How to Submit an Authorization or Referral Request

There are two ways to submit a request for an authorization or referral to Health Net Federal Services, LLC (Health Net): online or manually by fax or mail.


The online authorization and referral tools offer quick and easy submission and status tracking of prior authorizations, referrals, and inpatient and discharge notifications. Registration at is required for providers and staff to use the tools. Visit our registration page to sign up today.

Have a question about your request? Visit our Online Authorization and Referral Tools Assistance page.

Fax or Mail

The TRICARE Service Request/Notification form can be faxed or mailed to Health Net. You can click and type in each form field to complete the form without having to handwrite the information. If you are faxing information for multiple beneficiaries, separate each beneficiary's information with the fax separator page. To assist you with completing the TRICARE Service Request/Notification form, you can refer to the form completion guidelines.

Outpatient Services:
Outpatient Service Request form

Outpatient fax number: 1-888-299-4181

Inpatient Admission Notification or Pre-certification Services:
Inpatient Service Request form

Inpatient fax number: 1-877-809-8667

Our mailing address for requests is:

Health Net Federal Services, LLC
Authorizations and Referrals
PO Box 9470
Virginia Beach, VA 23450-9470

Please note: When submitting a request for services, the sponsor's Social Security number must be included on the request.

Is the request routine, urgent or emergent?

When submitting your request you will want to prioritize the type of care, for example routine, urgent or emergent care, as this will help ensure the request is processed appropriately. View our Prioritizing a Prior Authorization or Referral Request page for more information.

Other Helpful Information

  • The requesting or initiating provider should provide the beneficiary or servicing provider with the necessary medical records, such as laboratory results or X-rays, for the beneficiary's specialty care appointment.
  • If a referral from Health Net is required, Health Net will assign an authorization or referral number. This number will be included on the faxed letter to the provider. Be sure to include the authorization or referral number with your claim for proper reimbursement.
  • If the provider wants to provide additional services beyond what is covered by the initial prior authorization or referral, the provider must notify Health Net and a new authorization or referral will need to be coordinated.
  • If the provider is requesting a referral for a TRICARE Prime beneficiary to a non-network provider and there are network providers available within a 60-minute driving distance from the beneficiary’s home address who can see the beneficiary within access standards, then care will automatically be redirected to a network provider. Learn more on our Out of Network Request page.
  • TRICARE coverage of certain limited benefits is subject to specific clinical criteria. A letter of attestation can be submitted by the provider, in lieu of additional clinical documentation, for certain limited benefits.
  • Some services may have coverage limitations or be excluded under the TRICARE program. View our Benefits A-Z for more information.