of Referral (LOR) is required for all Tricare beneficiaries seeking treatment through a Licensed Professional Counselor, Licensed
Mental Health Counselor, or Pastoral Counselor.
submit the following LOR to your primary care or specialty care physician (e.g. psychiatrist) as soon as possible in order
to proceed with your treatment in a timely manner.
· The letter of referral is required before Tricare will process
any submitted claims, EVEN IF YOU HAVE RECEIVED AUTHORIZATION OF TREATMENT.
· The LOR must be signed by either an MD or DO – physician
assistants, nurse practitioners, etc. signatures will not be accepted by Tricare and the claim will be denied.
· The signed LOR must be returned to Counseling Psychology Associates,
LLC – this can be achieved either by you bringing it to our office or by requesting that your physician fax the completed
LOR back to our office at 706-653-2210.
· Please be sure to complete a Release of Information including
contact information for your physician at your next scheduled appointment if you have not already done so.
let us know if you have any questions or concerns about these requirements or procedures.
We will be happy to assist you in any way possible. If you do not currently
have a physician, we will be happy to make a referral.
for your attention and timely action in this matter. We appreciate your cooperation
in assuring that you are able to fully access the benefits you are entitled to!
Counseling Psychology Associates, LLC