrum Medical Inc. is not a participating provider with the plans below, we do accept assignment on most services:

• TRICARE STANDARD
• TRICARE EXTRA
• TRICARE PRIME (HMO) -- Without prior authorization, the patient will have a higher copay amount (usually 50 percent).
• TRICARE for Life – this a Medicare supplemental insurance

Pre-Authorization

Pre-authorization is required for non-emergency hospital admissions and other outpatient procedures. Please refer to your TRICARE manual or call your military hospital's health-benefits adviser. We have been informed that the following items/services require pre-authorizations:

• Air flotation mattress and/or electric hospital bed
• Gait trainers/standers
• Hoyer lift
• Insulin pump
• Power wheelchair or scooters
• Home Health Services