Welcome Logout

Network Providers

Network Applied Behavior Analysis (ABA) Provider Participation Packet

ABA group and sole providers interested in joining the Health Net Federal Services, LLC (HNFS) network for the TRICARE West Region contract must complete this packet and submit it to HNFS. Please also include a completed TRICARE Provider Group Roster

Indivdiual providers joining a group already contracted with HNFS are only required to submit our TRICARE Provider Group Roster.

Do not submit individual Provider Information Forms (PIFs) for ABA providers.  

Fax: 1-844-836-5818

Mailing Address:
Health Net Federal Services, LLC/TRICARE
Attn: Provider Network Management
PO Box 9410
Virginia Beach, VA 23450-9410

  • Created: Feb 20, 2020
  • Modified: Feb 20, 2020
  • View »

Network Provider Information Form

Existing Network Providers 
Network providers (excluding ABA providers) can complete and submit this form to request practice information updates. Follow the instructions on the cover sheet for submission. Please allow 21 days for processing. 

New Providers Interested in Joining the Network
In addition to the CAQH credentialing application, TRICARE network provider applicants (excluding ABA providers) must also submit a supplemental Provider Information Form or PIF. This supplemental application requests information unique to TRICARE that is not addressed within the CAQH application.

  • Please allow 21 days for processing. Keep in mind, the full credentialing process takes, on average, 60–90 days from the date we receive a completed application. 
  • You can check status using our Check Credentialing Status tool.
  • Provider groups with 20 or more individual providers can complete the TRICARE Provider Group Roster rather than a PIF for each provider. 
  • ABA providers must complete the TRICARE Provider Group Roster, regardless of group size.

You may mail or fax your completed PIF.

If faxing, use the fax cover sheet included in the form as the first page of your fax. Applications that do not have this cover sheet as the first page of the fax will not be processed.

Mailing Address:
Health Net Federal Services, LLC/TRICARE
Attn: Provider Network Management
PO Box 9410
Virginia Beach, VA 23450-9410

Fax:
1-844-224-0381

  • Created: Feb 7, 2020
  • Modified: Feb 7, 2020
  • View »

Network Provider Participation Packet

Professional providers interested in joining the Health Net Federal Services, LLC (HNFS) network for the TRICARE West Region contract must complete this packet and submit it to HNFS. The packet consists of a Provider Participation Agreement, Provider Information Form and IRS Form W-9. All professional providers associated with your agreement must be credentialed by HNFS.

Provider groups with 20 or more individual providers can complete the TRICARE Provider Group Roster rather than a PIF for each provider. 

Fax: 1-844-836-5818

Mailing Address: 
Health Net Federal Services, LLC/TRICARE
Attn: Provider Network Management
PO Box 9410
Virginia Beach, VA 23450-9410

  • Created: Aug 19, 2015
  • Modified: Jan 10, 2020
  • View »

TRICARE Provider Group Roster

Rather than submitting an individual Provider Information Form, Health Net Federal Services, LLC (HNFS) offers a TRICARE Provider Group Roster* for:

  • Provider groups joining the HNFS West Region network who have 20 or more individual providers they wish to credential
  • Existing network providers who would like to make changes to demographic or credentialing information to 20 or more individual providers
  • Groups who have a delegated credentialing agreement with HNFS (regardless of the number of individual providers)
  • ABA providers (including behavior technicians) who need to submit provider roster information to HNFS, regardless of group size.

Be sure to complete all columns in the spreadsheet and email it to PDMRoster@hnfs.com. See our Roster Help page for assistance in completing the roster.

Please allow up to 90 days for processing (45 days for loading certified BTs).  

HNFS will issue a determination letter to the credentialing point of contact for each practitioner once the credentialing process has completed.

*In order to access the roster, click the link above and save the Excel file locally on your computer. After completing all of the fields, save the file again and submit a copy to the email address above. 

  • Created: Feb 24, 2020
  • Modified: Feb 24, 2020
  • View »