Things to know about ROFR:
After it is determined a beneficiary needs to be referred for specialty care, the requesting provider will submit a referral/authorization request via web or fax to Humana Military for approval and ROFR processing.
Many times the military hospital or clinic will have the specialized services available. In this scenario, the military hospital or clinic will notify us, usually within one business day and the beneficiary will be referred to that facility.
The facility may contact the beneficiary to schedule an appointment and Humana Military will provide the beneficiary with the information for that health facility. If the facility cannot provide the services or care requested, the patient will be referred to a civilian network provider. However, it is important to understand if a provider is selected prior to the ROFR determination and the military hospital or clinic can provide the services and accepts the care, this overrides any prior provider selection, requiring the beneficiary to be seen at the military facility.
You can access your referral letters by logging into your self-service account. When you view a referral that has been processed, you will find a link to view your referral letter.Log in now