Managed Care-Consult Referral Management Center (CRMC)
Mission
To provide referral service to our beneficiaries.
Overview of the Referral Process
When your Primary Care Manager (PCM) recommends a routine referral for consultation with a specialty care provider, you can call the Consult and Referral Management Office (CRMC) office to check on the status of your referral at 706-787-6261 option 2 and leave a message with your name, contact number and a good time when you can answer a call. You should allow 24-48 hours after your PCM places the consult into the referral system for processing before calling the CRMC.
Active Duty (AD) and Tricare Prime beneficiaries have priority access to specialty care available within Dwight D. Eisenhower Army Medical Center (DDEAMC). Tricare rules require that if the care you need is available within a military treatment facility (MTF), and space is available, you will be referred there first. CRMC staff will assist you with the booking of your initial appointment.
Prime Network Referrals
If your recommended care is not available at DDEAMC, you will be referred to a network provider. In most cases this will be to a provider in the local community. Humana Military, the Managed Care Support Contractor for Tricare in the Augusta area will send you an authorization letter within 7-10 business days.
The authorization letter will provide you with the details about your referral including:
- The name and address of your specialty provider
- The type of care authorized
- The length of time you are authorized to receive that care
- The type and number of visits you are allowed before you need another referral
If you do not receive your referral, please contact
Humana or call 1-800-444-5445. You can also visit
the
MHS Patient Portal to view your authorization information. *Please note that it is each beneficiary’s responsibility to schedule network appointments.
Medicare/Standard/Direct Care Network Referrals
If you are enrolled in Medicare or are a TRICARE Standard beneficiary and the care recommended by your provider is NOT available at DDEAMC, you will be contacted by mail with a copy of your referral and a list of local providers. You can simply call the provider of your choice and schedule a referral. If they ask for additional information, please call the CRMC 706-787-6261 Press option 2 and leave a message with your name, contact number and a good time when you can answer a call. Because you do not require a Tricare authorization, you may use a network participating provider of your choice*Please note that it is the beneficiary’s responsibility to schedule network appointments. Any cost shares or deductibles for your civilian medical care are your sole responsibility.
Referral Results
If you are seen outside of DDEAMC, please have the network provider fax the record of care to the DDEAMC Results Coordinator Office at 706-787-7201.