Become a Non-Network Provider
Non-network providers do not have signed agreements with Health Net Federal Services, LLC (HNFS) and are, therefore, considered “out of network.” Providers may choose to participate on a case-by-case basis.
In addition to meeting state regulatory board licensing and/or certification requirements, non-network providers must also meet TRICARE policy requirements.
Note: TRICARE Prime beneficiaries must have approval from HNFS to seek care from non-network providers.
There are two types of non-network providers: participating and nonparticipating.
- Participating providers may choose to participate on a by-claim basis. They agree to file claims for TRICARE beneficiaries, accept payment directly from TRICARE and accept the TRICARE allowable charge as in full for their services.
- Nonparticipating providers do not agree to accept the claim-TRICARE allowable charge or file claims for TRICARE beneficiaries. They have the legal right to charge beneficiaries up to 15 percent above the TRICARE allowable charge payment for services.
- Single case agreements (SCAs) are only used in very limited and unique circumstances and do not apply to applied behavior analysis (ABA) providers.
|Doctors, dentists, therapists, counselors, and nurses.
||Individual Certification Application
Providers who have two or more individual providers working under a Tax ID Number.
Note: If your group or location is already TRICARE-certified and you wish to add a
new doctor, select Individual Application (above).
|Group Certification Application
|Ambulances, portable X-ray suppliers, durable medical equipment (DME), durable
equipment (DE) or assistive technology (AT) suppliers, clinical labs, and State Vaccine
|Supplier Certification Applications
|Hospitals, ambulatory surgical centers, skilled nursing facilities, birthing centers, hospice,
and home health agencies.
|Radiation therapy, cardiac catheterization clinics, freestanding sleep disorder diagnostic
centers, independent physiological laboratories, freestanding kidney dialysis centers,
freestanding MRI centers, comprehensive outpatient rehabilitation facilities, freestanding bone marrow transplant centers, diabetic self-management education program (ADA accredited); home infusion facilities, and pediatric home health agencies.
|Corporate Service Provider Certification Application
|Applied behavior analysis providers
||ABA Provider Certification Applications
All non-network provider certification applications should be sent via mail or fax to:
TRICARE West – Provider Data Management
PO Box 202106
Florence, SC 29502-2106
Once all information is received, processing time can take up to 30 days.