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TRI CARE
NETWORK INPATIENT/RESIDENTIAL SUBSTANCE USE DISORDER
REHABILITATION FACILITY (SURF) PROVIDER Application expect providers to submit claims electronically. If it is necessary to submit a paper
claim,
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How to fill out non-network inpatientresidential substance use
How to fill out non-network inpatientresidential substance use
01
Step 1: Gather all necessary information and documents
02
Step 2: Contact the non-network inpatient/residential substance use facility for admission requirements
03
Step 3: Complete the admission application form with accurate and detailed information
04
Step 4: Provide any necessary medical records or evaluations related to substance use
05
Step 5: Submit the completed application form and supporting documents to the facility
06
Step 6: Wait for the facility to review your application and provide further instructions
07
Step 7: Follow any additional steps or requirements given by the facility for admission
08
Step 8: Once accepted, coordinate with the facility for any necessary transportation or logistics
09
Step 9: Arrive at the facility on the scheduled admission date and complete any remaining paperwork
10
Step 10: Begin the non-network inpatient/residential substance use program as directed by the facility staff
Who needs non-network inpatientresidential substance use?
01
Individuals who require intensive substance use treatment and support in a residential setting
02
Those who prefer or require specialized non-network facilities for their specific substance use needs
03
Patients who don't have access to network inpatient/residential substance use programs
04
Individuals with unique treatment requirements or preferences not available within network options
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What is non-network inpatient residential substance use?
Non-network inpatient residential substance use refers to the treatment for substance use disorders at a facility that is not part of the individual's insurance network.
Who is required to file non-network inpatient residential substance use?
Providers who offer non-network inpatient residential substance use services are required to file the necessary documentation with the insurance company.
How to fill out non-network inpatient residential substance use?
Providers must complete the required forms detailing the services provided, dates of stay, and any other relevant information before submitting them to the insurance company.
What is the purpose of non-network inpatient residential substance use?
The purpose of non-network inpatient residential substance use is to ensure that individuals receive necessary treatment for substance use disorders at facilities that may not be covered by their insurance network.
What information must be reported on non-network inpatient residential substance use?
Providers must report information such as the name of the facility, dates of stay, services provided, and any other relevant details related to the treatment of substance use disorders.
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