Getting hospice referral, authorization, recertification

Hospice Referrals
To initiate a hospice referral, a provider should select a TRICARE network hospice provider (when a network provider is available) and refer the patient to the hospice provider. Once the hospice receives the referral, it will contact the beneficiary for an evaluation. TRICARE does not require an authorization for the initial hospice evaluation. However, an  authorization is required to receive hospice services. Once the patient elects hospice
care, the hospice will submit an authorization request to TriWest.

Hospice Authorizations

TriWest requires the following items to be submitted at the time of initial authorization or recertification. It is the hospice provider’s responsibility to provide the documentation to TriWest.

For initial hospice authorization:
•     Hospice providers should register for the secure provider Web site at www.triwest.com/provider. The initial hospice authorization should be
submitted online.

•     The patient hospice election form (also called hospice consent), signed and dated by the
beneficiary, should be attached to the online request. TriWest does not supply this form;
each hospice has its own.

For recertification:
•     Each benefit period requires a separate authorization. To request continuation of hospice
services, only the hospice authorization needs to be submitted.