Health Net Federal Services, LLC (HNFS) welcomes the opportunity to support our service members and their families in the TRICARE West Region and invite you to join our provider network as we carry on the vital mission of the TRICARE program. Together, we can provide health care excellence for our nation’s best.
The HNFS Network
HNFS currently completes processing of clean claims for our TRICARE providers in less than five days and offers online self-service tools to streamline your TRICARE transactions. Our TRICARE network providers agree to use web-based tools to check beneficiary eligibility, validate whether a service requires prior authorization, submit prior authorization and referral requests, and submit claims electronically.
We are offering providers the opportunity to join our network at 100 percent of the TRICARE maximum allowable reimbursement rate.
How to Join
Note: Professional providers include medical doctors and doctors of osteopathy (MDs/DOs), physician assistants (PAs), nurse practitioners (NPs), and physical, speech and occupational therapists (PTs, STs, OTs).
- Facilities and ancillary providers: Send an email to hnfsT2017ProvRel@Healthnet.com to request an HNFS West Region contract. The email must include:
- provider/organization name, street, city, state, ZIP code
- type of provider (for example, critical access hospital, home health agency)
- Tax Identification Number (TIN)
- point of contact name/title, telephone number, email address, and fax number
Facility/ancillary providers include hospitals (all types), home health agencies, ambulatory surgical centers hospices, skilled nursing facilities, and durable medical equipment and medical supply companies.
- Mental health care providers (includes applied behavior analysis providers): To join our mental health care network, visit www.mhn.com > Provider Site > Click here to visit MHN's Provider Portal > TRICARE West.
- In addition to meeting state regulatory board licensing and/or certification requirements, network mental health care providers must meet TRICARE policy requirements.
- Applied behavior analysis (ABA) providers:
Adding providers to an existing group
To add a provider to your network practice who has not been credentialed by HNFS, he or she must send in a Provider Information Form to ensure he or she gets credentialed by HNFS. The provider must have all information current with the Council for Affordable Quality Healthcare (CAQH®), as well. Provider groups with 20 or more individual providers can complete the TRICARE Provider Group Roster rather than a PIF for each provider. It can take HNFS 60 to 90 days to credential your new provider based upon the accuracy of the information provided.
Non-mental health care providers: Use HNFS' online check credentialing status tool. Enter the individual (Type 1) or facility/ancillary (Type 2) National Provider Identifier (NPI). Credentialing may take 60–90 days.
Mental health care providers (including applied behavior analysis providers): Use MHN's Credentialing Status Look-up Tool. Go to www.providers.mhn.com and click on the Credentialing Status menu on the blue navigation toolbar. (Network participants must log in to see their credentialing by clicking on the My Profile menu.) If you have questions about your provider's credentialing status, please send an email to MHN.Credentialing.Inquiry@healthnet.com. Credentialing may take 60–90 days.
Non-Network (TRICARE-Authorized) Providers
Providers not interested in joining our network can still support our military by becoming 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.
Previous UnitedHealthcare Military & Veterans Providers
If your practitioner(s)/health care delivery organization was previously credentialed by UnitedHealthcare, they are still required to be credentialed by HNFS. 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, surgicaland/or behavioral health providers must complete this HNFS credentialing process.*
*Behavioral health-only practices are contracted and credentialed through Managed Health Network, Inc. (MHN), a subsidiary of Centene Corporation and sister company to HNFS. For information on joining the West Region network as a behavioral health provider, Visit www.mhn.com > Provider Site > Click here to visit MHN’s Provider Portal > TRICARE West.
Facilities should use the following taxonomy codes when completing the TRICARE Network Provider Agreement as well as other health care provider documents. If your specialty does not appear, please visit http://www.cms.gov/ for more information.
- Psychiatric Unit (273R00000X)
- Chronic Disease Hospital (281P00000X)
- General Acute Care Hospital (282N00000X)
- General Acute Care Hospital - Children (282NC2000X)
- Rehabilitation Hospital (283X00000X)
- Hospice, Inpatient (315D00000X)
- Skilled Nursing Facility (314000000X)