TRIWEST INSURANCE

TriWest Online Care provides Video-Behavioral Health Care for its beneficiaries in the military.  Following is general information about this program.


TriWest Online Care Program:

      What is TriWest Online Care? The TriWest Online Care program is a Web-based assistance program with Tele-Behavioral Health Care for TRICARE active duty service members and active duty family members. This is a Department of Defense demonstration project to supplement the existing behavioral health program and to improve access to behavioral health providers. The supplemented services include additional resources in TriWest’s Behavioral Health Contact Center to conduct 24/7/365 non-medical behavioral health counseling. The project also establishes a network of Originating Site and Distant Providers willing and able to provide Tele-Behavioral Health Care using a video conferencing system.

      What is an Originating Site? An Originating Site is the site where an eligible TRICARE beneficiary is located when Tele-Behavioral Health Care is being furnished via a video conferencing system.

      What is a Distant Provider? A Distant Provider is the TRICARE behavioral health provider rendering Tele-Behavioral Health Care via a video conferencing system. The beneficiary must be located in the same state in which the Distant Provider is licensed. TRICARE beneficiaries located overseas will not participate in this demonstration project.

Authorizations for Tele-Behavioral Health Care:

      Is there a different process to request authorization for Tele-Behavioral Health Care? No, prior authorization requests should be submitted the same way as for in-person services, preferably online at www.iriwest.com/provider.

      How does a provider request that a service be provided via Tele-Behavioral Health Care? A provider should call 1-888-TRIWEST (888-874-9378) and follow the following prompts to the Behavioral Health Contact Center: Provider >> sponsor ID >> authorization >> behavioral, and then ask to schedule an appointment for Tele-Behavioral Health Care.

      Will TriWest use different criteria when approving Tele-Behavioral Health Care? No, the same criteria will be used to evaluate medical necessity. The same number of visits will be approved whether for in-person services or for TriWest Online Care.

Tele-Behavioral Health Care Appointments/Behavioral Health Contact Center:

      How does a beneficiary request an appointment for Tele-Behavioral Health Care? An eligible TRICARE beneficiary may call 1-888-TRIWEST (888-874-9378) and use the Behavioral Health prompt to reach the TriWest Behavioral Health Contact Center. The beneficiary can also access the Behavioral Health Contact Center through the TriWest Behavioral Health portal at www.triwest.com through webmail or Live Chat.

How is the appointment scheduled? The Behavioral Health Contact Center reviews the beneficiary’s eligibility for the services. The Behavioral Health Contact Center then coordinates with the Originating Site and the Distant Provider to schedule a visit. Beneficiaries may schedule subsequent appointments directly.

Does the beneficiary have to have an initial in-person encounter with a behavioral health provider? Not necessarily. The beneficiary can access the Behavioral Health Contact Center through the TriWest Behavioral Health portal through webmail or Live Chat, or by calling 1-888- TRIWEST (874-9378) and using the behavioral health prompt. The Behavioral Health Contact Center will assess the beneficiary’s eligibility and determine whether he/she may utilize the TeleBehavioral Health Care services.

Tele-Behavioral Health Care Sessions:

How is the Tele-Behavioral Health Care call initiated? The Distant Provider will call the Originating Site to initiate the Online Care session.

Can the beneficiary participate in Tele-Behavioral Health Care from his/her home? No. Even if the beneficiary has the appropriate computer and video equipment, all covered Tele-Behavioral Health Care visits must take place in a TriWest-approved Originating Site.

What kind of equipment is necessary to participate in Tele-Behavioral Health Care? Both the Originating Site and Distant Provider need a private room with a door in a comfortable environment, a telephone, and a computer with a Web camera and minimum technical requirements.