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Delegated Providers

If your provider group has a delegated credentialing agreement with Health Net Federal Services, LLC (HNFS), full roster submissions are required quarterly, with updates recommended a minimum of once a month. 

How to Submit Rosters 

HNFS offers two options for roster submissions:

1. Online using CAQH® ProView for Groups

2. Via email using HNFS’ TRICARE Provider Group Roster template:

  • For this option, email completed rosters to HNFS_delegated@HNFS.com.
  • We require delegated groups using the email option to submit rosters on our TRICARE Provider Group Roster template, as it includes all the data elements required for referral, provider directory and claims payment purposes. 
  • If you are unable to use HNFS’ group roster template, your delegation compliance auditor will work with you to make sure the rosters you submit have all the required elements.

Frequency of Roster Submissions

Full rosters

  • HNFS requires delegated groups submit a full roster at least quarterly (every 90 days). 
  • Per the delegated credentialing agreement, groups should submit full rosters within 10 days of their quarterly credentialing committee meetings.

Updates

  • HNFS recommends delegated groups send roster updates a minimum of once a month; however, we will accept updates weekly or even daily. 
  • If there are no changes in a given month, we ask groups still send an email indicating “no updates to report.”

If after 30 days from submitting your roster you experience claims issues due to effective dates, contact us for assistance.

Learn More about CAQH® ProView for Groups

HNFS is partnering with CAQH to offer an easy solution for delegated provider groups to maintain and share provider rosters with multiple health plans. CAQH ProView for Groups is an easy to use, secure web portal that enables provider groups to submit a single roster of their delegated providers for all participating health plans. The standard roster format meets data needs for enrollment, delegation oversight, and directory maintenance. 

How it works: 

  • Prepare one single delegated provider roster using the standard CAQH group roster format. 
  • Upload the roster in CAQH ProView for Groups. Log in to the web portal and click “upload roster.” The system will automatically check the roster for errors. 
  • Resolve any data errors. 
  • Authorize health plans, including HNFS, access. Each plan will only see the data for the delegated providers in their network. 
  • Track health plan access. 

Email us at HNFS_delegated@HNFS.com to get started. 

To learn more about CAQH ProView for Groups, visit CAQH’s ProView page or register for a Groups Perspective webinar

Delegated Credentialing Resources

Still have credentialing questions? Email HNFS at HNFS_delegated@HNFS.com.