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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)
  • Behavior technicians (BTs) who need to submit provider certification information to HNFS (regardless of the number of BTs)

Be sure to complete all columns in the spreadsheet and email it to PNMClerical@healthnet.com. 

  • Do not include providers located in the East Region states. 
  • Exceptions for ABA providers: BTs should indicate ‘RBT’ in the ‘Degree’ field. If not licensed, indicate the type of certification. The ‘Medicare Number’ field can be left blank.

Please allow up to 90 days for processing (21 days for loading certified BTs). 

  • You can check status using our Check Credentialing Status tool; however, you will need to enter in individual NPIs when using this tool.
  • While BTs are certified and not credentialed, they can also use the Check Credentialing Status tool to check certification status.   

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: Jan 10, 2020
  • Modified: Jan 10, 2020
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