Referral/Authorization Decision Support (RADS) Tool
- The RADS tool can be utilized to identify if healthcare services:
- Are a TRICARE benefit
- Require a Primary Care Manager referral
- Require a prior authorization and medical necessity review.
The tool indicates when to send requests and/or appropriate documentation to TriWest for processing.
The beneficiary refers to the actual patient potentially receiving
care. Select that beneficiary’s TRICARE plan.