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Network Providers

(Network) How do I check my credentialing status?

HNFS will notify you once credentialing is completed. You can also check your credentialing status or last credentialing effective date using our Check Credentialing Status tool*. 

If you are currently undergoing initial credentialing or re-credentialing, please make sure your CAQH profile is current and you have authorized HNFS to access your profile. Credentialing and re-credentialing are valid for three years.

Learn more on our Join Our Network page.

*Behavior technicians (BTs) are certified and not credentialed. Do not use the online Check Credentialing Status tool for BTs, as the results may not be accurate. 

 

(Network) How do I update the following demographics: address, phone number or fax number? 

You can update your address, phone number or fax number by using the Provider Demographics Update tool or our TRICARE Provider Roster

Please allow up to 21 days if using the Provider Demographics Update tool, and up to 45 days if submitting a roster, for updates to complete. 

 

(Network) How do I update my specialty information?

In order to update your specialty information, first make sure your information is listed correctly in the National Plan & Provider Enumeration System (NPPES). If correct, use our TRICARE Provider Roster to request specialty changes. 

Note: This process also applies to ABA providers updating their specialty (for example, RBT to BCaBA or BCaBA to BCBA).

 

(Network) How do I change my Tax ID or Social Security number? 

You can update your Tax ID or Social Security number (SSN) by faxing in a completed W-9 with a letter on company letterhead to HNFS. Network provider updates can take up to 21 days and non-network provider updates can take up to 30 days.  

 

(Network) How do I add a provider to my network practice?

To add a provider to your network practice, complete and submit our TRICARE Provider Roster or Provider Information Form. If your group has a delegated credentialing agreement, see our Delegated Provider page.

  • We strongly encourage groups who are adding five or more individual providers to submit a TRICARE Provider Roster (vs. the PIF) to expedite the process.
  • ABA providers MUST submit additions on a TRICARE Provider Roster. We cannot accept PIFs for ABA providers. 
     

If you are adding providers who have not been credentialed by HNFS or an authorized delegated organization within the last three years, the roster/PIF submission starts the network provider enrollment process. 

  • It can take up to 90 days to credential a new non-ABA provider once all completed information is received based upon the accuracy of the information provided.  
  • ABA supervisors and assistant behavior analysts are credentialed within 45-60 days of receipt of a completed application. Behavior technicians are certified (not credentialed) within 10 days of receipt of a completed packet (must include copies of current CPR/BLS certification and criminal history background check).

 

 

(Network) How do I add a location to a group?

You can add a location using the Provider Demographics Update tool or our TRICARE Provider Roster.

 

(Network) How do I remove a provider from my group practice?

You can remove a provider using our Provider Demographic Update Tool.

  • Providers not registered on www.tricare-west.com can complete our TRICARE Provider Roster to request this change.

If your group has a delegated credentialing agreement, see our Delegated Provider page. 

 

(Network) What are the requirements for a TRICARE Certified Mental Health Counselor?

Visit our Mental Health Counselor Provider Requirements page to learn about the requirements.

 

(Network) What is the role of a network provider?

Network providers serve an important role in TRICARE by complementing the services offered by military hospital and clinics. Network providers are civilian providers of choice for most TRICARE beneficiaries, and as a result, will typically receive higher TRICARE patient volume than non-network providers. A network provider agrees to a negotiated rate as payment in full for services rendered.

 

(Network) What states are in the TRICARE West Region?

The TRICARE West Region is comprised of 21 states: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (except the Rock Island Arsenal area), Kansas, Minnesota, Missouri, (except the St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (areas of Western Texas only, including Amarillo, Lubbock and El Paso), Utah, Washington, and Wyoming. 

 

(Network) Which credentialing applications does HNFS accept? Am I required to use CAQH?

Network providers must ensure a credentialing application is completed, current and accessible by HNFS. HNFS uses CAQH® for its provider network application and credentialing process in all states except Minnesota and Washington. (These states have special circumstances and the credentialing process can be completed with another entity.)

For all other TRICARE West Region states: Submit/update credentialing applications with CAQH.

  • All providers must verify their CAQH profile allows for global access or specifies that HNFS can access their CAQH record.
  • For CAQH access issues, contact the CAQH Help Desk at 1-888-599-1771.
     

(Network) What is a delegated group?

HNFS recognizes that many provider groups have their own credentialing department to verify individual provider requirements such as licensure, education, professional liability insurance, adverse sanctions, etc. If you are a provider group with its own credentialing department, consider expediting the TRICARE West Region network credentialing process by allowing HNFS to delegate credentialing to you. This will allow HNFS to use the credentialing data you have already collected, which can be submitted to HNFS in an electronic format. 

By delegating the majority of the credentialing process to the provider group, rather than HNFS, the credentialing process is streamlined. Groups are able to submit practitioners on a TRICARE Provider Roster (rather than individual Provider Information Forms), which allows for a quicker turnaround time to get practitioners through the network approval process and loaded into HNFS’ systems.

See also our Delegated Credentialing fact sheet.

 

(Network) What happens after a group is approved for delegated credentialing?

Once approved by HNFS’ Credentialing Committee, HNFS will request a full and up-to-date provider roster from the group. Visit our Delegated Provider page for more information.

 

(Network) How often are delegated groups required to send HNFS a full roster?

HNFS requires delegated groups submit a full TRICARE Provider Roster via email 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. 

 

(Network) When should delegated groups send practitioner additions, demographic updates and/or practitioner terminations?  

HNFS recommends delegated groups send TRICARE Provider 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.”