Welcome

Become a TRICARE Provider

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.

Note: HNFS will credential through completion any providers who submitted TRICARE applications to MHN prior to May 13, 2019. If you are contracted for commercial and TRICARE business, MHN will continue to process the commercial portion of your application.

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 online, and submit claims electronically.

How to Join

  • Applied behavior analysis (ABA) providers: Complete and return via fax or U.S. mail the Network ABA Provider Participation Packet, which includes an ABA-specific Provider Participation Agreement, the Provider Information Form and IRS Form W-9.
  • Professional providers (except ABA): Complete and return via fax or U.S. mail the Network Provider Participation Packet, which includes the Provider Participation Agreement, Provider Information Form and IRS Form W-9.

    Professional providers include medical doctors and doctors of osteopathy (MDs/DOs), physician assistants (PAs), nurse practitioners (NPs), psychiatrists, psychologists, master level mental health providers, and physical, speech and occupational therapists (PTs, STs, OTs).

    Network mental health providers must meet TRICARE policy requirements in addition to meeting state regulatory board licensing and/or certification requirements. 
     
  • 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, psychiatric facilities, and durable medical equipment and medical supply companies.


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. (See note below regarding behavior technicians.)

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.

All providers must verify their Council for Affordable Quality Healthcare (CAQH®) profile allows for global access or specifies that HNFS can access their CAQH record.

Credentialing status

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.

Note: Behavior technicians (BTs) are certified, not credentialed. Log in to XPressClaim® to verify the BT is listed. It can take HNFS up to 14 days from the date we receive a completed application to load the information. Individual BTs will not display in the TRICARE West Region Network Provider Directory. 

If you have questions about credentialing status, please send an email to HNFS.Credentialing@healthnet.com.

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 (see credentialing section above).

Additional Information

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)