2019 TRICARE Provider Handbook Now Online to Preview

Friday, November 30, 2018

As the Managed Care Support Contractor for the TRICARE West Region, Health Net Federal Services, LLC (HNFS) is honored to serve the approximately 2.9 million TRICARE beneficiaries in the TRICARE West Region. Your participation ensures our active and retired military service members and their families will continue to have access to quality health care in the coming years.

TRICARE Provider Handbook now online
The Jan. 1–Dec. 31, 2019 TRICARE West Region Provider Handbook, which contains important information concerning TRICARE contract requirements, is available to preview. Please review the full contents of the TRICARE West Region Provider Handbook, as it is a component of your TRICARE Provider Agreement.

Network provider requirements
As a reminder, network providers/groups agree to:

  • Submit TRICARE claims electronically (except for providers who are in Alaska). HNFS strongly recommends signing up for electronic funds transfer (EFT) and electronic remittance advice (ERA) for faster payments and remits. Learn more on our Claims Submission page.
  • Comply with prior authorization and referral requirements. Learn more on our Is Approval Needed? page.
  • Not receive or accept, for any reason, reimbursement in excess of the TRICARE/CHAMPUS Maximum Allowable Charge. Learn more on our Balance Billing page. 
  • Maintain credentialing requirements for all providers within the group. Learn more on our Become a TRICARE Provider page.
  • Provide consultation reports, operative reports and/or discharge summaries – also known as clearly legible reports – to referring providers in a timely manner. Learn more on our Clear and Legible Reports page.
  • Help keep our provider directory current by updating your demographic information (location, providers in your practice, telephone, email, fax number). Learn more on our How Do I Update My Demographics page.

This list is not inclusive.

Go online for the latest TRICARE information
Changes to TRICARE programs are continually made as public law, federal regulation and HNFS’ managed care support contract are amended. For the most up-­to-date information, please refer to the latest information on our website. 

HNFS greatly values your commitment to the health and well-­‐being of our uniformed service members and their families. Your participation in the TRICARE provider network is essential to the success of the program.