Referrals and Authorizations

By clicking on the Relocation button, you will be asked for updated information to aid you in obtaining a new referring provider if needed.

Relocation Notification

Which of the following best describes your relocation? (* Required)

Moving from TRICARE West Region to TRICARE East Region.
Click here to identify East States.

Moving from TRICARE West Region to TRICARE Overseas Program (TOP)

Moving more than 100 miles from my current address but staying within the TRICARE West Region.
Click here to identify West States.

Do you know your new location address? (* Required) Do you know your new location address? (* Required)

Yes

Country *

This field is required.

Please enter new address (* Required)

Street *

This field is required.

Street Address 2

City *

This field is required.

State *

This field is required.

State *

This field is required.

Zip *

This field is required.

Do you need assistance finding a new provider? (*Required)

Yes

Please enter your contact preferences below and one of our Care Coordination staff will contact you within 1 business day to assist you.

Contact Preferences *

This field is required.

Email *

This field is required.

Text *

This field is required.

Phone *

This field is required.

Preferred time of day *

This field is required.

In order for claims to pay to a new provider, please contact TriWest and update the request via the secure portal or contact Care Coordination @ 833-555-5555.

TRICARE Region States

State details will appear here.

If this is a permanent relocation, please be sure to update your address in DEERS.

My Referrals and Authorizations