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Mailing Addresses/Fax Numbers

Claims

TRICARE West Claims Submission
Health Net Federal Services, LLC
c/o PGBA, LLC/TRICARE
PO Box 202112
Florence, SC 29502-2112
Fax: 1-844-869-2504

Routine Correspondence
Health Net Federal Services, LLC
c/o PGBA, LLC/TRICARE
PO Box 202100
Florence, SC 29502-2102
Fax: 1-844-869-2812

Claims Adjustments/Allowable Charge Review
Health Net Federal Services, LLC
c/o PGBA, LLC/TRICARE
Allowable Charge Review
PO Box 202100
Florence, SC 29502-2100
Fax: 1-844-869-2812

Other Health Insurance Questionnaire
TRICARE West - OHI Questionnaire
PO Box 202102
Florence, SC 29502-2102
Fax: 1-888-237-6262

Third Party Liabilty (TPL) Correspondence
TRICARE West - TPL Correspondence
PO Box 202103
Florence, SC 29502-2103
Fax: 1-844-869-2813

Electronic Funds Transfer (EFT) 
TRICARE West Region
EFT/ERA Enrollment
PO Box 202109
Florence, SC 29502-2109
Fax: 1-844-730-1369

Electronic Remittance Advice (ERA)
PGBA, LLC/TRICARE Electronic Data Interchange
PO Box 17150
Augusta, GA 30903
Fax: (803) 264-9864

TRICARE Pharmacy Claims 
Express Scripts
PO Box 52132
Phoenix, AZ 85072

Out-of-Region Claims
TRICARE East Region Claims
PO Box 7981
Madison, WI 53707-7981

Enrollment

TRICARE Prime, TRICARE Prime Remote/TRICARE Prime Remote for Active Duty Family Members, TRICARE Select (enrollment forms)
Health Net Federal Services, LLC
PO Box 8458
Virginia Beach, VA 23450-8458
Fax: 1-844-388-8282

TRICARE Reserve Select/TRICARE Retired Reserve/TRICARE Young Adult (enrollment forms)
Health Net Federal Services, LLC
PO Box 9028
Virginia Beach, VA 23450-9028
Fax: 1-844-388-8282

Enrollment Payment Method Changes
Health Net Federal Services, LLC
PO Box 8608
Virginia Beach, VA 23450-8608
Fax: 1-844-785-2604

Provider Services

Network Participation Agreement Packet
Health Net Federal Services, LLC/TRICARE
PO Box 9410
Virginia Beach, VA 23450-9410
Fax: 1-844-836-5818

Provider Information Form
Health Net Federal Services, LLC/TRICARE
PO Box 9410
Virginia Beach, VA 23450-9410
Fax: 1-844-224-0381

Non-Network Provider Updates 
TRICARE West Provider Data Management
PO Box 202106
Florence, SC 29502-2106
Fax: 1-844-730-1373 

Appeals and Grievances

Authorizations Appeals
Health Net Federal Services, LLC
TRICARE West Authorization Appeals
PO Box 2219
Virginia Beach, VA 23450-2219
Fax: 1-844-769-8007

Claims Appeals
Health Net Federal Services, LLC
TRICARE West Claims Appeals
PO Box 8008
Virginia Beach, VA 23450-8008
Fax: 1-844-802-2527

Grievances
Health Net Federal Services, LLC
Attn: Grievances
PO Box 8128
Virginia Beach, VA 23450-8128
Fax: 1-844-802-2531

Fraud and Abuse

Program Integrity
Health Net Federal Services, LLC
Attn: Program Integrity
PO Box 10310
Virginia Beach, VA 23450-10310
Fax: 1-844-734-1266

Medical Management

Case Management DOMA
PO Box 9528
Virginia Beach, VA 23450-9528
Fax: 1-888-965-8438

Chronic Care/Disease Management (DM)
PO Box 2808
Virginia Beach, VA 23450-2808
Telephone: 1-844-732-2436
Fax: 1-888-965-8823

Privacy

Authorization to Disclose
TRICARE Legal Documents
PO Box 8818
Virginia Beach, VA 23450-8818
Fax: 1-844-308-8877

TRICARE For Life

TFL Customer Service
Wisconsin Physicians Service (WPS)
TRICARE For Life
PO Box 7889
Madison, WI 53707-7889

TFL Claims Submission
Wisconsin Physicians Service (WPS)
TRICARE For Life
PO Box 7890
Madison, WI 53707-7890

TFL Overseas Claims
TRICARE Europe (Europe, Africa, Middle East)
Wisconsin Physicians Service (WPS)
PO Box 8976
Madison, WI 53708-8976

TRICARE Overseas

Active Duty Service Members
TRICARE Overseas Active Duty
PO Box 7968
Madison, WI 53707-7968

Non-Active Duty Service Members
TRICARE Eurasia-Africa
TRICARE Overseas
PO Box 8976
Madison, WI 53707-8976

Non-Active Duty Service Members
TRICARE Latin America/Canada/Pacific/Puerto Rico/Virgin Islands
TRICARE Overseas
PO Box 7985
Madison, WI 53707-7985