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Credentialing Overview

Health Net Federal Services, LLC (HNFS) conducts credential reviews on all network providers to determine if providers meet the minimum requirements of the Defense Health Agency, HNFS and URAC. As part of their provider agreements all practitioners must complete the HNFS credentialing process.

Provider Credentialing Applications

Network providers must ensure they have a complete and current credentialing application accessible to HNFS. HNFS uses CAQH for its provider network application and credentialing process. Log in to the CAQH Provider Data Portal to access the online application.

Note: Minnesota providers have special circumstances and use a different credentialing process.
 

Autism Care Demonstration

Network applied behavior analysis providers, including behavior technicians, must use the Network TRICARE Provider Roster template.
 

Childbirth and Breastfeeding Support Demonstration

Certified labor doulas, lactation consultants and lactation counselors are encouraged to use the roster template.

Credentialing Status

  • New practitioners, facilities and vendors: Please allow up to 90 days from the time HNFS Credentialing receives a completed application to complete the credentialing process.
  • ABA practitioners: Please allow up to 60 days from the time HNFS Credentialing receives a completed application to complete the credentialing or certification process. 

    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.)

Roster Submission Guidelines

HNFS offers a Network TRICARE Provider Roster template for network provider groups to add newly affiliated providers and submit demographic updates or terminations. 

Important: Please do not submit Word or PDF versions of the roster template. HNFS will only process rosters submitted on our template as Excel documents.

Check out our Network TRICARE Provider Roster Tutorial for a visual walkthrough on filling out the roster template and tips for avoiding common mistakes.
 

Incremental/Monthly Rosters (Adds, Updates, Terms)

HNFS prefers to receive changes on a monthly basis; however, we will accept daily or weekly updates.
 

Full Rosters (Delegated Providers Only) 

HNFS prefers to receive a full roster every 90 days; however, we will accept a full roster every 180 days.
 

New Practitioner, Facility and Vendor Submissions

Use the roster template, and email completed rosters to pdmroster@hnfs.com.
 

ABA Practitioner Submissions

Use the roster template, and email completed rosters to HNFS_ABARosters@hnfs.com.
 

Delegated Practitioner Submissions

Use the roster template, and contact your Delegation Compliance Auditor (DCA) for information on where to submit rosters.