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.
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
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