TRICARE West for Providers
Prime Referral Waiver Ends
Submit Online as of April 16
Revised Approval Process
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Five Things to Know
- If you previously submitted outpatient requests via fax, we will only accept online requests as of April 16, 2018. We encourage you to visit our Authorization Submissions page to learn about our online submission tools and register on our website.
- Not all specialty care referrals require HNFS review. Please verify approval requirements using our Prior Authorization, Referral and Benefit Tool before submitting your request.
- Health Net Federal Services, LLC (HNFS) will honor referrals and authorizations issued by UnitedHealthcare Military & Veterans (UnitedHealthcare) through their 2018 expiration dates, even if the servicing provider is not a part of the HNFS West Region network. TRICARE Prime beneficiaries who choose to see a different civilian provider than the one authorized by UnitedHealthcare, may see any network or non-network provider of that specialty. Keep in mind, Point of Service charges will apply after June 30, 2018, should the beneficiary continue care with a non-network provider without HNFS approval.
- TRICARE Prime beneficiaries whose previous UnitedHealthcare primary care managers (PCM) are not in the HNFS West Region Network Directory, or who have not yet been assigned a PCM, can see any non-network TRICARE-authorized PCM through June 30, 2018, and Point of Service charges will not apply.
Beneficiaries enrolled in TRICARE Select can see any TRICARE-authorized provider (network or non-network), however, out-of-pocket costs will vary based on the provider's network status.
- If you have recently completed our HNFS West Region Network Provider Participation Packet and would like status, you can check credentialing status online. Please keep in mind the full credentialing process may take 60–90 days from the time we receive a complete application. HNFS will notify you once credentialing is completed.