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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 invites you to join our provider network.

Visit our Provider FAQs to learn more about the states we serve, becoming a TRICARE provider, adding providers to an existing practice, authorizations, and claims. 

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.

 

Join Our Network

  Provider Types How to Join Special Instructions
Professional Providers

 

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

 

Complete and return via fax or U.S. mail the Network Provider Participation Packet. Note to mental health providers: Network mental health providers must meet TRICARE policy requirements in addition to meeting state regulatory board licensing and/or certification requirements. 
ABA Providers

 

Applied behavior analysis (ABA) providers include TRICARE-authorized Board Certified Behavior Analysts® (BCBAs), BCBA-doctoral (BCBA-Ds), licensed behavior analyst (LBA) or other qualified TRICARE-authorized independent providers with a scope of practice for independent practice of ABA.

 

Complete and return via fax or U.S. mail the Network ABA Provider Participation Packet.  
Facilities Facilities and ancillary type providers include hospitals, ambulatory surgical centers, hospices, skilled nursing facilities, psychiatric facilities, and home health agencies, durable medical equipment and medical supply companies. 

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

Facilities should use the following taxonomy codes: 

  • 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)

If your specialty does not appear, please visit http://www.cms.gov/ for more information. 

 

Welcome Toolkit

New to our West Region network? Access our Welcome Toolkit for important resources.
 

Adding Providers to an Existing Group

Please review our "How do I add a provider to my network practice" FAQ to learn more. 
 

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.

Note: HNFS will credential through completion any mental health 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.
 

Delegated credentialing

Provider groups who have their own credentialing department can allow HNFS to delegate the credentialing to the group. Visit our Network Provider Frequently Asked Questions to learn more. 
 

Credentialing status

Providers can check their credentialing status online. Enter the individual (Type 1) or facility/ancillary (Type 2) National Provider Identifier (NPI). Credentialing may take 60–90 calendar days.

  • Behavior technicians (BTs): While BTs are certified and not credentialed, they can use the Check Credentialing Status tool to check certification status after 21 days following submission of a completed application. Individual BTs will not display in the TRICARE West Region Network Provider Directory. Please allow HNFS up to 21 days to load certified BTs. 

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

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. Otherwise, contact HNFS should you have questions.)

 

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).