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.
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
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