Updated On: 1/22/2013 7:59:18 AM
REFERRAL MANAGEMENT OFFICE
The Referral Management Office (RMO) is responsible for facilitating the referral process for all Active Duty Service Members and TRICARE Prime beneficiaries enrolled to Reynolds Army Community Hospital. The hours of the RMO are 7:30 a.m. to 4:30 p.m. It is located adjacent to the TRICARE Service Center on the first floor of the hospital near the south entrance. You may also reach a staff member by calling (580) 558-2000, option 4, during these hours.
How the Referral Process Works
Your Primary Care Manager (PCM) is responsible for directing all of your health care needs. If a referral is needed to a specialty care provider, your PCM will enter a referral through the electronic medical record. The majority of referrals are processed by the staff of the Referral Management Office. Within 24 hours, a registered nurse will review your referral and make the determination of where best to obtain the specialty care your PCM has requested. Although the first choice is always Reynolds, our facility may not be available depending on current capability and capacity at our specialty clinics. If the service is available inside RACH, you will be called by one of the RMO staff to assist you with scheduling your appointment, generally within 48 hours from when it was ordered. To ensure that a member of the RMO is able to reach you, please stop by any clinic front desk to update your address and current phone numbers. If you have not received a call within five days from when your referral was ordered, please call the RMO.
with a Network Provider
If the specialty care your PCM requested is not available within RACH, the RMO staff will coordinate with the TRICARE contractor to obtain an authorization with a civilian network provider for your specialty care needs. Once the authorization is obtained, one of the RMO staff will contact you to assist you with scheduling an appointment with the assigned civilian provider. Humana Military will also mail you an authorization letter to your current address as listed in DEERS. This letter will detail who the authorized provider is, how many visits you are authorized, and will specify a length of time that the authorization is valid. The same system that calls to remind you of an appointment at Reynolds will also call to inquire if you want to use an existing referral. If you choose to make your own civilian appointment after receiving your authorization letter, please contact the RMO office so that they will be able to notify your PCM of your anticipated appointment date. Once the RMO receives information that an appointment has been booked, this system will no longer call you regarding that referral. This will assist us with obtaining the consultation report from your civilian specialist. Please keep a copy of this letter and note the date that your authorization expires. If a follow up appointment is needed and your authorization has expired, a new referral will be required from your PCM.
Do I Need to Take My Records
to the Civilian Provider?
One of the services offered by the RMO is that they will fax a copy of your pertinent records to the authorized civilian provider. If you had a related X-ray or MRI, please contact radiology to obtain a copy to take with you to your civilian appointment.
Your provider may refer you to a Case Manager if you have certain healthcare management needs. Case managers assist patients and families in coordinating unique, chronic, and catastrophic healthcare services; including appointments with specialists, hospitals and other agencies such as home health, hospice or medical equipment companies. If you would like more information please visit the Medical Management Division, located adjacent to the TRICARE Service Center near the south entrance of the hospital. read more...