december 2010 examiner

By Gabrielle KirkTRICARE Management Activity

Constant anxieties anddepression can take atoll on a service mem-ber health and nega-

tively impact their daily life. Itcan be difficult for a servicemember with these two emo-tions to tell if they are goingthrough a rough patch or if it issomething more.

Some service members homefrom deployment can experiencethese two emotions, along withsymptoms of traumatic stress,including distressing recollec-tion of events, nightmares,numbness and avoidance, sleep

problems and irritability oranger. Excessive use of alcoholor other substances may also bea sign of service members suf-fering these behavioral prob-lems.

While many are reluctant toseek behavioral health carebecause they’re afraid a ‘stigma’surrounds behavioral healthproblems, TRICARE stronglyencourages service membersand their families not to waituntil the problem worsens. TRI-CARE coverage includes helpwith anxiety, depression, trau-matic stress or other behavioralhealth problems service mem-bers and their families may befacing. Visitwww.tricare.mil/mentalhealth

for TRICARE mental healthbenefits information, links, pro-grams and contact information.

One program available to ben-

THE EXAMINER

Volume 18, No. 12 December 2010C

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Did you know?...

Robert E. Bush Naval Hospital

“Serving with Pride and Professionalism”

You have the right toexpress your concerns

about patient safety and qual-ity of care.

There are several avenuesopen to you:

* Through the ICE web-site.

* Through the NavalHospital Customer CommentCards.

* The Hospital’s CustomerRelations Officer at 760-830-2475, or any of the CustomerRelations representatives inthe hospital’s clinics.

Or Directly to the JointCommission via:

E-mail [email protected]

Fax:Office of Quality Monitoring630-792-5636

Mail:Office of Quality MonitoringThe Joint CommissionOak Renaissance BoulevardOakbrook Terrace, IL 60181

http://www.med.navy.mil/sites/nhtp/pages/default.aspx

An Award Winning Publication

TRICARE Provides Answers to Behavioral Health Questions

Second Class Petty Officer Association got together to discuss the new leadership and future goals of the association. Association PresidentHM2 (SW) Bernardstine Bethea, and VP HM2 Julian Guillen want to encourage fellow PO2s to get involved and participate in great fellow-ship. During the meeting, Naval Hospital Twentynine Palms Command Master Chief Hughes brought in Command Master Chief of NavyMedicine West (CMC Debora) to re-instill values of the Hospital Corps. PHOTO BY HM2 JENNA TADLOCK

SCPOA Encourages Membership for Leadership Development...

Continued on page 7

Clinic Closure During Holidays

It is time once again for everyone to start making holiday plans...it’s the same for the hospital.Outpatient Clinics at the Robert E. Bush Naval Hospital including

the Adult Medical Care Clinic will be closed Dec. 23 -- 24 forChristmas. All clinics will also be closed Dec. 30 -- 31, for the NewYear’s holiday.

The hospital’s Multi-Service Ward and Desert Beginnings LDRPwill remain open. Also, the hospital’s Emergency MedicineDepartment will remain open for emergent care services.

Pharmacy and Radiology will provide services to inpatient andEmergency Medical Department patients.

The staff of the Robert E. Bush Naval Hospital wishes everyone asafe and healthy holiday!

By Martha Hunt, MAHealth Promotions CoordinatorRobert E. Bush Naval Hospital

Ok, so you can benchpress 325 pounds,think you are healthy?Maybe. Maybe not.

Health and wellness is morecomplicated than how low yourcholesterol level is or how manymiles you run every day. If anyone part of your life is out ofbalance, then your overall healthand wellbeing will suffer.

The World HealthOrganization (WHO) definitionof health states: “Health is astate of complete physical, men-tal and social well-being and notmerely the absence of disease orinfirmity.” Wellness is a state ofoptimal well-being. It’s not sim-ply the absence of illness, but animproved quality of life result-ing from balanced physical,social, mental, emotional, spiri-tual and environmental health.

The components of total well-ness include: Spiritual, Physical,Mental, Emotional,Environmental and Social well-ness. Spiritual wellness involvespersonal beliefs, morals or reli-gion. It is how we find purposein life and meaning in what wedo and believe. Spiritual healthis found in the philosophies thatwe live by. If we don’t havesomething that guides us andgives us a moral foundation,then we will not be able to setgoals and purpose in our life.

Physical wellness is how webest take care of our bodies

given the physical restraints wemay experience due to age orphysical condition. Just becausesomeone age 50 is physicallyunable to accomplish what theydid at age 20, it does not makethem physically unfit. It simplymeans that their bodies havechanged due to age. We need tosimply do the best we can withthe gifts we have. To that end,get an annual physical exam(including dental and eyeexams) and be consistent withself-exams like breast selfexaminations of you are awoman and testicular cancerexaminations for men.

Make sure you keep yourimmunizations up to date aswell. Regular exercise and abalanced diet helps keep yourbody tuned up to meet the chal-lenges of every day life. Be sureto find an activity that youenjoy, however, or you willresent having to exercise. Whenyou engage in activity that youlike, such as walking, then youare more likely to actually do it.Avoiding tobacco and alcoholfurther reduces your risk of can-cer, heart and lung disease aswell as other chronic diseasessuch as diabetes.

Mental wellness involves find-ing things that stimulate usintellectually and challenge us.If our jobs are boring or we sim-ply sit home at night and playNintendo or watch TV, then westop growing intellectually andbecome bored. In fact, videogame playing has been linked toattention deficit disorder in kids

who play these games for morethan one hour per day.

Emotional wellness is definedby how well we deal with stress.When we let stress run wild inour lives, our blood pressureand blood sugar rises and we arejittery all the time. Think ofstress as running the engine ofyour car in high gear all thetime without moving out of yourdriveway. What would this do toyour car? Stress does the samething to our bodies. Stress leftout of control wears away at ourbodies and leaves us open to ill-ness.

Environmental wellness refersto our overall environment, notjust to our work or home envi-ronment. Are you exposed totoo much noise or pollution inyour neighborhood or at work?

Are you exposed to second handsmoke, a known cancer causingagent? Is your work space andhome comfortable and designedfor safety? This includes wear-ing seatbelts and making surethat safety controls are in placeto prevent injury.

Social wellness is defined bythe people around us. It is notdefined by how many friends orfamily members we have, butby the quality of those relation-ships. If we surround ourselveswith friends or family who wishus harm or who are angry or areusers, then these are not healthyrelationships. We need to besure that those people around usreally care about us and are sup-portive of us, especially whenwe need help.

Social health also involves

going out and meeting new peo-ple and staying active in ourcommunity. When you wallyourself off from your commu-nity and family, you becomelonely and isolated and that isvery unhealthy. People who aresocially isolated from familyand community have beenshown to die much younger andhave much poorer quality oflife.

Overall wellness is a life-longprocess that helps you to maxi-mize your potential. If any onecomponent of wellness isignored, your life becomesunbalanced and unhealthy. So?You run 5 miles every day,based on the above componentsof health, are you really ashealthy as you think you are?

2 -- The Examiner -- December 2010

Published by Hi-Desert Publishing, a private firm in no way connected with the Department of Defense, the UnitedStates Marine Corps, United States Navy or Naval Hospital, Twentynine Palms under exclusive written contract withthe Marine Air Ground Task Force Training Command. The appearance of advertising in this publication, includinginserts or supplements, does not constitute endorsement by the Department of Defense, the United States MarineCorps, the United States Navy or Hi-Desert Publishing of the products or services advertised. Everything advertisedin this publication shall be made available for purchase, use, or patronage without regard to race, color, religion, sex,national origin, age, marital status, physical handicap, political affiliation, or any other non-merit factor of the pur-chaser, user or patron. If a violation or rejection of this equal opportunity policy by an advertiser is confirmed, thepublisher shall refuse to print advertising from that source until the violation is corrected. Editorial content is preparedby the Public Affairs Office, Naval Hospital, Twentynine Palms, Calif.

Commanding OfficerCaptain Ann Bobeck, MSC, USN

Executive OfficerCaptain Michael Moeller, MC, USN

Command Master ChiefHMCM (FMF) Kevin Hughes, USN

Public Affairs Officer/EditorDan Barber

Command OmbudsmanValatina Ruth

Care Line 830-2716Cell Phone (760) 910-2050

The Examiner welcomes your comments and suggestions concerning the publication. Deadline for submission ofarticles is the 15th of each month for the following month’s edition. Any format is welcome, however, the preferredmethod of submission is by e-mail or by computer disk.

How to reach us...Commanding Officer Naval HospitalPublic Affairs OfficeBox 788250 MAGTFTCTwentynine Palms, CA 92278-8250Com: (760) 830-2362DSN: 230-2362FAX: (760) 830-2385E-mail: [email protected] Publishing Company56445 Twentynine Palms HighwayYucca Valley, CA 92284Com: (760) 365-3315FAX: (760) 365-8686

Here’s to your health...

What is wellness? Maybe it’s a Little More Complicated Then You Thought

Patients seen in October -- 10,049Appointment No Shows in October -- 1,032

One in ten patients do not show up for their appointments atthis hospital. If an appointment is no longer needed, please callso another patient can be seen.

To make an appointment call -- 760-830-2752To cancel an appointment call -- 760-830-2369

By Elaine Wilson American Forces Press Service

WASHINGTON, Nov. 16, 2010- Young children from militaryfamilies are more likely to seekmental and behavioral healthcare when a parent is deployedthan when a parent is at home, amilitary study has concluded.

Findings also show that chil-dren of married couples -- withthe father as the service member-- are more likely to seek carethan children with a marriedmilitary mother or with a singleservice member parent, saidlead researcher Navy Cmdr.

(Dr.) Gregory H. Gorman, astaff pediatrician with theUniformed Services Universityof the Health Sciences.

The study, which includedmore than a half million chil-dren from active-duty families,will be published in theDecember issue of the journal‘Pediatrics’ and was posted onthe journal’s website Nov. 8.

From fiscal 2006 to 2007, ateam of researchers examinedthe records of more than642,000 military beneficiariesages 3 to 8. They looked at alloutpatient visits - whether tomilitary or civilian facilities --billed to TRICARE, the mili-

tary’s health care system. Theythen matched those records upwith parents’ deploymentrecords.

Compared to a baseline of careestablished prior to deployment,researchers found that militarychildren are 11 percent morelikely to seek care for behav-ioral and mental health issuesduring deployments than whenthe parent is at home, Gormansaid.

Gorman said he broke issuesdown into three categories: anx-iety disorders; pediatric behav-ioral disorders, such as attentiondeficit disorder; and stress disor-ders, which include post-trau-

matic stress disorder and othertypes of stress reactions. Thestudy indicated an overall rateincrease of 15 to 19 percentwithin these categories, withrates of anxiety and stress disor-ders showing the highestincreases.

The findings substantiate whatthe military community hasanecdotally known for a longtime: deployments affect chil-dren. However, Gorman said,“It’s the first time ... we’vequantified how it really affectschildren and how it affects themilitary community as awhole.”

The findings are particularlysignificant when set against thebackdrop of an overall decreasein medical visits for issues suchas colds or routine care, Gormansaid. The study indicated a 10 to11 percent drop in visits forphysical ailments while a parentwas deployed, he explained.

The drop in medical treatmentmakes sense, Gorman said,since the spouse is acting as asingle parent.

“They’re juggling a lot moreresponsibility, so perhaps thethreshold for bringing a child infor a doctor's visit may change,”he said. They may defer on rou-tine visits, for example, until theparent returns from deployment,he said.

Researchers also found distinc-tions based on a child’s age anda parent’s gender, and theynoted a gradual increase in care-seeking rates as childrenincreased in age.

Gorman attributes this to olderchildren’s wider array of emo-tional and behavioral responses.However, children’s gender did-

n’t seem to play a significantrole, he said, with girls and boysexperiencing the same impacts.

However, gender did play arole among parents. Researchersfound that when the caregiverback home was the mother, themental health visit ratesincreased. However, if the care-giver was the father, less of anincrease was seen, Gorman said.He also noted an increase incare for children of marriedservice members, as opposed tothose of single service members.

Gorman chalked up these dis-tinctions to recognition. Motherstypically are the primary care-givers, and may be more in tunewith a child’s behavioral andmental health needs than thefather, he explained. And, dur-ing a deployment, a child of asingle service member may goto live with an extended familymember or close family friend,who may not be as aware of thechild’s behavioral norms, so isless likely to recognize varia-tions, he added.

“We probably underestimated[the increase] in those popula-tions,” Gorman said.

Gorman said he hopes thestudy will go a long way inhelping to identify issues amongmilitary children and how tobetter address them, particularlyamong civilian providers.

The study examined 6.5 mil-lion outpatient visits, of whichtwo-thirds were with civiliandoctors, he said. Many civilianproviders may not be aware ofthe unique stressors militarychildren face or the resourcesavailable to help them, headded.

By Martha Hunt, MA CAMFHealth Promotions Coordinator Naval Hospital Twentynine Palms

Get ready to fight off infection. Colds andflu are the leading cause of visits to thedoctor, leading cause of school absen-teeism and the leading cause of missed

work.Here are some common Cold versus Flu

Questions and Answers:

What is the difference between a cold and the flu?

The flu and the common cold are both respiratoryillnesses but they are caused by different viruses.Because these two types of illnesses have similarflu-like symptoms, it can be difficult to tell the dif-ference between them based on symptoms alone. Ingeneral, the flu is worse than the common cold,and symptoms such as fever, body aches, extremetiredness, and dry cough are more common andintense. Colds are usually milder than the flu.People with colds are more likely to have a runnyor stuffy nose. Colds generally do not result in seri-ous health problems, such as pneumonia, bacterialinfections, or hospitalizations.

How can you tell the difference between a cold and the flu?

Because colds and flu share many symptoms, itcan be difficult (or even impossible) to tell the dif-ference between them based on symptoms alone.

Special tests that usually must be done within thefirst few days of illness can be carried out, whenneeded to tell if a person has the flu.

What are the symptoms of the flu versus the symptoms of a cold?

In general, the flu is worse than the commoncold, and symptoms such as fever, body aches,extreme tiredness, and dry cough are more com-mon and intense. Colds are usually milder than theflu. People with colds are more likely to have arunny or stuffy nose. Colds generally do not resultin serious health problems, such as pneumonia,

bacterial infections, or hospitalizations.Wash your hands. Use soap and warm water.

Wash all of your hand surfaces, including yourwrists, and wash for at least 10 seconds. Use thetoweling to turn off the water faucets so you don’tre-contaminate yourself with cold and flu viruses.

Cover your nose and mouth when you sneeze andcough. Didn’t your Mom teach you this as a kid?Well, she was right. Covering your mouth and nosewhen you sneeze or cough prevents you from giv-ing your flu or cold to someone else.

Clean and disinfect high traffic areas in yourhome. The kitchen, bathroom, and kids areas arehigh contamination areas in your home. By keep-ing them clean and disinfected, you kill most of theviruses causing the flu.

An easy to make disinfecting solution is 1/4 cupof bleach in one gallon of warm water. However, ifusing a bleach solution on children’s toys, use onlyone tablespoon of bleach in one gallon of water.Remember... never mix bleach and ammonia as acleaning solution as this creates poisonous vapors.

There is no cure for a cold or the flu but manyover the counter medications may help relievesymptoms. Ask the pharmacy for more informa-tion.

Suggestions for treating a cold or the flu:* Get plenty of bed rest* Drink lots of fluids* Take a safe pain reliever for headache and

fever. Always ask a health care provider beforegiving any pain medication to children under theage of 20 years.

* Use over the counter medications for conges-tion, cough or nasal discharge

* For flu, a flu vaccination can help prevent fluor lessen the severity if you do get it.

* Taking large doses of Vitamin C has neverbeen proven to help prevent colds or the flu. Infact, taking too much of any vitamin or supple-ment can be harmful. Ask the pharmacy aboutsafety of any vitamin or supplement before takingit.

The best way to prevent getting a cold or the fluis by basic good hygiene. Your mom told you tocover your mouth and wash your hands for a rea-son; so you would be healthier and happier.

The Examiner -- December 2010 -- 3

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Tis The Season For Cold and Flu Prevention

Children of Deployed More Likely to Seek Mental Health Care

Continued on page 6


Super Stars...

HM1 Teri Charles, LeadingPetty Officer, Primary CareClinic, receives a Gold Star inlieu of second Navy andMarine Corps AchievementMedal.

CS2 Clinton Drewery,Combined Food Operations,receives a Gold Star in lieu ofa second Navy and MarineCorps Achievement Medal.

HM3 Michael Hagglund,Optometry, receives his secondGood Conduct Medal.

HM2 Jonathan Kegley,Manpower Department,receives a Navy and MarineCorps Achievement Medal.

HM3 Brian Lundy, StaffEducation and Training,receives a Navy and MarineCorps Achievement Medal.

HM3 William Roots, Main OR,receives a Navy and MarineCorps Achievement Medal.

HM2 Peter Brandi, POMI office, is piped ashore at his recentretirement ceremony. Brandi served 20 years of honorable servicein the United States Navy.

HM3 Corey Messner, GeneralSurgery/Orthopedics, receiveshis first Good Conduct Medal.

YNSN Courtney Taylor,Manpower, receives a Navyand Marine CorpsAchievement Medal.

HM2 Melissa Torres,Anesthesia/PACU, receives aGold Star in lieu of her secondNavy and Marine CorpsAchievement Medal.

HM3 Michael Hagglund, Optometry, takes the oath at his recentreenlistment ceremony.

Continued on page 8


TriWest Offers New Service to Combat Major Depression--Expanding Condition Management Programs to include Depression--

TriWest HealthcareAlliance has a newDisease Managementprogram for Major

Depression now being offered toeligible West Region TRICAREbeneficiaries.

Beneficiaries suffering fromMajor Depression, also knownas clinical depression, canreceive extra help throughTriWest Healthcare Alliance,which manages the TRICAREmilitary healthcare entitlementon behalf of the Department ofDefense (DoD) for 21 westernstates.

Major Depression is the mostcommon depressive disorder.More than 20 million Americanshave been diagnosed withdepression according to theNational Institutes ofHealth...about the equivalent ofNew York State’s population.Clinical depression is a dis-abling disease characterized bypersistent and enduring sadness,unhappiness and negativity thatinterfere with one’s daily life.Generally, a person who isdepressed also exhibits at leastthree other symptoms, such assleep disturbance, significantdrop in energy levels, weightgain or loss and frequent irri-tability.

TriWest’s DiseaseManagement department alsooffers support to beneficiarieswith diabetes, asthma, lung dis-eases (COPD) and heart failure.The depression program,launched by TriWest inNovember, is a no-cost entitle-

ment for those who are eligible.Eligibility is determined byTRICARE and is based onclaims history. Once a benefici-ary is identified as eligible toparticipate in the program, theDoD refers the beneficiary toTriWest. A Disease Managementhealth coach then contacts thebeneficiary and invites him orher to participate in the pro-gram.

The Major Depression DiseaseManagement Program has anumber of services to help bene-ficiaries including a healthcoach who works with the bene-ficiary and the primary caremanager to tailor an action plan.The health coach will then workwith the beneficiary until theplan’s goals are met. As needed,the beneficiary can also accesssmoking cessation, exercise,medication and nutrition helpfrom his or her TriWest healthcoach.

TriWest also works alongsidethe Military Health System tooffer additional behavioralhealth resources to support thosein need, including the TRI-CARE Assistance Program(TRIAP). Here eligible benefici-aries, including services mem-bers and their families, canaccess private, confidentialcounseling sessions 24/7 with alicensed therapist via Internet(Skype), chat or over the tele-phone. These sessions are non-clinical and intended for generallife issues, such as stress man-agement or relationship prob-lems. For more information,

visitwww.triwest.com/onlinecare.

Beneficiaries can find addi-tional resources at www.tri-west.com/depression andwww.tricare.mil.

About TriWestTriWest Healthcare Alliance

partners with the Department ofDefense to do “Whatever ItTakes” to support the healthcareneeds of 2.7 million members of

America's military family. APhoenix-based corporation,TriWest provides access to cost-effective, high-quality healthcare in the 21-state TRICAREWest Region.

Life’s Lesson...

There is always a lot to be thankful for, if you take thetime to look. For example, I’m sitting here thinking hownice it is that wrinkles don’t hurt....

The best way to keep kids at home is to make a pleasantatmosphere... and let the air out of their tires.

On the other hand, the best way to keep kids from movingback home after they leave is to make them take their bedwith them when they move out.

By Brian P. SmithTriWest Healthcare Alliance

Families facing deploy-ments and those lookingforward to homecom-ings face challenges.

These challenges are different,but they both revolve aroundchange. Change is not alwayseasy, but there are tools andresources that can help militaryfamilies cope with making tran-sitions.

You and your family haveaccess to a variety of medicaland non-medical counseling andbehavioral health optionsthrough TRICARE andDepartment of Defense pro-grams. When you are strugglingwith stress and family andchange ñ wouldn’t it be great tofind help that fits your sched-ule? What if you could schedulethat help around an injury, anillness, your job or other obliga-

tions?At home or online, there are

tools and programs to help you.TRICARE Assistance ProgramAnytime of the day or night,

when it’s convenient for you,contact TriWest Online Careover the phone (1-888-TRI-WEST), or online chat(triwest.com/OnlineCare) forbehavioral health informationand crisis intervention.

You can also ask about theTRICARE Assistance Program(online videoconferencing) forone-on-one non-medical coun-seling. It is:

* Non-reportable (except asrequired by law)

* Private* FreeThe phone and chat options

are available to all TRICAREbeneficiaries. The online videooption is available in the U.S.for:

* Active duty service membersand spouses

* TRICARE Reserve Selectenrollees

* Those eligible for theTransitional AssistanceManagement Program

* Eligible family members

over the age of 18.You won’t need a referral or

prior authorization to talk tosomeone and you can use theservice as many times as need-ed. Connect online from any-

where with an Internet connec-tion and, for video, a webcam.If medical support or a higherlevel of care is needed, they canhelp you find the proper servic-es.


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“Hopefully, this will help to inform civilian pediatric providers,” hesaid. “They also need to be aware of the resources that they can callon for these families.”

Gorman also said he sees a positive application among militaryproviders. While the military has made great progress in addressingmilitary children’s issues with deployment-cycle training andresources such as Military OneSource, the study can help in targetingtraining efforts for providers, specifically in the areas of recognitionand prevention efforts for children, he said.

He’d also like to see targeted interventions in the future, such as forchildren of female service members, he said, as well as studies specif-ically aimed at children of the Guard and Reserve and teenagers. Healso called for a closer look at individual diagnoses, such as attentiondeficit disorder.

Overall, studies like this one add to the discussion of how the nationwages war, Gorman said.

“It’s very important to take care of military beneficiaries,” he said.“It adds as much to preserving the fighting force as providing bulletsand beans to the front lines.”

It’s also the right thing to do, he said. “These are people we are sworn to take care of,” he said, “and we

need to find exactly what they need.”

Children of Deployed...Continued from page 3

Transition Support is Readily Available to Military Families

Self AssessmentsThere may be times when you ask yourself, “are these feelings normal?” or “does anyone else feel this

way?” Self-assessments are one way to help you identify potential concerns and start working on solutions.You can find anonymous assessments and other self-help resources for military members at:

* TriWest’s Behavioral Health Portal (www.triwest.com/BH)* www.afterdeployment.org* www.mentalhealth.va.gov* www.militarymentalhealth.orgStress and change are parts of military life. When it feels like you’re alone in your situation, there are

resources as close as your phone or computer.

By Tyler PattersonTriWest Healthcare Alliance

Your primary caremanager has referredyou to a specialist.Once your authoriza-

tion is approved and arrives inthe mail (in about a week),you’ll be able to make yourappointment.

But what if your authorizationcould arrive in hours instead ofdays?

One option is registering for asecure TriWest.com account,where you can review or printyour referrals and authorizationselectronically in 12 to 36 hours.

You can also make thoseappointments that much quicker,and be on the road to getting thecare you need.

Just log in to your registeredaccount and click ‘Go Green,’and choose from electronicauthorization and referral letters,Explanation of Benefits state-ments or fee statements. Youcan even start receiving yourselected letters in your e-mailinbox instead of your mailbox.

And there are more benefits toreceiving your authorization andreferral letters online:

* Want to change your special-ty provider? You can...online,right from your account.

* Going to a new provider?Your authorization letter linksdirectly to contact, map andpractice information.

* Don’t worry about misplac-ing or losing your authorizationletter. Print a copy from anycomputer with an Internet con-nection, whenever you need it.

West region TRICARE benefi-ciaries can learn more aboutgoing paperless and managingtheir referrals and authorizationsonline atwww.triwest.com/gogreen. Newusers can click ‘Register’ to setup an account, while existingusers can click ‘Login’ to getstarted right away.

Turbocharge Your TRICARE Referral

By Tyler PattersonTriWest Healthcare Alliance

Has your primary care manager (PCM)decided that you need to see a specialist?Getting the care you need is just foursimple steps away:

Get a referralIf you are a TRICARE Prime beneficiary who

needs specialty medical care, you’ll need to getyour PCM to submit a referral request. If you useTRICARE for Life, TRICARE Standard/Extra,TRICARE Reserve Select or TRICARE RetiredReserve, you don’t need a referral to see a special-ist, although you may need a prior authorization forsome services. Contact TriWest at 1-888-TRI-WEST (874-9378) to find out.

Wait for your authorization letter to arrive

Good news: you can shave a few days from the

process in this step. Register for paperless authori-zation letters at www.triwest.com/Paperless andyou will receive your authorization letter electroni-cally within 24 hours of TriWest authorizing yourreferral. If you aren’t registered, you’ll receive yourletter in the mail about a week after your referral isauthorized.

Set your appointmentYou can either schedule an appointment with the

specialist you were referred to, or you can use theProvider Directory atwww.triwest.com/ProviderDirectory to find anotherTRICARE network provider. Remember to callTriWest and let us know who your new providerwill be if you use the Provider Directory to find adifferent specialist.

Notify TriWest at 1-866-876-2383To help manage your care, it’s important that your

PCM receives the consultation or treatment recordsfrom your specialist quickly. We can help if you let

TRICARE Referrals and Specialty Care

Continued on page 7


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eficiaries is the TRICAREAssistance Program (TRIAP).TRIAP brings short-term profes-sional counseling assistancedirectly into the home.Beneficiaries with a computerand Web cam can speak ‘face-to-face’ with a licensed coun-selor over the Internet at anytime of the day or night.Eligible beneficiaries can accessTRIAP an unlimited number oftimes, and these non-medicalservices are confidential and donot become part of militaryhealth records.

Service members and theirfamilies dealing with substanceabuse or traumatic stress symp-toms have access to an anony-mous online self-assessment atwww.militarymentalhealth.org.The self-assessment leads theparticipant through a brief seriesof questions about how he orshe has been feeling.Participants who are experienc-ing these symptoms will receiveinformation on possible treat-ment options and where theycan get help. The online screen-ing is not a substitute for anevaluation by a health care

provider. The self-assessmentcan be valuable tool to helpdecide if he or she could benefitfrom care from a behavioralhealth care provider.

Learn more about the behav-ioral health care options avail-able through the Department ofDefense, TRICARE, the servic-es and communities around thecountry at www.tricare.mil/men-talhealth. While there is a veryfine line when comparing anxi-eties to excitement and sadnessto depression, your TRICAREbenefit is always here for you,providing guidance and support.

Continued from page 1

TRICARE Provides Answers...

us know when your appointment is scheduled. Have your appoint-ment date, tracking number and Sponsor’s Social Security Numberready. Don’t forget to let us know if your appointment date changes.

That’s all there is to it. The only thing you’ll need to do after lettingTriWest know your appointment date is to go to your appointment.

Want to make things even more convenient? While you’re signingup for electronic authorization letters at www.triwest.com/Paperless,don’t forget to check out our other online features like paperlessclaims, paperless explanation of benefits statements, online enroll-ment fee payments and more.

TRICARE Referrals...Continued from page 7

Musicians BandTogether to ReleaseFree CD to Troops

WASHINGTON, D.C (Nov. 22,2010) -- As a thank you to mili-tary members for their serviceand sacrifice, Grammy Award-nominated musician JohnOndrasik and 13 other artists arecontributing their talents to CD‘For the Troops IV.’Nov. 22 the CD has been avail-able for free download to activeduty Service members, veteransand their families worldwidewith a valid military ID atwww.shopmyexchange.com.Another 200,000 hard copies ofthe CD are being sent to mili-tary bases, USO Centers, andother locations across the nationand overseas, courtesy ofTriWest Healthcare Alliance andOperation Homefront. “I’m excited to launch CD ‘Forthe Troops IV’ with a new rosterof fantastic artists and greatsongs,” said Ondrasik, who per-forms under the pseudonymFive For Fighting and spear-headed the CD’s development.“This year’s CD has a bit morepop and a few surprises, but atits core is a thank you to thosewhose sacrifices secure our free-dom and that of our children.”The complete track listing of“For the Troops IV” is: * Matchbox 20 -- “If You’reGone” * Wynonna -- “What the WorldNeeds”* Mat Kearny -- “Nothing Leftto Lose”* Brandi Carlile -- “Before It

Breaks” * Five For Fighting -- “Note toan Unknown Soldier”* Our Lady Peace -- “PaperMoon” * 12 Stones -- “We Are One” * Ingrid Michaelson --“Mountain and the Sea” * Barenaked Ladies -- “FourSeconds”* Gavin DeGraw -- “Free” * Rocket Club -- “One BeautifulThing” * Finger 11 -- “Gather andGive” * Ryan Star -- “Last TrainHome” * John David Kahn --“American Heart”“Like John Ondrasik, we strong-ly believe that music can be aneffective and healthy mentalbreak during times of stress orfamily separation,” said TriWestPresident and CEO David J.McIntyre, Jr. “We are exception-ally grateful for individuals likeJohn and the other contributingartists who are driven to thankour Service members in memo-rable ways and who encourageothers to do the same.”


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HM2 Derrill George,Patient AdministrationDepartment, takes theoath at his reenlistmentceremony

december 2010 examiner

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