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Letter of Referral (FOR) Physician Referral Form for TRI CARE beneficiaries accessing care with Licensed Mental Health Counselors, Licensed Professional Counselors, or Pastoral Counselors. Instructions:

How to fill out btricareb physician referral bformb

How to fill out a BTRICARE physician referral form:

1. Start by obtaining a copy of the BTRICARE physician referral form. This form can usually be found on the BTRICARE website or by contacting your local BTRICARE office.
2. Fill in your personal information. This includes your name, address, phone number, and any other required contact details. Make sure to provide accurate and up-to-date information.
3. Provide your healthcare provider's information. This includes their name, address, phone number, and any other necessary details. It is essential to choose a healthcare provider who is within the BTRICARE network to ensure coverage.
4. Indicate the reason for the referral. Specify the type of healthcare service or specialist you are seeking and the medical condition or symptoms that require attention. Provide any relevant medical history or documentation that supports your need for the referral.
5. If there are specific treatment or therapy requirements, provide details in the appropriate section of the form. This could include things like necessary tests, medications, or procedures.
6. Review the completed form for accuracy and completeness. Ensure that all the required fields are filled out correctly and that you have provided all the necessary information.
7. Submit the form to the appropriate BTRICARE office or submit it through the provided online portal. Follow the instructions provided to ensure your referral is processed in a timely manner.

Who needs a BTRICARE physician referral form:

1. Active-duty military personnel and their eligible family members who need specialized medical care that is outside the scope of their primary care provider.
2. Retired military personnel and their eligible family members who are enrolled in BTRICARE and require specialized medical care.
3. Certain beneficiaries who are not covered under the BTRICARE Prime plan but may be eligible for referrals on a case-by-case basis.

Please note that specific eligibility requirements and guidelines may vary, so it is best to consult the official BTRICARE website or contact your local BTRICARE office for more information.

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