Visit our Frequently Asked Questions to learn more about the states we serve, becoming a TRICARE provider, adding providers to an existing practice, authorizations, and claims.
Join the West Region Network
Thank you for your interest in caring for military service members, retirees and their families. Your request to join the network will be evaluated based on network need and agreement with the following:
- Accept the TRICARE Maximum Allowable Charge (TMAC) minus an agreed-upon discount as payment in full.
- Agree to a discount off 100% of TMAC or billed charges if no TMAC exists.
- Agree to submit claims and authorizations electronically for TRICARE beneficiaries.
- Agree to use the Health Net Federal Services, LLC (HNFS) standard roster format to submit provider information (adds, updates, terminations).
HNFS is currently accepting network applications for the following:
Contact our Customer Service Line for all other network participation specialty considerations and additional network information.
Note: Providers still interested in supporting our military can become a non-network provider. TRICARE-authorized providers must meet specific licensing and certification requirements and be certified by TRICARE to provide care under the TRICARE program.
Welcome Toolkit
New to our West Region network? Access our Welcome Toolkit for important resources.
Credentialing
HNFS is required to conduct a credentials review on each network provider to determine if the provider meets the minimum requirements of the Defense Health Agency, HNFS and URAC. As part of the provider agreement process, medical, surgical and/or mental health care providers must complete this HNFS credentialing process.
Credentialing application agencies
Network providers must ensure a credentialing application is completed, current and accessible by HNFS. HNFS uses CAQH® for its provider network application and credentialing process in all states except Minnesota and Washington. (These states have special circumstances and the credentialing process can be completed with another entity.)
For all other TRICARE West Region states: Submit/update credentialing applications with CAQH.
- All providers must verify their CAQH profile allows for global access or specifies that HNFS can access their CAQH record.
- For CAQH access issues, contact the CAQH Help Desk at 1-888-599-1771.
Delegated credentialing
Provider groups who have their own credentialing department can allow HNFS to delegate the credentialing to the group. Visit our Frequently Asked Questions to learn more.
Credentialing status
Please allow up to 90 days from the time we receive a completed application for HNFS to complete the credentialing process for new providers.
- We issue credentialing approval letters to the credentialing point of contact for each provider.
- You can check credentialing status using our Check Credentialing Status tool. Enter the individual (Type 1) or facility/ancillary (Type 2) National Provider Identifier (NPI).
Note: Credentialing status is different than network status. Please refer to your Provider Participation Agreement for network status and effective date. (If your group has a delegated credentialing agreement, contact your group’s credentialing department for your contract execution date.)
