If you are part of an HMO (Health Maintenance Organization) you are required to have a referral from your primary care physician prior to services rendered. Tricare Prime will also require referral. As out-of-network providers, we find that Tricare Prime generally requires patients to stay in-network for oral appliance therapy.
Sometimes an authorization is required for you to see a provider who is not contracted with your insurance company (out-of-network provider like us). This process is called “prior authorization” or “pre-authorization” and can take a few days to a few weeks to complete. Please call your insurance to find out if they require any special authorizations for visits to out-of-network providers (see next page for specific codes to inquire about)